Read the whole magazine - Australian Medical Association (NSW)

Transcription

THE NSW
THE OFFICIAL PUBLICATION OF THE AUSTRALIAN MEDICAL ASSOCIATION (NSW)
PRINT POST APPROVED PP100000829
VOL 8 - NUMBER 04 - JULY/AUGUST 2016
doctor
SPECIAL EDITION: DOCTORS’ HEALTH & WELLBEING
GET YOUR HEART RACING WITH LUXURY AT SYDNEY CITY LEXUS
EXCLUSIVE TO AMA MEMBERS
Discover a new level of luxury and smooth performance at Sydney City Lexus. It is with pleasure that Sydney City Lexus offer
this incomparable driving experience to you with Lexus Corporate Programme, by providing a service uniquely tailored to
our corporate clients.
PURCHASING FROM SYDNEY CITY LEXUS
WILL NOW BE EVEN MORE REWARDING
EARN
POINTS*
Earn one Qantas Point** for every dollar
spent on the purchase of a new Lexus.
BENEFITS OF THE LEXUS CORPORATE
PROGRAMME INCLUDE:
•
•
•
Three year / 60,000km complimentary scheduled
servicing*
Four year / 100,000km warranty#
Reduced dealer pre-delivery fee
EXCLUSIVE TO AMA MEMBERS:
•
•
•
Earn one Qantas Point** for every dollar spent on the
purchase of a new Lexus
Priority invitations to Sydney City Lexus
corporate events
Dedicated Lexus / AMA Member contact person
for all enquiries
LEXUS CORPORATE PROGRAMME
INCORPORATES ENCORE PRIVILEGES:
•
•
•
•
Complimentary service loan vehicles and pick-up and
drop off during servicing
Lexus DriveCare providing 24 hour roadside assistance
Lexus Exclusive Events
Beyond by Lexus Magazine
824 Bourke St, Waterloo NSW 2017
(02) 8303 1900
sydneycitylexus.com.au
*Complimentary scheduled servicing expires at 3 years or 60,000km from the date of first registration, whichever occurs first. Conditions apply. See Sydney City Lexus for further details. # Whichever occurs first. **Offer
applicable to Private and ABN buyers, who are current members of AMANSW, on all new vehicles purchased between 10th of August 2015 - 30th of June 2016. Sydney City Lexus reserves the right to extend any offer.
Excludes demonstrator and pre-owned vehicles. You must be a member of the Qantas Frequent Flyer program to earn and redeem points. Complimentary membership will be offered to customers who are not already members.
Membership and Qantas Points are subject to the terms and conditions of the Qantas Frequent Flyer Program available at Qantas.com/terms. To earn Qantas Points, Qantas Frequent Flyers must provide their membership
number. Please allow six weeks for the points to be credited to your account. Points can only be awarded on the purchase of an eligible new vehicle between the 10 August 2015 to 30 June 2016. Points paid on total net contract
price after discount but before trade-in. Visit http://www.sydneycitylexus.com.au/smallprint/amansw for full terms and conditions.
THE NSW
doctor
THE OFFICIAL PUBLICATION OF THE AUSTRALIAN MEDICAL ASSOCIATION (NSW)
The Australian Medical
Association (NSW) Limited
ACN 000 001 614
Street address
69 Christie Street
ST LEONARDS NSW 2065
Mailing address
PO Box 121, ST LEONARDS NSW 1590
Telephone (02) 9439 8822
Outside Sydney Telephone 1800 813 423
Facsimile (02) 9438 3760
Outside Sydney Facsimile 1300 889 017
Email [email protected]
Website www.amansw.com.au
The NSW Doctor is the bi-monthly publication of
the Australian Medical Association (NSW) Limited.
contents
Features
09
Future Practice workshops
12
Profile: AMA (NSW) President
Printing by A.R. Rennie Printers, Caringbah.
Views expressed by contributors to The NSW
Doctor and advertisements appearing in
The NSW Doctor are not necessarily endorsed by
the Australian Medical Association (NSW) Limited.
No responsibility is accepted by the Australian
Medical Association (NSW) Limited, the editors
or the printers for the accuracy of the information
contained in the text and advertisements in
The NSW Doctor.
The acceptance of advertising in AMA (NSW)
publications, digital, or social channels or
sponsorship of AMA (NSW) events does not in any
way indicate or imply endorsement by the AMA.
Executive Officers 2014-2015
President Professor Bradley Frankum
Vice President Dr Kean-Seng Lim
Chairman of Council Dr Michael Bonning
Hon Treasurer Dr Danielle McMullen
Chair, Hospital Practice Committee
Dr Fred Betros
Chair, Professional Issues Committee
Dr Sandy Jusuf
Director Clin A/Prof Saxon Smith
Director Dr Andrew Zuschmann
DIT Representative Dr Kate Kearney
Secretariat
Chief Executive Officer Fiona Davies
Medical Director Dr Robyn Napier
Chief Financial Officer Stephen Patterson
Director, Medico Legal and Employment
Relations Andrew Took
Director, Policy & Industrial Relations Sim Mead
Director, Services Kerry Evripidou
Editor
Andrea Cornish
[email protected]
Designer
Clarissa Cowan
[email protected]
Advertising enquiries
Michelle Morgan-Mar
[email protected]
18
Regulars
2 President’s word
4 From the CEO
6 DIT diary
10News
32 Careers news
34Medico-Legal
36 Golf events
38 Members & Classifieds
40 Member services
amansw.com.au I 1
PRESIDENT’S WORD
Time for a national obesity plan
The prevalence of obesity and the severity of health implications have steadily
increased in Australia over the past 30 years. The time to act is now.
Australia has led the way in tobacco
control and this has required decades
of coordinated, multi-pronged,
government-led policies and programs.
Taxing cigarettes has been a cornerstone
of this success.
No sensible person would argue against
the importance of measures to decrease
smoking, drug abuse, road trauma, and
infectious disease transmission.
So where is our Federal Government’s
comprehensive program to tackle
what can only be described as an
emergency for our community in the form
of obesity, overweight and diabetes?
Almost 65% of Australians are obese
or overweight. Being overweight has
become the new norm. We know that
metabolic and cardiovascular risks are
but part of the problem, with increasing
evidence of mental health issues,
reproductive health issues and cancer
risks in obese individuals.
We also have unacceptably high levels
of childhood obesity, with one in four
children being overweight or obese – a
problem that potentially sets children up
for a lifetime of ill health.
I am calling for an urgent, comprehensive
action plan to tackle this crisis from
the newly-elected Federal Government.
Funding must be made available for
a range of action steps, including:
•Much greater public education
and awareness campaigns through
schools, primary health facilities
and media.
• Access to exercise and lifestyle
programs, not just for those who can
afford to pay for private services.
• And, the introduction of a tax
on sugar-sweetened beverages
(SSBs). Evidence is mounting around
the world of the value of taxing soft
drinks. A number of countries have
introduced taxes with evidence of
reduced consumption of the product,
and changes to the formulation by
manufacturers to reduce the sugar
content. There is no diet that must
contain sugar-sweetened beverages.
There is always a healthy alternative.
There are no health benefits to sugarsweetened beverages. Revenue
raised from a tax on SSBs can
be quarantined for use in obesity
treatment and prevention plans.
The NSW Premier has identified
childhood obesity as a priority for his
government and a substantial amount
of money has been allocated in the
State Budget.
I am calling on the Prime Minister to
respond to this crisis facing Australians
of all ages, and to show leadership
in tackling the problem with a
comprehensive national program.
The health and potential economic
benefits are enormous, and the time
to act is now. dr.
• Better design of communities to
facilitate active lifestyles.
• Access to bariatric services in
public hospitals, including surgery
for the subset of patients in whom
evidence shows clear health benefits.
• Ongoing education of health
professionals to help them deal
better with helping patients who
are overweight.
[email protected]
@bradfrankum
www.facebook.com/amansw
Prof Brad Frankum President, AMA (NSW)
2 I THE NSW DOCTOR I JULY/AUGUST 2016
Take the pain out of health fund
claiming with HealthPoint.
Commonwealth Bank now offers Australian Medical Association
NSW members on the spot claims, rebates and payments.
Commonwealth Bank provides Australian Medical Association NSW members with a new range of market
leading health fund claim solutions. Process private health fund rebates, Medicare benefits and gap
payments with one easy terminal and get your EFTPOS funds in your Commonwealth Bank account on the
same day, every day*.
Faster claims processing:
•
Simplify processing: Process Medicare Easyclaim and private health fund rebates on the spot. No more
invoicing or missed payments – just fast, easy card transactions.
•
Reduce admin: Cut paperwork for your patients and your practice, reducing the load on your staff, freeing
them up to focus on higher quality service.
•
Faster payments: Receive your EFTPOS settlement funds into your Commonwealth Bank business account on
the same day, every day*.
•
Peace of mind: With specialised training and 24/7 phone support for you and your staff, you can be
confident that you are in good hands.
To take advantage of our special rates and fees, please call
Australian Medical Association NSW on 02 9439 8822 or email
[email protected] and start saving today.
Important Information: *Available to eligible customers with a Commonwealth Bank business transaction account and a linked Commonwealth Bank eligible merchant
facility. ‘Same day’ includes all card sales made up to until 10pm (AEST). Third party products not included, which includes payments from Medicare and private health
funds for claims processed. Everyday Settlement applies to EFTPOS and gap payments, which are treated as normal credit/debit transactions (for Commonwealth Bank
account holders). Funds received by a practice for Medicare and private health funds claims are processed by the relevant organisation (Medicare or private health
fund) and are processed according to their timeframes. Applicants for this offer consent to their name and merchant identification being provided to Australian Medical
Association NSW to confirm their membership and eligibility for the offer. Australian Medical Association NSW may receive a fee from the Commonwealth Bank of Australia
for each successful referral. Referral Fees are not payable on referrals from existing relationship managed customers. This has been prepared without considering your
amansw.com.au
I are
3
objectives, financial situation or needs, so you should consider its appropriateness to your circumstances before you act on it. Full fees, charges,
terms and conditions
available on application. Commonwealth Bank of Australia ABN 48 123 123 124.
FROM THE CEO
Caring for yourself
and colleagues
The mental and physical health of doctors and
medical students remains an ongoing concern for
the profession, as doctors face greater risk of mental
illness and stress-related problems.
This month, we are pleased to bring you
a special edition focusing on Doctors’
Health and Wellbeing. For a profession
with such a strong focus on caring
for others, doctors don’t do so well
managing their own physical and mental
health. This edition brings together some
of the best thinkers on these issues.
They offer thoughtful insights into the
challenges and the opportunities of
caring for your colleagues and for your
own health.
The focus of this edition was created to
celebrate the launch of the expanded
Doctors’ Health Advisory Service. The
Doctors’ Health Advisory Service has
been operating in NSW for more than
30 years. The service has run on the
dedication and commitment of an
amazing group of volunteer doctors.
Under an agreement reached with the
Medical Board of Australia last year, the
service will be expanded with
the provision of annual funding from
doctors’ registration fees. This will allow
the service to expand and to take
on a much broader role in providing
both first call immediate assistance
and ongoing support for doctors and
medical students.
We recently held an excellent forum
with the DHAS and key representatives
from the medical defence associations,
local health districts, the Medical
Council of NSW, HETI and the HCCC.
It was an exciting and inspiring
opportunity to discuss how to improve
support for doctors and students. We
will be reporting further on this project as
it develops.
of previous President Clin A/Prof Saxon
Smith. I welcome our new President,
Professor Brad Frankum. I first met Brad
over a decade ago during the turmoil
of Campbelltown and Camden. Brad
has made an exceptional contribution
to his hospital and his region (and of
course medical education generally
through the University of Western
Sydney) and we look forward to a busy
two years ahead. dr.
In this edition, we also introduce you to
our new President and Board. I would
like to acknowledge the excellent work
[email protected]
Fiona Davies CEO, AMA (NSW)
Caring for
Colleagues 2016
A program to help you to help your colleagues.
Sunday 28 August 2016 • 9am – 5pm
Young or old, GP or specialist, in the public or private sector - all of us, at some time or
another, find ourselves with a ‘duty of care’ for colleagues. It may be in our role as a clinician,
training supervisor, teacher, mentor or employer. It’s not always easy to do it well and there
are important pitfalls to avoid, but we can make a world of difference.
An application has been made to the RACGP and ACRRM for approval as an accredited
learning activity.
For more information and to register for the seminar visit www.amansw.com.au/events/list
AMA House, 69 Christie Street
AMA/DHAS Members $65*
Non-members $99*
*plus booking fee
Experience something special on
your next NEW CAR purchase.
Save up to
10%
on the RRP
of most new
cars.
Avbs
AustrAlAsiAn
Call 1300 76 49 49 or visit www.avbs.com.au
Personalised Service
Impartial Advice
Right Price
No Stress
AustrAlAsiAn
VEHIclE BUYING SERVIcES
Preferred provider
This is an exclusive (free) member service and is available on all makes and models amansw.com.au
of new cars.
I 5
AMAAVBS0001
DIT DIARY
Our just awards
The experience of UK junior doctors begs the question
– what if the same were to happen here?
Australian JMOs have watched uneasily
as their counterparts in the UK have
held signs above picket lines in freezing
cold weather, forced to protest unfair
changes to their basic contract. First
tabled by the NHS two years ago, this
proposed contract was repellent. Hard
numbers varied according to which side
was publishing the analysis, yet whatever
way the data was crunched it amounted
to more hours for less money. The NHS
claimed these cuts would be offset by a
13.5% salary increase; but with extended
“normal” daytime hours from 7am to
10pm, and all day Saturday, this was a
spurious claim. Annual pay rises were
also to be scrapped. The NHS’s intention
was to funnel the savings from these cuts
into rostering more doctors on weekends
and nights, inevitably extending everyone’s
working hours in the process. When DITs
pointed out the inequity this would impose
on anyone with young children or carer’s
responsibilities (as well as in general)
the NHS responded with an unabashed
“what’s good for the one is good for the
many” press statement that admitted
the new policies disadvantaged women,
in particular.
Thanks to the tireless negotiating efforts of
the British Medical Association, a potential
compromise may have been reached.
Although it’s not quite what UK DITs had
hoped for, the extension of overtime hours
is not as diffuse, and new provisions
including accelerated training pathways
for people with carers’ commitments
to catch up make the contract less
discriminatory. We won’t know if these
changes will be accepted until it goes to
a referendum in October. Prior to this last
round of talks, UK DITs were considering
an indefinite walk out, possibly
accompanied by mass resignations.
Even if an agreement is reached, social
media chatter indicates morale in the NHS
is at an all-time low and DITs have lost
faith in the NHS. Hard-working, idealistic
junior doctors have been accused of
“showing a regrettable disregard for
patient care” by the Department of
Health (UK) for attempting to maintain
adequate remuneration and a workplace
that doesn’t openly discriminate against
women and families. UK DITS are, in my
opinion, entirely justified in their actions.
To borrow a British parlance, the NHS
is having a laugh if they think extreme
austerity can sustain a health service of
any quality.
Could this kind of impasse ever develop
in Australia? If it did, what would we do
about it? It’s not as far off as we might
think. Recent years have seen attacks
on Medicare, cuts to public hospital
funding, and mass resignations of salaried
medical officers in Queensland. Doctors
have been threatened with jail-time for
speaking out about the wellbeing of their
asylum seeker patients.
We do have one very distinct advantage
over our counterparts in the UK though,
and that’s The Alliance. Being a doctor is
mostly an intellectual pursuit and we’re not
used to having to organise and mobilise
the way other industries have in the past,
but it’s becoming necessary. Having The
Alliance already in place to represent our
interests is invaluable. Things might not
be as bad as they are in the UK (yet),
but making sure we are represented and
our rights protected will go a long way to
prevent us being put in the same position.
ASMOF have been reviewing the NSW
Public Hospital Medical Officers Award,
which is the award that covers most
Junior doctors working in NSW. The
award has not been updated since 1983
(over two decades) meaning the award
is older than I am. ASMOF have been
discussing proposed changes with
the MOH and have recently sought
agreement from the MOH to vary the
award to reflect a 2.5% increase whilst
also seeking agreement to continue
the discussions with regards to the
substantive matters which have not yet
been agreed to and which significantly
affect JMOs. A vote was recently
undertaken via survey and the option
to accept the 2.5% whilst continuing
to discuss proposed changes was
overwhelmingly supported by JMOs.
Due to the NSW Governments Wages
Cap Policy, any changes proposed by
ASMOF must be cost neutral. In order
to offset ASMOFs proposed changes,
the MOH propose to remove ADO’s,
remove the higher increment when being
seconded to a rural hospital, and increase
the time from 10 hours to 12 hours before
overtime kicks in. These are just some of
the proposed changes and ASMOF will be
continuing to meet with members over the
coming weeks/months.
Make sure you join ASMOF and have
your say about the proposed changes.
Junior doctors are the foundation of our
public health workforce, we must protect
our ability to do our jobs properly and
safely with adequate compensation or
providing quality healthcare to Australia
will become impossible. dr.
@elizamilliken
Dr Eliza Milliken Junior Doctor
Doctors-In-Training
Awards
7 October 2016
NOMINATE NOW!
Do you know an inspiring Registrar, JMO,
Teacher or JMO Manager?
NSW Minister for Health Registrar of the Year
$10,000 cash prize
NSW Minister for Health/HETI/Cutcher & Neale JMO of the Year
$10,000 cash prize
ASMOF (NSW) – Teacher of the Year
$5,000 cash prize
HETI/ASMOF (NSW) – JMO Manager of the Year
$5,000 cash prize
Nominate at amansw.com.au/nominations
Nominations close 1 September 2016
The awards will be presented by NSW Health at AMA (NSW) / ASMOF (NSW) Alliance
Doctors-in-Training Cocktail Party at ‘The Ivy Sunroom’ Level 3, Ivy. 330 George St, Sydney
Contact Michelle Morgan-Mar on [email protected] or 9902 8143
General sponsor
A joint initiative of AMA (NSW), ASMOF (NSW) and HETI
amansw.com.au I 7
COLUMN
A tale of
two services
Jon Fogarty contemplates what makes for good service –
particularly when it comes to general practice.
It was a tale of two cities or, more
accurately, two services, that led me
to ponder the service I provide at
my practice.
“Our serviceman will be there within
45 minutes. He will text you five minutes
before he arrives. The cost of a new
starter motor is $X.
Tale 1: The gutters at my house are
leaking. I google “Leaking Gutter Fixing
Person” and a dozen names pop up.
"Now, is there anything else I
can help you with today,
Jon?” She was so nice,
I was tempted to ask
if she could quickly
run the vac over the
lounge room, but
I didn’t.
The first number is disconnected, the
second “doesn’t do, sort of, fixing gutters
mate”, and the third says that Mick will
ring me. Mick doesn’t ring and the next
day I ring back and am told that my call
is important to them and to please stay
on the line ...
Finally, I contact Nate. “Too easy”, he
assures me. I am always nervous when
I hear this because my experience is
that it nearly always ends up too hard.
Nate will be there on Tuesday at 8am.
“No worries, mate."
By 9am, no Nate. I ring. A bleary
sounding Nate says he is “sick as”.
Not, fortunately fully spewin’ but clearly
crook. Next Tuesday? "Too easy, mate."
I ring on Monday night to confirm. On
Tuesday he turns up (late) and gives a
rather gloomy prognosis for the gutter
and agrees to start work next Monday.
And … gosh, you’ve already guessed ...
no Nate. I phone, no answer.
Tale 2: While awaiting Nate, the starter
motor on my car dies and I ring the
NRMA. Here starts an unpaid promo for
the largest road service organisation.
The machine asks me if I am safe
(press 1), are there children locked in
the car? Then I speak to a human.
“Can I call you Jon?" Certainly.
To be brief, a
neatly turned
out bloke turned
up in 45 minutes.
He did something
mysterious under
the bonnet of
the car. He was
entirely polite and
uncomplaining,
and charged me the
quoted sum. The car
and owner have been
happy ever since.
All of which leads me to
think that for reasons of
both courtesy and good
business, we could all give
thought to how well our
phones are answered, whether
we text patients in advance if we
are running late and whether our
75-year-old patient prefers to be called
Alice or Mrs Armytage.
It also leads me to ask if anyone knows
a good gutter fixing person? dr.
A Tale of Two Services has been reprinted here
with permission. This article was first published in
Australian Doctor magazine.
FEATURE
Future Practice
I
Following the launch of our
Future Practice campaign
in May, AMA (NSW) held an
extremely successful event
for GPs looking to transform
their businesses.
The Coalition Government’s
announcement to extend the Medicare
freeze until 2020 was a devastating
blow to medical practice in Australia,
particularly general practice. If
maintained, the freeze threatens to
cripple thousands of medical practices
and force all Australians to pay more for
their healthcare.
For many GPs, the announcement was a
tipping point. With the freeze potentially
stretching out for seven years, many
have no choice but to pass on the
increased costs of running their practices
to patients.
For GPs looking at ways to make
their practices more sustainable, AMA
(NSW) has launched Future Practice – a
platform for medical practitioners who are
interested in providing quality care in the
midst of the Medicare freeze.
In conjunction with the campaign, AMA
(NSW) launched its Future Practice
website (www.futurepractice.com.au)
which covers all aspects of creating a
quality, patient-centred, economically
viable practice, offering a wealth of
resources, including case studies, videos,
and a community for GPs to share ideas.
The Future Practice website also offers
general practitioners a free health check,
a detailed benchmarking exercise and a
fee for service pricing guide.
AMA (NSW)’s first-ever Future Practice
workshop was one of the best attended
events we have held this year – proof
that many GPs are looking for ideas
on how to build more innovative,
sustainable practices.
MY GP
d 1
rA3_FINAL.ind
eMyGP_Poste
0262_FP_ILov
QUALITY
CARE
COSTS
The workshop featured
What does
this mean for
a presentation from
you?
Cathy Baynie, NSW/ACT
State President of the Australian
Association of Practice Management
(AAPM). Ms Baynie has had an extensive
career as a practice manager and has
joined AMA (NSW) as a consultant to
answer any questions AMA members
may have about innovating their practice.
Ms Baynie’s presentation looked at the
current financial challenges for general
practice, focusing on the Medicare
freeze, as well as the Practice Incentive
Program, which is not indexed and is
now being "streamlined", as well as the
pending introduction of Healthcare Home
and voluntary registration model.
Ms Baynie emphasised to GPs that the
decision to make any change, whether
it be to transition from bulk billing,
increase fees, or introduce new services,
is challenging. She cautioned attendees
that before any such changes can be
implemented it is imperative practice
systems are in place; this includes
management systems, IT systems,
human resource systems, appointment
and recall systems.
Her presentation also stressed
the importance of benchmarking
and the development of KPIs
and targets.
According to Ms Baynie, practices need
to focus on quality care and service
delivery in order to "sell" any changes.
They also need to be transparent in all
QUALITY
CARE SAVE
S
A strong pr
im
lives and sa ary health care system
ves money.
has frozen
The govern saves
your rebate
ment
until 2020.
What will it
cost you?
am
1/06/2016 11:35
their dealings with patients surrounding
any costs, and lastly, GPs need to
educate patients as to what Medicare
really is – emphasising that Medicare is
their insurance and that patients need to
fight for higher rebates.
Her advice to all practices looking to
make a change is, “what will work for
one practice may not work for another,
so it is important to assess demographic
needs and be innovative.”
Feedback from the night revealed that
some doctors felt that their practice
managers were not in a position to
implement and manage the practice
to a level that was required and were
looking for education and resources
to assist with these processes.
Other concerns that surfaced during
the event were the difficulty of
maintaining high quality care standards
and delivery, whilst sustaining their
businesses. Managing chronic disease
on a limited budget was also highlighted
at the forum.
AMA (NSW) will be holding several more
Future Practice events in the coming
months. Please visit amansw.com.au
or futurepractice.com.au for updates.
For members unable to attend the
workshops, they will also be available
as webinars. dr.
amansw.com.au I 9
NEWS
AMA Awards
NSW demonstrated its exceptional work in advocacy
and communications – taking home two awards from
the National Conference.
The AMA National Conference held in May recognised states and territories for their work over the previous year engaging
government and the public on prominent healthcare issues and policy areas.
AMA (NSW) was recognised for its exceptional achievements in both these areas, taking home both Best Lobby Campaign
and Best Public Health Campaign.
Best Lobby Campaign –
Clinician Engagement
Don’t let your
sunscreen burn out
AMA (NSW) began this
long-term project after the Garling
Inquiry in 2008 identified the breakdown
of good working relations between
clinicians and managers in the public
hospital system as an impediment to
good, safe care for patients.
In February 2015, AMA (NSW), the
Australian Salaried Medical Officers’
Federation NSW (ASMOF), and NSW
Health Minister Jillian Skinner signed a
world-first agreement to embed clinician
engagement in the culture of the public
hospital system, and to measure how
well doctors are engaged in the decisionmaking processes of Local Health
Districts.
The judges commended AMA (NSW)
for its persistence, saying the progress
in addressing this longstanding issue
was a significant achievement in both
health policy and the government/
profession relationship.
Under the agreed arrangements set
out in the Joint Statement, AMA
(NSW) and ASMOF (NSW) will conduct
an annual survey of senior medical
practitioners to gauge their level of
engagement in the public health system.
Over time, these surveys will build up a
picture of clinician engagement within
the NSW public health system, as
perceived by senior medical practitioners
working in the system.
3 Check expiry date
3 Apply generously
3 Reapply every 2hrs
3 Store in a cool place
UVA/UVB
Broad Spectrum
Protection
Always stay
sun safe
REAPPLY
often
...and DON’T
let your sunscreen
burn out
UVA/UVB
Broad Spectrum
Protection
http://sunscreen.amansw
.com.au/
Best Public Health Campaign – Sunscreen Use
AMA (NSW) ran a widely recognised
and broadcast educational campaign
on sunscreen use and storage
in 2015/2016.
The campaign attracted good media
coverage in the Telegraph, on TV evening
news bulletins and on radio. The fact
that heat damages sunscreen is largely
new information, which generated a high
level of interest from print and broadcast
media.
With its clear message, the campaign
drew on new research showing that
many Australians do not realise that
sunscreen can lose up to 40% of its
effectiveness if exposed to temperatures
exceeding 25 degrees Celsius.
The campaign’s secondary messages
were about ensuring people wear enough
(40 mL for full body protection), buying
fresh sunscreen every year, and ensuring
that it is reapplied every two hours.
The campaign received extra traction
with the surprising results of the medical
student survey, which found that onethird of medical students still sunbake to
tan, despite knowing the skin cancer risk.
The judges said while all entries
were of a particularly high standard,
the AMA (NSW)’s campaign sent a
timely reminder to all Australians of the
need to be sun smart.
This campaign was very relevant to
all Australians because skin cancer
accounts for 80 per cent of all newly
diagnosed cancers and we have one of
the highest incidences of skin cancer
in the world. About 95 per cent of skin
cancer is caused by sun exposure. dr.
NEWS
The Hope Challenge
A 12-hour football marathon to be held in September will honour the memory
of two doctors and raise money for The Black Dog Institute.
A 12-hour football marathon to be held
in September will honour the memory
of two doctors and raise money for The
Black Dog Institute.
Since 2000, the tight-knit community
of West Pymble in Sydney’s northern
suburbs bonded together on a weekly
basis over a social game of touch
football. Its members, however, were
recently shocked and saddened at
the loss of one of their long-standing
members, Dr Rick Hope, who worked
as a gastroenterologist at Norwest
Private Hospital, City West Specialist
Day Hospital and Southern Highlands
Private Hospital. He also took
appointments at Blacktown/Mount Druitt
and Westmead hospitals.
It’s the second time this small club
has faced such a loss – in 2012,
another much beloved member,
committed suicide.
Wishing to make a stand for all those
suffering from depression and other
mental health issues, the Sunday social
group are organising a family-friendly
event to raise funds for The Black Dog
Institute. It is intended to be held close to
the date for RU OK? Day.
The Hope Challenge will celebrate life
and especially honour the two doctors
now lost to the community.
As well as raising money for The Black
Dog Institute and promoting awareness
of mental health, organiser Phillip Ross
says the day is intended to demonstrate
to those who may be suffering from
depression “that their community cares
and are willing to help.”
Look for more information on how to
donate or participate in the next issue of
The NSW Doctor. dr.
While the date is being finalised, the
game will start at 8am and finish at 8pm.
SPECIALIST CONSULTING SUITES
SAN CLINIC PARKWAY
FO
RS
A
FA LE
ST
-S
EL
LIN
G
San Clinic Parkway, Wahroonga
-
Cnr. Fox Valley Rd & Comenarra Parkway
Unique opportunity to purchase individual, architecturally
designed specialist consulting suites in a superb working
environment.
Artist Impression
• Convenient hospital access
• Walking distance to your operating theatres/inpatients
• Suites for sale from 52m2 - 121m2 approx or larger if required
• High exposure location
• Potential depreciation allowances
• Beneﬁt from the San’s massive redevelopment & expansion
Grow your practice alongside the San,
NSW’s largest private hospital.
For further information, please contact
Phillip Apelbaum 0419 559 555
Artist Impression
1300 133 885
amansw.com.au I 11
PROFILE
Fit for the job
Professor Brad Frankum stepped up from Vice President to take over the top
job at the AMA (NSW) in May. The immunologist/allergist and former Deputy
Dean of Clinical Education at WSU proves he’s ready for the challenge.
AMA (NSW) President, Prof Brad
Frankum stepped into the position
on 17 May – just weeks before both
the Federal Election and the delivery
of the NSW Budget.
With the prospect of a continued
Medicare freeze and uncertainty over
Federal funding for public hospitals,
it’s been a baptism by fire for the
newly-elected President. Media doorstops, meetings with candidates in
swing electorates, and numerous calls
from print and broadcast media have
dominated his already busy schedule,
which involves running his own private
practice, as well as serving as a Staff
Specialist at Camden and Campbelltown
Hospitals and the Executive Clinical
Director of the hospitals. In spite of all
this, Prof Frankum has handled the
increased attention and responsibility
with his usual composure and
equanimity.
The Professor is no stranger to
the pressure cooker of life – both
professionally and personally.
A new convert to Crossfit, Prof Frankum
entered his first Masters competition this
year at the age of 50. Not only did he
win, but he also managed to resuscitate
one of other competitors who had a
cardiac arrest – “which was really quite
stressful, as you can imagine, with about
150 people watching.”
An avid sportsman, Prof Frankum
complements Crossfit with horse
riding and show jumping,
which he enjoys on his 24-acre
rural property in Camden.
While he still competes,
Prof Frankum was
formally an elite level show jumper
who represented Australia in his
younger days.
The other core focus for his
presidency will be Federal funding
for public hospitals.
“I’m very committed to exercise,” he
admits. “And that’s partly my interest in
public health and obesity.”
“Both the Coalition and Labor have
pledged some modest health funding
to get us through to the end of the next
election cycle. However, the fiscal cliff
we were headed for in 2017 has merely
been pushed out to 2020. This continued
uncertainty over funding continues to
throw long-term health planning for how
resources will be deployed into question.
NSW hospitals need to know they will
be able to continue to operate beyond
2020,” he says.
In the next two years of his term, Prof
Frankum plans to make obesity his
top priority. Although he is encouraged
by Premier Mike Baird’s $14 million
investment to tackle childhood obesity,
he believes we need to establish a
comprehensive, multi-pronged approach
to address this rising epidemic.
“In Australia, we’ve been very successful
with our public health campaigns, for
example tobacco control. The reason
we have been successful has been the
coordinated approach – education,
media, taxation – all of those things
combined have led to Australia having
the lowest rates of smoking in the
industrialised world. So I cannot
understand why we are not doing
the same for obesity, overweight
and diabetes.”
In Australia, 65% of adults are overweight
and obese, while one in four children
also fall into those categories. Like the
sword of Damocles, obesity threatens
to cripple hospitals’ ability to deal with
the downstream effects – particularly,
increasing numbers of patients with
diabetes, cardiovascular problems,
cancer, maternal health issues and more.
“We’ve got to do something,” Prof
Frankum says. “The growing obesity
epidemic presents a lifelong risk of poor
health outcomes and spiralling health
costs, including increased demands on
public hospitals.”
Ongoing issues, such as the Medicare
freeze, training places for junior doctors
and workforce distribution, continue to
be challenges and will remain a priority in
his presidency.
Prof Frankum has faced major
political challenges in the past – the
Campbelltown Hospital crisis in 2004
was his come to Jesus moment –
sparking his involvement with the AMA.
“I realised at the time, the absolute
necessity of the AMA and what they
could do that nobody else could do
and also, the need for all of us to be
members. Not just because we might
need them in a crisis, but because of the
great advocacy work that is done.
He adds, “Doctors need to be part of
every health conversation. If we stand
back and let non-medical people make
all of the decisions about the health
system then we’ve only got ourselves to
blame if we don’t like it.” dr.
amansw.com.au I 13
PROFILE
AMA
(NSW)’s
Board of
Directors
On 17 May 2016,
AMA (NSW) elected a
new board of directors
– many of whom are
by now familiar to
members for being
tireless advocates
for the profession.
In keeping with the
theme of this issue,
Board members
discussed what they
identify as the key
issues in doctors’
health and wellbeing,
as well as their own
coping strategies.
Q.
Dr Kean-Seng Lim
Dr Michael Bonning
Dr Lim is the 2015 RACGP General
Practitioner of the Year and is a member
of the AMA (NSW) Council. He also
serves on the Professional Issues
Committee.
Dr Bonning is a GP Registrar in western
Sydney and is a serving medical officer
in the Royal Australian Navy, a director
of Cor Mentes Health Consulting and
a passionate advocate for healthcare
equity, including Indigenous health.
Vice President
He is a GP Principal in a group practice
in Mt Druitt and a GP Supervisor. He has
previously served on the RACGP Faculty
Board and WSDGP Board.
He is currently the Secretary of the Mt
Druitt Medical Practitioners Association.
Dr Lim says the pressure on doctors to
achieve the best patient outcomes in a
fragmented and underresourced system
is a major source of stress.
Dr Lim makes his own health and
wellbeing a personal responsibility.
“For me, the foundational element
is to take responsibility for what is
immediately around you – becoming an
active participant in your own destiny.
This means changing what you can
change and structuring your workplace
to provide the best support to all who
work in it, but also recognising that
there are things beyond our immediate
control, which we may have to work in
partnership with others to influence.”
Chair, Council
According to Dr Bonning, mental
health needs to be addressed in
medical school.
“It is telling that many of the changes
regarding stress occur early in medical
school and are then perpetuated during
clinical training. Therefore the challenge
for doctors and educators is to identify
what in our training system affects the
students coming in and work to mitigate
its impact.”
In terms of looking after his own mental
health and wellbeing, Dr Bonning relies
on three ‘r’s to help him through the day.
“There is a really powerful technique
from Dr Adam Fraser which uses the
transitional times in life – between
patients, between meetings, between
work and home – to do three things:
reflect, rest and reset. Reflect uses
specific positively-framed questions,
such as ‘what went well’, ‘what did I
achieve’, and ‘how do I get better?’ Rest
gets you to do something that makes
you present in that transition, such as
listening to music. Finally, reset asks you
to put yourself in the right headspace
and focus on what you want to get out of
your next interaction.”
Dr Danielle McMullen
Dr Fred Betros
Dr Sandy Jusuf
Dr McMullen is a GP registrar practicing
in Sydney’s inner west. She graduated
from UNSW in 2010, completed a
Diploma of Child Health, a Certificate in
Reproductive and Sexual Health, and is
a graduate of the Australian Institute of
Company Directors.
Dr Betros is a general surgeon practicing
in western Sydney and the Hawkesbury
district in Sydney’s north-west. He has
VMO appointments at Blacktown and
Hawkesbury Hospitals and a private
practice encompassing suburbs from
Bella Vista to Windsor.
Dr Jusuf is a dual-trainee in emergency
medicine and psychiatry, having worked
in various metropolitan and rural
hospitals in Australia and overseas,
including the United Kingdom and the
Solomon Islands.
Since her prevocational training across
a number of rural and metropolitan
hospitals, she has undertaken GP
training in clinics in NSW and the NT.
Dr Betros commented that doctors face
several barriers when it comes to seeking
help for a mental or physical illness.
Hon. Treasurer
She advocates passionately on behalf of
doctors-in-training and has been chair of
the NSW DITC since 2014. She is part
of a number of GP and DIT committees
both Federally and in NSW.
Dr McMullen recognises the need for
doctors to take time to reflect in order to
cope with pressures of the job.
“Doctors face significant health and
wellbeing issues – we all know about
the long hours and heavy workload in a
sometimes isolated environment. But we
also share in our patients’ stories every
day, some more traumatic than others.
Without support, debriefing, and positive
coping strategies, these stories can
become a heavy weight to bear.
“Personally, I try to make time for the
things I love – cooking, reading, spending
time with friends and family. I find my
work with the AMA helps to balance my
clinical work. And the odd yoga class to
get centred is helpful too!”
Chair, Hospital Practice Committee
“The reluctance to seek help for fear of
being labelled as ‘impaired’ is a huge
barrier our profession needs to address.
We often work in environments that are
difficult at professional, emotional and
personal levels. Our biggest hurdle is to
create a culture that is supportive and
encouraging enough to allow a doctor to
actively seek help.”
When it comes to maintaining his own
wellbeing, Dr Betros feels balance is key.
“I’m a firm believer in the adage that you
work to live, not live to work. We all aim
to put our patients first, but I believe that
a balanced work and recreational lifestyle
is essential to health and wellbeing. I
work with a group of colleagues who are
like-minded and recognise that one of us
is overwhelmed with a heavy workload,
helping each other out is essential. It’s
amazing how much a small gesture of
help makes a difference. I always take
the approach that what goes around,
comes around.”
Chair, Professional Issues Committee
She currently works as a psychiatry
registrar in the Northern Sector and
an emergency registrar at Canterbury
hospital.
Dr Jusuf is a graduate of the Australian
Institute of Company Directors
and on the Board of the Doctors’
Health Advisory Service NSW. She is
passionate about doctors’ health and
set up the Health and Wellbeing website
for junior doctors.
In terms of looking after her own mental
health and wellbeing, Dr Jusuf makes an
effort to separate work from home life. “I try to leave work at work and switch
off when I get home. If something really
bothers me, I debrief with others – either
colleagues or friends outside of work
who know me well.
“A work-life balance is very important
to me. I schedule in time to myself
as well as time with loved ones,
including my cute little dog, to relax
and do fun things.”
amansw.com.au I 15
PROFILE
Clin A/Prof Saxon Smith
Dr Andrew Zuschmann
Dr Kate Kearney
Clin A/Prof Saxon Smith graduated from
the University of Otago, Dunedin in 2000,
holds a Masters Degree in Health Law
from the University of Sydney and is a
graduate of the Australian Institute of
Company Directors and a fellow of the
Australasian College of Dermatologists.
Dr Andrew Zuschmann has a
commitment to teaching and the
development of a sustainable workforce.
Dr Kate Kearney is a medical registrar,
completing physician training at St
Vincent’s Hospital in Sydney. She
graduated from the University of Sydney
in 2012 and completed a Masters of
Medicine in Clinical Epidemiology in 2014
from the same institution.
Director
After interning at the Gold Coast Public
Hospital, he worked in various clinical
roles in public and private hospitals
across NSW, with the Australian
Red Cross Blood Service and as a
clinical researcher.
Clin A/Prof Smith is currently in private
practice in Gosford, a VMO dermatologist
at Royal North Shore Hospital and a
clinical senior lecturer at The University
of Sydney.
According to Clin A/Prof Smith, all too
often doctors put others ahead of their
own needs.
“I feel the constant pressure of trying
to provide care to a large population
who have limited access to specialist
dermatology care, as well as trying to
balance the desire to be the best father,
husband, friend, supervisor and mentor,
to those in my life. Sadly, like most of
us, taking care of myself ends up on
the bottom of the daily ‘to do list’. But
taking time to simply eat lunch, setting
aside time to exercise, as well as time
to sit with my son playing Lego or
superheroes, makes me a better person
and a better doctor. Some things are too
important to take for granted.”
Director
He is a Staff Specialist at Sutherland
and St George Hospitals, with a private
practice in Miranda.
Dr Zuschmann is a Specialist
Obstetrician and Gynaecologist and
Fertility Specialist.
He graduated from the University of
NSW in 1996 and completed specialist
training in 2005.
According to Dr Zuschmann, doctors’
health and wellbeing is about focusing on
the micro.
“For many, myself included, we tend to
focus on the macro – ‘I’m taking Friday
off to play golf’ or ‘I’m not on call this
weekend so plan on spending time with
the kids’. As someone with a young
family and a job that features irregular
and unpredictable hours on top of the
‘office’ job, the problem I find is focussing
on the micro. The challenge is setting
aside, or just finding, regular time for
reflection, personal time, and exercise.
When you’re a small business owner
it’s all too tempting to do paperwork, or
see an extra patient in that spare hour.
We should be more opportunistic and
disciplined about our health.”
DIT Representative
She is currently one of the deputy chairs
of the AMA Federal Council of Doctorsin-Training, and is a member of the Adult
Medicine Division Education Committee
of the Royal Australasian College of
Physicians. She participates in a number
of other committees and working groups
across the AMA and RACP.
Dr Kearney says there is a need to create
healthy workplaces for doctors to better
promote health and wellbeing among
medical professionals. She also calls
for greater support among colleagues
and identifies the need for doctors to
ask for help when feeling stressed and
overwhelmed. Addressing burnout and
the factors that lead to it is another key
issues, says Dr Kearney.
AMA (NSW) Careers Service
Need advice about
prevocational
training, applying
for intern, RMO
and fellowship
positions?
M E D I C A L S U I T E S AVA I L A B L E F O R L E A S E
BU I L D YO U R P R AC T I C E
A N D R E P U TAT I O N
AT S Y D N E Y ’ S M O S T P R E S T I G I O U S
MEDICAL ADDRESS
British Medical Association House
Suite 101, Level 1 135 Macquarie Street, Sydney
Give yourself the AMA Edge
Contact Anita Fletcher on 9902 8158
or [email protected]
P: 02 9241 2158 | E: [email protected]
W: sydneymedicalspecialists.com.au |
sydneymedicalspecialists
KDMA 40th Annual Conference
SMS002 Quarter Page ad 89x120mm -v2.indd
2
28/04/2016 10:26 AM
Join us for one of the most iconic & breath-taking locations…
25th September - 2nd October 2016
Post Conference Tour - Western Front
via Canterbury & Paris from
2nd - 9th October 2016
Don’t delay - Seats are filling up fast !!
FOR BOOKINGS & ENQUIRIES
NORTHSHORE TRAVEL
Vivienne & Samantha
Shop 35, 767 Pacific Highway
Gordon NSW 2072
T: +61 (2) 9418 2546
E: [email protected]
ramsaydocs.com.au
@RamsayDocs
ramsay-health-care
amansw.com.au I 17
Doctors’
health and
wellbeing
In this special edition of The NSW Doctor, we
look at the particular issues affecting doctors’
health and wellbeing and what medical
professionals can do to better cope with the
unique barriers to treatment that exist for
doctors, as well as the stressors associated
with the profession.
amansw.com.au I 19
HOLD
ON
Medical school in the 1970s was like an express train. Medical
courses were being shortened, but medical knowledge was
expanding exponentially (with no internet yet to provide a portable
memory bank!). As we hurtled through the shortened course, all
extraneous “baggage” was ejected, including holidays, non-medical
subjects, and “soft” topics like ethics or medical law.
Like my peers of the time, fresh out of
high school and passively accepting the
roller coaster ride of medical training, I
was not going to complain. Pathology
specimens, anatomy dissections and
patient examinations provided plenty
of excitement, and we all knew that
if we stopped to question the course
framework we risked being left behind or
asked to exit.
Internship and residency were similarly
frenetic. Clinical responsibility brought
with it the intoxicating blend of
confidence and self-doubt. Postgraduate
training proved even more intense than
undergraduate study. At the same time
we were trying to balance other aspects
of our lives – getting married, buying
homes, having children.
No one during my medical training
prepared me for the potential negative
consequences of a career in medicine.
In the rush, there was little time to reflect
on the possible consequences of this
potent mix of expectation, drive and
adrenaline. We were all invincible, and the
socialisation into a medical career had
made us dismissive of failure or distress.
However, years later at graduation
reunions the conversation inevitably
turns to the boy from our year who
jumped from the Harbour Bridge during
the second year of our course, with no
acknowledgement from the Faculty, and
to others who have suffered since.
It was during the 1980s, as a young
rural GP that I first began to understand
that the very career that we loved, that
we invested so much into, that our
patients respected, could also harm us.
I was fortunate to be in a large practice
with great colleagues, but began to
realise that the cumulative grief that I
experienced (stillborn babies, teenagers
killed in traffic accidents, young mothers
dying from cancer) would inevitably
affect me if I did not find a way to
acknowledge, accept and deal with each
loss. The sudden suicide of a young
doctor in a nearby town, someone with
whom I shared patients, came as a
lightning bolt.
I have spent a substantial part of the last
30 years studying the health of doctors.
Most doctors love what they do, and are
valued and respected by their patients.
Yet the psychosocial morbidity of doctors
is of great concern, as documented in a
number of studies in recent years. Why
the paradox? There is no simple or single
answer, but we can recognise and name
a number of factors. As doctors we are
altruistic, perfectionistic and anxious;
these are the characteristics that got
us into and through the competitive
world of medical training, and the same
characteristics that our patients value.
Doctors are also emotionally sensitive,
another characteristic that our patients
expect and deserve, but these same
curricula. There is overwhelming evidence
characteristics predict strongly for the
that a balanced, happy clinician provides
risk of burnout, which itself is predictive
of “distress” in the form of poor
psychosocial outcomes at a personal
and relationship level.
a better level of care to their patients, and
of course we and our families deserve to
be happy and content as well.
resilience. These topics are now core
Prof Simon Willcock is a Professor
of General Practice and Discipline
Head at Sydney Medical School and
a Senior Staff Specialist at Hornsby.
His educational and research interests
parts of undergraduate and postgraduate
include the health of doctors. dr.
I am pleased that the last 20 years
have witnessed broad discussion about
doctors’ health and strategies to maintain
amansw.com.au I 21
When your PATIENT
is a DOCTOR
Dr Narelle Shadbolt advises treating patients who are also doctors
the same way you would any other patient – with empathy,
respect, confidentiality, thoroughness, and professional objectivity.
Evidence from around the world
suggests that doctors represent an
at-risk population. Compared to the
population as a whole, they have
higher rates of depression and anxiety,
stress-related illness and unfortunately,
alcoholism, substance abuse and
suicide. And yet doctors find it difficult to
access appropriate health care – ‘Illness
doesn’t belong to us. It belongs to them,
the patients.’ Equally, when confronted
with another doctor as a patient, the
treating doctor may feel uncomfortable
and ill equipped.
Doctors who have been ill report
both anecdotally and via surveys that
because they were a doctor, they were
inadequately informed about their
progress and follow-up, and were not
offered enough psychological support.
Many doctors report having suffered
from a medical condition they would like
to have discussed with a clinician but
did not do so because they were a
doctor. Those contemplating consulting
another doctor for their own health,
express concern about confidentiality,
lack of confidence in a treating doctor
and embarrassment about how to
behave in the consultation. The internal
conversation usually relates to their
uncertainty regarding their self-diagnosis
– it’s as if they expect to be grilled as
they were on ward rounds when they
were students.
As much as we try to normalise the
situation, there is something unique
about the therapeutic encounter between
a doctor and a doctor-patient. The
usual model is: doctor – healthy, wise
and trained; patient: sick, naïve and
untrained. Both sides of this equation
have changed. The treating doctor has
no specific training for this encounter
and he or she may feel insecure and
fearful of criticism. When the patient
is a doctor there is a strong sense of
identification with their situation, which
together with an exaggerated sense
of responsibility and a keen sense of
needing to be exemplary can result in a
loss of objectivity. Sometimes this results
in the treating doctor unburdening his or
her own issues and fears with the doctorpatient. There may be a reluctance to
ask about important but sensitive areas
such as drug and alcohol use, sexual
problems or mental health issues.
There may be a wrong assumption
that the doctor-patient would disclose
any important symptoms and therefore
these may not be specifically asked
about. There may be a reluctance to do
a thorough physical examination. The
treating doctor may feel out of control,
take short cuts, ask the doctor-patient to
self-diagnose or just simply chat about
the latest crisis in the health system and
avoid the whole encounter.
When a doctor presents for medical
attention they are often in crisis. They
have often waited too long and there is
a need to respond quickly. They may
have put up with significant symptoms
including pain for some time. They may
have partially investigated and treated
themselves and fear disclosing this. They
may feel isolated and even ashamed –
letting the side down by getting sick.
We know that doctors like to be in
control, and this sense of lack of control
is heightened by a fear of illness. Doctors
are often obsessive and perfectionist,
and as a patient this means they want to
get better immediately and may deny or
minimise symptoms; they want to please
the treating doctor and may not report
treatment failures or non-compliance.
We know that doctors are more likely
to have problems with mental health,
particularly anxiety and depression,
substance use and issues related to
relationships. These problems are the
most difficult for which to seek help. If
you can’t go and see another doctor
for help with a physical illness, how are
you going to seek help for a mental
illness, an alcohol problem or a sexual
problem? These problems may also be
associated with a perception of stigma
and judgement. Mandatory reporting
laws have also created fear in both
treating and patient doctors. There is no
requirement to report illness where it is
being appropriately managed and patient
safety is not at risk. Professionalism is
paramount – your doctor-patient should
be able to rely on you for confidentiality
in all circumstances – even when you
meet them at a medical conference or
private function.
So there is learning to be done on both
sides. The first step may be to normalise
healthcare for doctors – encourage
normal healthcare behaviours including
regular health checks. Promote the
importance of establishing a relationship
with a healthcare provider – a GP. As
colleagues, we should discourage
corridor consultations, self-referrals and
management options that are outside
of what is usual. As senior doctors, we
should model appropriate healthcare
behaviours and discuss this with our
students and junior colleagues. When
your patient is a doctor treat them
as any other patient: with empathy,
respect, confidentiality, thoroughness,
and professional objectivity. Don’t make
assumptions and take responsibility for
examination, investigation, treatment and
follow-up. Give them permission to be in
the patient role.
Everyone is going to be sick sometime,
and everyone – even doctors – need
to allow themselves to be a patient,
and they are entitled to the very
best healthcare. dr.
Dr Narelle Shadbolt
MB, BS; FRACGP; MFM(Monash)
Senior Lecturer, General Practice,
Northern Clinical School Joint Head
of the Discipline of General Practice
Sydney Medical School.
amansw.com.au I 23
Coping with death
The death of a patient is sadly frequent for many doctors. Prof Garry Walter
suggests medical practitioners take time to reflect on adverse events.
The rewards of medical practice are
numerous. Among them is the joy of
witnessing many of our patients get
better through our efforts. Another is the
intellectual stimulation in keeping abreast
of the medical sciences that inform
our work. The list of rewards is indeed
lengthy. Yet a career in medicine is also
attended by many challenges, including
being the recipient of difficult, patientrelated news: the confirmation following
investigations of a terminal illness,
a patient suicide, the unanticipated
demise of another. In a large number of
medical practices, news of this type is
not infrequent. How are we, as doctors,
affected by such news and how might
we respond?
Patient adversity will always impact on
treating doctors – it is unsurprising, even
reassuring, that those drawn to a helping
profession are in some way moved by
events affecting their patients.
However, it is the nature and
extent of the impact
that may become a
source of concern
for the doctor,
doctor’s family and professional
colleagues. Among the factors that
determine how an individual doctor will
be affected are the following: the type
of adverse patient event, the nature of
other stressors (e.g. work-related or
family) being endured by the doctor,
the doctor’s “connectedness” (family
and professional), and a personal or
family history of previous psychological
difficulties. Accordingly, a range of
responses may occur. The isolated
practitioner with a history of major
depression for whom a patient suicide
is the most recent in a succession
of adverse patient outcomes may
understandably struggle to cope, but
doctors in other contexts may also
be affected by patient adversity, and
responses are not always predictable.
What steps should be taken? The
first step is to not ignore the impact of
difficult, patient-related news. Creating
opportunity to reflect on such news, and
if necessary discussing it through
informal and formal networks, is
important. Some doctors may
require further assistance,
and for a few there may be
legitimate concerns about
their safety. Due attention to
work-life balance is always
relevant for doctors, but
especially at times like this:
“Am I allowing sufficient
time to unwind and
engage in enjoyable
activities?”, “Am I
allocating adequate
time to be with
others?”, “Am I obtaining
sufficient exercise?”
and “Is my diet OK?”
are questions that
are as important
as any others in
these situations.
A service like the Doctors’ Health
Advisory Service (DHAS) can become
crucial for those affected. Formed in
1982 with the support of the Medical
Benevolent Association of NSW and
AMA (NSW), the DHAS provides personal
advice to medical practitioners and
students facing health difficulties. The
advice is mostly in relation to stress and
mental health problems encountered
by doctors and students, including
issues pertaining to problematic drug
and alcohol use. In the case of a doctor
receiving difficult, patient-related news,
the DHAS offers a confidential forum
whereby the affected practitioner can
discuss the impact of such news and
how they are faring overall. The DHAS
may then suggest and help organise
referral to a GP, psychologist, psychiatrist
or other health professional, depending
on the circumstances of the case. The
DHAS also offers to co-ordinate care and
monitor progress.
Just as many aspects of medical
practice contribute to the satisfaction
of a career in medicine, the day to day
challenges cannot – and should not –
be dismissed. By reflecting on traumas
such as difficult, patient-related news
and by accessing, as appropriate,
informal and formal sources of
support, the outcomes can be very
positive. Through providing a collegial,
professional and responsive service,
the DHAS is able to assist doctors
and students who might otherwise feel
overwhelmed by such events. dr.
Professor Garry Walter
AM MB BS, BMedSc, PhD, FRANZCP,
Cert. Child Adol. Psych.
Foundation Medical Director, Doctors
Health Advisory Service (NSW/ACT)
Health check
for junior doctors
Dr Sandy Jusuf, creator of JMO Health, a website
developed to promote the health and wellbeing of
junior doctors, shares her insight into the unique
stressors many interns face.
Now halfway through 2016, I hope this
year’s interns have started settling into
their new rotations and life as doctors.
Some of you will have taken to it like a
duck to water – enjoying looking after
patients, applying all those skills acquired
over the last few years, as well as the
prestige and financial independence that
a medical career comes with. Others,
however, might have come across some
unexpected challenges.
Being a junior doctor comes with all the
usual pressures of life, but there are also
unique stressors:
1. Hierarchy
There is still a hierarchy in medicine, and
as an intern you are at the bottom. Whilst
a lot of work is being done to change
the culture and to eradicate bullying and
harassment, it still exists and will take
time to improve.
2. Training positions
With the growing number of medical
graduates there is a constant struggle
to find enough placements for each
of them. Unfortunately, there is fierce
competition to get into a desired training
program which is causing a lot of angst
and stress for junior doctors. The AMA
and other organisations have worked
for a number of years on this issue and
will continue to pressure government
to ensure more training positions are
created. One thing you can do is join the
AMA and get involved.
3. Working hours
We know that working excessive hours
or nightshifts increases the risk for
burnout and depression. Furthermore,
working evenings or weekends places a
strain on relationships or our social life.
4. Rural placement
Being seconded to different hospitals and
rotations away from home is a common
scenario, but the impact on our social
life is often overlooked. Whilst some
embrace it as an opportunity to meet
new people, others can find it challenging
as they miss their partners, family or
friends, and are removed from their
social network.
5. Personal reasons
The factors that motivated us to become
doctors (intellectual challenge, altruism,
parental pressure) can also become the
ones that place us at increased risk of
negative effects (perfectionism, poor
emotional expression, poor coping skills
to deal with stress, self-sacrificing, low
tolerance for uncertainty, e.g. diagnostic
uncertainty, uncertainty of training
positions, or job security in long-term).
In addition, there are a number of barriers
to seeking help:
• Fear of lack of confidentiality or privacy
•Embarrassment
• Stigma of ill-health in the profession
So, if you are feeling stressed,
distressed or burnt out, what
can you do about it?
1. Ensure you have your own GP.
2. Prevention is easier than
treatment. Look after yourself
and ensure you have a work-life
balance:
Serenity: take time out and do
something relaxing
Exercise: do some regular exercise
or your favourite sport
Love: stay connected with your
friends, family and partner
Food: eat well and drink wisely
3. If you have specific issues you
are dealing with, you might need
to seek more specialised help like
finding a psychologist/psychiatrist
or seeking a Drug, Alcohol and
Gambling Services (DAGS)
Counsellor.
4. Further help is available through
following websites or organisations:
• Perceived impact on colleagues
and patients
•jmohealth.org.au
• Perceived impact on career
development
•AMA
• Perceived implications of mandatory
notification
• Difficulty of access (lack of
time, experienced personnel,
geographic isolation)
•DHAS
• Beyond Blue
•Lifeline
•EAP
More resources can be accessed
on the above websites as well.
• Expectation that doctors will work
while unwell
I hope that the rest of 2016 is great for
you and the beginning of a satisfying
career. Just remember there is help
available when needed. dr.
amansw.com.au I 25
When you are a patient
They say doctors make the worst patients, but it doesn’t have to be
that hard. Doctors’ Health Advisory Service’s Jill Gordon explains.
An article in JAMA in 2011 reported on
a study that showed doctors actually
recommend different treatments for
patients than they would choose for
themselves. It suggests that we may
be less objective when considering our
own health – a finding that backs the old
adage that the doctor who treats him/
herself has a fool for a physician.
If it makes good sense to consult a
trusted colleague about health issues,
especially serious ones, why is it that we
so often fail to do so? .
Dr Margaret Kay, Medical Director
of the Doctors’ Health Advisory
Service in Queensland has studied
the problems that doctors face when
they think about being patients. Fears
include, embarrassment, reluctance
to admit to ‘weakness,’ concerns
about confidentiality, and a fear of
mandatory reporting.
In medical school and later on in our
careers we are often rewarded for
hiding our ignorance and parading our
knowledge. You only have to look at
some of the performances that we
see in hospital rounds to appreciate how
important it is for some people to flaunt
their knowledge. Not surprisingly, it is a
lot more difficult to admit that we don’t
know a lot about a particular condition
that may have caught up with us.
Being a good patient isn’t that hard –
model yourself on those patients whom
you like yourself – the ones who are
cheerful, succinct, honest, collaborative
and appreciative – the ones who really try
to do what the doctor ordered! dr.
Should you suspect something is wrong, here are some hints on how to
approach the situation:
1.Don’t delay. Even if the problem proves to be trivial there’s no point in
procrastinating. You’re not so important that your patients can’t manage without
you for the time it takes to see a doctor for what ails you.
2.Find a GP that you like and respect. Stick with them and allow them to do their
job. If you are trying out a new doctor and you don’t get a sense of rapport, try again.
3.Don’t fear that you might be overly discursive. It’s more likely that you’ll be
tempted to cut corners and fail to give a full account of your symptoms. If necessary
take some notes into the consultation and don’t apologise for doing so.
4.Don’t hesitate to ask for explanations of anything that you don’t understand and
if the problem is serious, consider using your smart phone to record the consultation
so that you can listen to it later. It’s not only patients who forget 50% of what is said
in a medical consultation; doctor-patients are likely to do the same thing.
5.We all catastrophised in medical school and we often keep on doing it later
on. Common things occur commonly, so rather than nursing secret fears, make
an appointment.
6.If you need a referral to a specialist, negotiate politely with your GP over the
choice of a suitable person and take his or her advice. Your best mate from medical
school might not be the right person to see, and your GP will have had feedback
from a range of patients with the same condition that you have.
7.Try not to be ashamed of psychological symptoms. Doctors are especially
prone to depression, anxiety disorders and to a degree of obsessionality and
rumination that can make life miserable.
8.Men in particular can suffer from alexithymia: the inability to experience and
express a full range of emotions. The suffering that emerges can be felt as physical
symptoms, and the connection with stress is not always clear until you’ve had the
chance talk it through – that’s the beauty of medical confidentiality; it’s an opportunity
to discuss concerns that may be hard to express.
9.Don’t argue about payment. It may seem old-fashioned but if your doctor adheres
to the ethical principle of not charging colleagues accept it with grace. If s/he
charges you more than the Medicare rebate, that’s a great pity; s/he has missed the
opportunity to demonstrate, in a tangible way, that a medical consultation is much
more than a business transaction.
Sing
(and tell the blues so long)
Dr Bernard Haylen extols the mental health benefits
of singing – it’s cheaper than therapy, healthier than
drinking, and more fun than exercise.
‘Sing (and tell the blues so long)’ –
so goes the title of one of the most
famous songs from the father of
Australian Rock n Roll, Johnny O’Keefe.
Whilst the lives of musicians can be a
roller-coaster – and Johnny’s was as
much as any – they are never happier
than when they are singing.
All of our lives have twists and turns
and ups and downs. Those in doctors’
orchestras would tell you about how
relaxing it is playing an instrument in that
setting – it takes you to another zone,
removed from life’s multiple stresses.
Singing is no different.
There’s been quite a lot written on
both the “feel-good” and the health
effects of singing, particularly in a
choir. Researchers at the University
of Gothenburg, Sweden, found that
choristers’ heartbeats synchronize when
they sing together, bringing about a
calming and meditative effect that is as
beneficial to our health as yoga. Singing
soothes the nerves and elevates the
spirits. These benefits have variably been
suggested to be the result of the release
of endorphins or oxytocin or to lower
levels of cortisol. Studies have shown
singing lessens feelings of depression
and loneliness.
Professor Graham Welch, Chair of Music
Education at the Institute of Education,
University of London, has studied health
benefits of singing for 30 years, citing the
physical benefits as an aerobic activity
increasing oxygenation and exercise of
upper body, laryngeal and facial muscle
groups, as well as with the psychological
benefits, such as an increased sense of
community and belonging to a shared
endeavour. Singing in groups is one of
life’s great natural team activities.
A joint Harvard and Yale study showed
that choral singing increased the life
expectancy of the population of New
Haven, Connecticut, concluding that
singing promoted both a healthy heart
and an enhanced mental state. Another
study at the University of California has
reported higher levels of immune system
proteins in the saliva of choristers after
performing a complex Beethoven piece.
Other benefits of singing variably cited
are: an increase in poise, self-esteem
and presentation skills; strengthening of
memory and concentration; improved
lung capacity and posture; animation
of body, mind and spirit; expanding, via
singing beautiful lyrics, one’s imagination
and appreciation of the world around us;
an improved ability to listen; a greater
appreciation of the art and talents of
great singers or groups; an ageless
enjoyment therapeutically, physically
and emotionally.
It has been said that group singing is
certainly cheaper than therapy, healthier
than drinking, does not put on calories
and is more fun than working out. It is
one thing in life where feeling better is
pretty much guaranteed.
Dr Bernard Haylen belongs to the
Sydney Male Choir. If you’re interested
in joining you can contact him at
[email protected] or Ron Brown at
[email protected]. dr.
amansw.com.au I 27
Farewell
to the Father
Tim Elliott’s memoir of his father, Dr Max Elliott, details his dad’s heartwrenching battle with mental illness. Tim first published his story in The
Sydney Morning Herald’s Good Weekend magazine. The article generated
one of the largest reader responses in the paper’s history and sparked his
book, Farewell to the Father, which was released in March 2016.
As his son, Tim Elliott, describes in his
memoir Farewell to the Father, Max
was educated at Scots College, where
he was instructed to seek achievement
above all: ‘Nothing succeeds like
success.’ Max became a prefect at
Scots, a senior cadet officer and the
school swim champion.
A talented athlete, Max also played
Rugby Union for Australia, travelling
with the Wallabies to New Zealand (1952)
and South Africa (1953) and played prop
in the 1957 Test against the All Blacks in
Sydney.
Following in his family’s footsteps, Max
went on to study medicine at Sydney
University where he graduated in 1955
with Second Class Honours.
“He was a massive overachiever and a
perfectionist,” says Tim. “In everything,
there was a nagging feeling that he might
not be doing it to the maximum of his
ability. If he jogged, he had to jog 10
kilometres a day, if he played rugby,
he had to play rugby for Australia…
but his quest for perfectionism really
destroyed him.”
When Tim was 12, his Dad was
diagnosed with clinical depression. These
days, Max probably would have been
diagnosed with bipolar.
Tim recalls that his dad’s mood didn’t just
swing. As he wrote in an earlier article
for The SMH, Tim said: “it careened and
“
“
Dr Max Elliott, a thoracic physician at
Royal North Shore Hospital for more
than 20 years, did not do things by
half measures.
looped, it ploughed through the house
like a runaway rollercoaster, smashing
down walls, clearing out corridors,
unhinging doors. My father on a high was
utterly shameless; it was like watching
someone make love to the cosmos, on
stage, before an ovation of angels.”
To his colleagues, he was known as
‘Mad Max’.
“They regarded him as slightly off-kilter,
with a lot of manic energy and some
rather unpredictable behaviour, and I
think they did suspect he had mental
health issues,” Tim says. “But I don’t
think back in that day that they ever
would have felt comfortable questioning
But underneath his Dad’s relentless,
obsessive work ethic, was a real compassion
for his patients.
The Wallabies on tour in South Africa, 1953 (max, top right)
him – I think they let Dad cruise along for
quite a while in not such a great state.”
As Tim recalls in the book, he didn’t see
much of his Dad when he was growing
up. Most days, Max would leave the
house before the rest of the family was
awake and not return until late in the
evening. Even then, Max would spend
hours at the kitchen table working
until midnight.
Tim writes in Farewell to the Father:
Dad was a romantic: he loved poetry,
sunsets; Beethoven’s Moonlight
Sonata was his favourite piece of
music. But when it came to work he
was relentless, a haircloth penitent,
flogging himself to a bleeding pulp.
Mum called him a ‘workaholic’, which
I confused with ‘alcoholic’. As a boy,
I pictured Dad sitting at his desk,
swigging from a bottle. Who knows,
maybe he did? He was certainly gone
a long time, leaving for work before I
got up and returning after I’d gone to
bed. Then, because he always had
More Work To Do, he would set up
office at the kitchen table, dictating
his excruciatingly detailed patient
histories and examining X-rays,
wobbling them up to the wall light
and squinting at them through his big,
square, gold-framed glasses. This
he would do until eleven or twelve,
or even one or two in the morning.
Sometimes I would wake and wander
into the kitchen and give him a hug.
Or not, depending on his mood.
Then, much later, I would hear him
downstairs, roaring like the wolf in
‘The Three Little Pigs’, about to blow
our house down.
But underneath his Dad’s relentless,
obsessive work ethic, was a real
compassion for his patients. According to
Tim, Max really liked the idea of helping
people and he really loved his patients.
“His devotion to them was absolute, and
they loved him in return,” Tim says.
Tim recalls the story of an Italian cake
maker, Ross Rocka, who owned a
pasticceria in San Souci. Max had saved
Mr Rocka’s daughter’s life about the time
that Max’s third child, Camilla, was born.
So every year on Camilla’s birthday, Mr
Rocka would deliver a custom baked
birthday cake to their family home – for
the next 21 years, until the imagined debt
was repaid.
In Farewell to the Father, Tim writes:
But, God, was he a good doctor.
His sentimentality and emotionalism,
which was the flip side of his hysteria,
afforded him an uncommon depth
of compassion. Mum spoke of the
almost mystical way in which he
could inform a patient of the very
worst, sit with them while they
absorbed it – waiting as they wept or
went blank – and then say something
that allowed them to rise from
their seat and walk out the door in
something other than a state of utter
and complete desolation. ‘I don’t
know how he does it,’ she would say,
as if pondering a piece of conjury.
According to Tim, his Dad had many
“regulars” – patients that he saw for
amansw.com.au I 29
decades. However, the death of patients
tended to agitate Max’s underlying
mental health issues.
“His emotional palette was really vivid.
Anything could tip him over the edge or
into a bout of hysterical happiness or
hysterical sadness. He had a morose
streak anyway, and the deaths definitely
exasperated his tendency toward selfloathing, in that perhaps that he didn’t
do more.”
Tim recalls in his memoir:
I suppose there are doctors who can
divorce themselves from their work,
who go home every night as happy
as larks, but Dad wasn’t one of them.
Dad didn’t obsess over his patients’
deaths – he wasn’t in awe of death
itself. And he didn’t weep over their
pain and tribulations. But plenty of
people he treated inevitably ended up
dying, and when they died, they took
a tiny bit of my father with them. It
was a slow, cumulative process – like
waves chewing away at the base of
a cliff – and it gradually eroded his
goodwill and love of life, a commodity
that with some people, Dad included,
appears to be perilously finite. Lust
for life, joie de vivre, hope, whatever
you want to call it – it’s the fossil fuel
of the soul. Once it’s gone, it’s gone.
Max never confided in his colleagues
about his mental health issues, in large
part because he was afraid he might
lose his authority, or worse, he might
lose his job.
However, Tim says towards the end
of his Dad’s career, many colleagues
became worried about his ability to
perform his duties as a senior physician.
“He became obsessive with tiny details.
And the consultations took so long
appointments were backed up 10, 15
“
“
Max never confided in his colleagues about his
mental health issues, in large part because he
was afraid he might lose his authority, or worse,
he might lose his job.
patients. The other doctors were looking
at him, going ‘what the hell, what are
you doing in there?’ They were worried,
thinking ‘is he making good decisions, is
he in doubt about what he’s doing?’ But
he had been pretty damn competent for
so long that they were thinking he must
have some plan here. However, they
never said to him, ‘Hey what’s going on?’
In the end, Max decided to retire from
the hospital in 1987 as a Consulting
Physician, after almost 30 years of
service as a clinician and teacher. In the
same year, he closed his private practice.
Initially it was a relief, Tim says. But
eventually Max didn’t know what to do
with all of the physical and intellectual
energy that he had devoted to being
a doctor.
“You forget how to enjoy yourself and
inevitably run out of ways to fill your day.
So when he stopped he was bit lost. He
had a lot of self-worth bound up in that
job,” Tim says.
Tim writes that his Dad’s depression
increased, as did his volatility. “He raged,
he ranted, he roared.”
The family worried about their Mum’s
safety, as Max had attacked her before.
They talked about having him committed
and when Tim was 16, Max agreed to a
short stay in a psychiatric clinic.
Max had attempted suicide several
times – the first time was when Tim
was about eight. As Tim got older,
the attempts, which involved pills and
medication, intensified.
Eventually, after a particularly violent
episode, Tim and his mother left
(Tim’s older siblings had already moved
out). Max took his own life several
months later. His family found him on
23 March 1988.
Tim Elliott , author
It took Tim nearly three decades to write
about his father – initially publishing an
article in The SMH in 2014.
He wrote: “Dad is gone, but he is never
gone; he is without life but alive. He’s the
closest thing I have to an Old Testament
God, both vengeful and tender. When he
chose death, he placed himself beyond
us, leaving behind an unbridgeable
distance across which he still stares with
those big brown eyes, looking at me and
for me, asking to be made whole. For
26 years I’ve searched for the key that
might have made him so, that would
have unlocked him and healed him. But,
of course, there is no key for people like
Dad. There is no answer. There is no
peace. This is what he understood and I
did not. Dad is still with me, and I’m glad
of it. I still love him. He’s my father. dr.
Lifeline: 13 11 14.
Farewell To The
Father by Tim
Elliott is published
by Picador,
RRP $39.99
NOTICE
Casual vacancies on
AMA (NSW) Council
Following the AMA (NSW) Annual General Meeting held 10 May 2016, Council
passed a Special Resolution allowing the composition of Council to change.
Council approved the creation of five additional unrestricted general member
positions. The positions are open to any AMA member and will be casual
vacancies. From 2017, the positions will be included in the standard Council
election process. If you are interested in pursuing any of these positions, please
contact AMA (NSW) on (02) 9439 8822.
The changes relate to improving diversity and representation
of Council and making the process of applying to Council
more accessible.
AMA (NSW) acknowledges the importance of reflecting
the diversity of the medical profession within its Council.
The Council of AMA (NSW) is made up of geographic and
speciality representatives and six nominated representatives
from the unrestricted class, of whom three must be general
practitioners. There are 29 positions on Council, plus one
student position.
While it is recognised that any eligible member can and
should stand for election in an appropriate position, in
practice, there can often be a reluctance to stand for
election where it is perceived that there is already an
incumbent in the role. This is particularly notable for groups
with less representation on Council, such as women and
doctors from overseas backgrounds (either in terms of
training or family of origin).
The Council of AMA (NSW) is proposing the expansion
of the Council to create five additional unrestricted
general member positions. While these positions will be
open to any AMA member, it is hoped that the additional
positions will encourage more members to be involved in
AMA (NSW) Council.
Council passed these amendments at its AGM:
1.)AMENDING CLAUSE 35.1, 35.1(x), 35.3 COMPOSITION OF COUNCIL
• Clause 35.1 to be amended to increase the number
of Councillors from 29 to 34;
• Clause 35.3 provides for three terms on Council
(as opposed to six) and the exemption for time spent
serving as an Officer of the Association remains;
2.)AMENDING CLAUSE 36.1, 36.2 –
ELECTION OF COUNCIL
• Clause 36.1 to be amended to reflect the increased
number of Councillors;
• Clause 36.1 requires a candidate for Council to
be nominated by one member of the Association
(as opposed to two or more);
• Clause 36.1(g) to be amended to reflect the change
of requirements for the candidate information sheets
in the event of a contested election for a position or
position on Council;
• Clause 36.2 to be amended to delete the reference
to the Industrial Relations Act 1996, as provisions of
the Act referred to do not apply to AMA (NSW).
3.)INSERTING NEW CLAUSE 36A –
TRANSITIONAL PROVISION
• Clause 36A provides Council with the power to appoint
five members to the Unrestricted General Class in 2016.
Those persons must vacate office at the 2017 AGM and
those persons may nominate for election in 2017.
4.)AMENDING CLAUSE 50 – NOTICES
• Clause 50 has been amended to provide for the
provision of notices personally, by post, by facsimile, or
electronically and by publication in The NSW Doctor.
• Clause 35.1(x) to be amended to increase the number
of Councillors in the Unrestricted General Member
Class from six to 11;
amansw.com.au I 31
NEWS
Careers Service hits the road
AMA (NSW)’s Careers Service has already met with hundreds of doctors
in 2016 to offer support and practical advice. Since February, the Careers Service has
been going out to hospitals across the
State to inform doctors about the careers
support available to our members and
equip them with practical advice for CVs,
applications and interviews.
These visits – from Sydney Metro to
Wagga, Coffs and New England – have
enabled the Service to make face-to-face
contact with over 300 doctors.
So far, the Careers Service has visited
RNSH, St George, Liverpool, RPA, POW,
Port Macquarie, Wagga, Manly, Fairfield,
Coffs Harbour, Belmont, John Hunter,
Maitland, Taree and Tamworth – with
more events to come.
The Careers Service also enjoyed a
lively and impressive fundraising event at
Western Sydney University with its very
enthusiastic cohort of final year students.
TESTIMONIALS
“I would like to say thank you for your help with my interview
preparation last year for surgical positions. I have since secured
two staff specialist positions.” - Bariatric surgeon
“Excellent talk – would be great to have this every year.”
- Coffs JMO
“Highlighting the need to plan and prepare early. Clear and
concise presentation.” - Coffs JMO
“Highlighted the advantages of joining that I was unaware.”
- Fairfield
“Excellent delivery, relevant topic. Would have been useful at
earlier stages of career.” - Manly
May took us to Adelaide for the
RACP trainees’ day, (part of the RACP
Congress) where we had the opportunity
to meet physician trainees from around
Australia and New Zealand and share
experiences about the often daunting
application and interview process.
Careers Adviser Anita Fletcher spoke
at the Congress and has been invited
to take part next year at the RACP
Congress’s Bringing Specialists Together
Sharing Knowledge, Building Skills event
in Melbourne 8-10 May.
This activity has meant that word about
the Careers Service is getting around and
requests for assistance are on the rise.
If you would like to benefit from the
service, email [email protected]
or phone Anita Fletcher on 9902 8158.
Members will also have seen an invitation
to our Careers Expo at the SMC in
Goulburn Street Sydney through email;
please see ad on p33 for more details.
Careers weekend Coffs Harbour Health Campus
Careers Service has assisted Interns, SRMOs, consultants and surgeons with
CVs, cover letters, interview skills, and pathways across a diverse range of
specialties, including:
•Physician
•GP
•Opthalmology
•Surgery
•Anaesthetics
•Emergency
•Oncology
•Cardiology
•Neurology
MEDICAL
AMA NSW/ASMOF NSW ALLIANCE
CAREERS EXPO
VENUE
SMC Conference &
Function Centre
66 Goulburn Street
Sydney NSW 2000
REGISTRATION
8.30am – 9am
EXHIBITION
9am – 4.30pm
DATE
Saturday 6 August 2016
✔
Speak with representatives from the colleges
and training organisations
✔
Industry insights and talks from prominent guest speakers
✔
Find out about future vocational training and career
opportunities
✔
A great opportunity for graduating medical students and
Doctors-in-Training to meet key industry influencers and
future colleagues
✔
Equip yourself with necessary application and interview
skills, give yourself a competitive edge
✔
A great place to meet influential
organisations and network
FREE
EVENT
Registrations/Timetable: amansw.com.au/event/ama-nsw-asmof-nsw-alliance-medical-careers-expo
Sponsorship opportunities: [email protected]
Enquiries: [email protected]
Platinum sponsor
amansw.com.au I 33
MEDICO-LEGAL
Andrew Took
Director
Medico-Legal
and Employment
Relations
The Community
Network – not so
community-minded?
Kym Gardner
Senior Solicitor
Are your broadcast ads reaching your target
audience? It can be difficult to measure – unless
you have evidence that your audience doesn’t
even have a working TV!
The AMA NSW
Medico-Legal team
Such was the case with one advertiser
and a company known as The
Community Network (currently trading as
Multimedia International Services Pty Ltd).
Andrew Campbell
Solicitor
Ivy Tseng
Policy and Legal
Advisor
Sarah Connor
Policy and Legal
Advisor
Sarah Fam
Policy and Legal
Advisor
Eden Weller
Paralegal Officer
The Community Network (TCN) offers
digital advertising services, where
they install digital televisions in local
businesses and offer advertising slots
which are broadcast on these televisions
to a range of businesses.
The Community Network has been
subject to an Australian Competition
and Consumer Commission (ACCC)
investigation since 2015 which has
culminated in court action with Australian
Competition and Consumer Commission
v Multimedia International Services Pty
Ltd [2016] FCA 439.
The Federal Court found that TCN had
engaged in unconscionable conduct
in its dealings with one small business,
and making false and misleading
representations to two other small
businesses and wrongly accepting
payment from them.
The case revealed that the televisions
to display the advertising were not
yet installed (nor were they for several
months thereafter) when TCN sold
the advertising time and the customer
had started paying for the time. TCN
also refused to release this small
business from the contract even
though no advertising services had
been provided, continuing to use debt
collectors, threats of legal action and
an adverse credit rating to claim the
remaining contractual amount.
TCN was ordered to pay penalties of
$230,000 for breaching the Australian
Consumer Law in its dealings with the
three small businesses which were
the focus of the court case. TCN is
also subject to a court enforceable
undertaking starting on 27 April 2016
for a period of five years in which TCN
has undertaken not to continue certain
business practices.
Despite this ACCC matter going on,
we have had members in very similar
situations where they did not receive
the services they purchased under a
contract signed over 18 months ago,
have tried to terminate contracts, and
yet continue to receive correspondence
chasing payments. dr.
Too much of a good thing
Do you have any employees who have
been with you for eight years, earn lots
of time in lieu and have a mountain of
annual leave stored up?
A recent review of modern Awards has
led to some small, but nonetheless
important changes to do with granting
and taking annual leave. These changes
relate to excessive annual leave accruals,
cashing out annual leave and granting
annual leave in advance.
Excessive annual leave occurs when
an employee is not a shift worker and
has more than eight weeks of annual
leave accrued. Concerned you or your
employee may have an excessive leave
balance? Employers are able to direct
employees to take leave if they have an
excessive leave balance. However, first
they must request a meeting, where
the employer and employee genuinely
attempt to come to an agreement
to reduce or eliminate the excessive
leave balance.
If you do direct an employee to take
leave there a few things to keep in mind:
firstly, an employee cannot be directed
to take leave for any period less than one
week; secondly, an employee cannot be
directed to take a leave for any period
that will result in their leave balance being
less than six weeks; lastly, an employer
cannot direct an employee to take leave
commencing less than eight weeks after
the direction, or more than 12 months
after the direction. Remember, employers
must be consistent with any leave
agreements they have with employees.
Alternately, an employee may choose
to cash out some of their annual leave if
they have an excessive leave balance. In
doing this, an employee cannot cash out
more than two weeks of annual leave
in a 12-month period and cannot cash
out any amount of leave which would
lead to their remaining balance being
below four weeks.
In addition, the Commission has decided
to include a new term in the Awards for
granting leave in advance. This means
that employees can now take leave,
before they have accrued the entitlement,
if agreed upon by the employer. This
new inclusion will enable mutually
beneficial flexibility for both employers
and employees.
AMA (NSW) recommends that employers
consider the needs of the business
and the needs of the employee before
granting any leave in advance, cashing
out annual leave or before directing an
employee to take leave. dr.
When the worst happens
Nobody wants to think about it, but
what happens if you suddenly are unable
to practice medicine and have to shut
down your practice? No doubt you
have income protection insurance or
other insurances that cover the financial
concerns for your family, but what about
the burden of sorting out what to do
with the patients’ ongoing needs, your
practice and your staff? Obviously this
falls to your partners, associates or fellow
directors if you are in a group situation,
but if not, it becomes an additional
concern for your family.
Recently our team assisted the daughter
of a long term member who had had
a stroke. The member was a solo GP
with a thriving 30-year-old trusted
practice. Unable to deal with the
practice, it was left to the GP’s eldest
daughter to sort out what needed to
be done in her absence.
We recommended to the daughter that
she keep support staff working for at
least four to six weeks, to ring all patients
with appointments booked, and to
answer the phone for anyone looking for
the doctor. The incoming mail needed
to be reviewed and where necessary, if
clinical in nature, then another medical
practitioner would need to review the
information and decide where follow up
was needed. Ultimately, she would need
to work with the support staff to send
letters to all current patients advising
them the practice had to close due to
unforeseen health issues.
We advised that ideally the letter should
also list other GPs in the area for patients
that had any ongoing problems that
required regular consultations, and a
recommendation to find another primary
care provider as soon as possible. The
original medical files could then be
transferred to the new GP. For those files
not moved to alternative practices there
is the obligation to store the medical files
for seven years, ensuring that there is
an identified access point, for example,
through a post office box where patients
can write to for a copy of their files.
Should the worst happen, the obligations
are extensive, but the AMA (NSW)
is happy to assist where we can in
guiding members and their families
through this maze. dr.
amansw.com.au I 35
GOLF EVENTS
President’s Cup 2016
It wasn’t an easy day at the course, but President’s
Cup winner Dr Michael Burke came out on top.
A crisp, sunny, winter’s morning
welcomed 31 players to beautiful
Pennant Hills Golf Club for the 2016
President’s Cup.
Despite recent severe storms in the
area, the course was well presented
and played particularly hard as the
scores reflected.
Winner of the Cup, on a count-back
with 40 stableford points, was a very
consistent regular Dr Michael Burke,
and another regular Mr Dean Lucas in
second place.
Winners of the 2BBB with 45 points
were Drs Ivan Cottom and Ian Meakin,
just nudging out Drs Stuart Ludowici and
Michael Burke on 44. Nearest the pins
went to Dr Jeff Myers and Mr Graeme
Lovett. It could be said that the rest of
the field put in a sterling effort and it
would be politic not to mention some
of their scores.
A special welcome was extended to "first
timers" Dr Lawrie Guitronich, Mr Stephen
Patterson and Mr Kerry Evripidou. It was
also pleasing to see Mr Michael Henley
leading the TressCox team.
Runner up Mr Dean Lucas with
Dr Robyn Napier
A very sincere message of
congratulations was extended by
Dr Alec Harris to our leader, Dr Robyn
Napier on her award of the Order of
Australia Medal in the Queen’s Birthday
Honours list. Mention was also made
that one our great supporters and
sponsors, Mr Paul Betar also received
an OAM at the same time. Well done to
both of them.
Our next event is the Spring Cup at
Terrey Hills Golf Club on Thursday 1
SPRING CUP // Thursday 1st September
Terrey Hills Golf Club
INTERNATIONAL SHIELD // 22nd to 30th October
New Zealand – Registrations now open
BMA CUP // Friday 2nd December
NSW Golf Club
AMA (NSW) Golf Society
Claudia Gillis
9439 8822
Winner Dr Michael Burke with Dr George Thomson
& Dr Robyn Napier
[email protected]
September. All doctors and their partners
with a recognised golf handicap are
welcome to join us.
This year’s International Shield will be
held in New Zealand 22-30 October.
In the meantime, good golfing to all.
For any inquiries about the Golf
Society please contact Claudia Gillis
at AMA (NSW) 02 9439 8822.. dr.
Cape Kidnappers Golf Course
AMA (NSW) Golf Society 2016
International Shield – New Zealand
This year’s International Shield
competition will be held in the northern
island of New Zealand on some of the
most scenic golf courses in the world.
Six rounds of golf will be played at
Wairakei International Golf Couse, the
Kinloch Club, and Cape Kidnappers.
Accommodation will be for six nights
in the luxurious Hilton Lake Taupo and
three nights in Scenic Hotel Te Pania.
All transfers are included and nonplaying partners are warmly welcomed.
Places are limited, please contact
Claudia Gillis 9439 8822 or
[email protected] for
a full itinerary. dr.
15TH ANNUAL CONTINUING PROFESSIONAL EDUCATION (CPE) SEMINAR
This 1½ day seminar covers current developments in medical practice with updates in the treatment of diseases,
preventative health issues and is designed to assist experienced practitioners towards meeting the CPE requirements.
Date
| Saturday, 23 July – 9am-4pm and Sunday, 24 July – 9am-1pm
Venue | Y3A Theatre, Macquarie University (enter Balaclava Road)
Cost | AMA members $150. Non-members $200.
Includes morning teas and lunch on Saturday.
This seminar will be submitted for QI&CPD points approval by the RACGP QI&CPD Program.
Register online: www.amansw.com.au
For more information or to make a booking Jenni Noble phone 02 9902 8140 or email [email protected]
amansw.com.au I 37
MEMBERS
A warm welcome to all of our
new members this month
Get more from your membership today and utilise our medico-legal and
industrial relations team for advice, our preferred partner advantages,
member services and events throughout the year. To find out more phone
our membership team on 02 9439 8822.
Dr Ahmad Al-Hindawi
Dr Julie Argent
Dr Benjamin Armstrong
Dr Shrivaney Arrudsivah
Dr Martiane Bersano
Dr Jenna Besley
Dr Jill Bukofzer
Dr Andrew Cepak
Dr Chloe Champion
De Crespigny
Dr Vimal Chand
Dr Joseph Chiha
Dr Ping Shu Choi
Dr Anne Collins
Dr Veronica Corrigan
Dr Monique Damasco
Dr Omprakash Damodaran
Dr Kashmira De Silva
Dr Alexandra Draney
Dr Victoria Edwards
Dr Mohamed El Molla
Dr Ahmad Elgendy
Fionnuala Fagan
Dr Amireh Fakhouri
Dr Chitra Fernando
Dr Ann Formaz-Preston
Dr Christopher French
Dr Natasha Gandhi
Dr Chris Ganora
Dr Michael Gao
Dr Emma Gilbert
Dr Dharshan Giritharan
Dr Leigh Golding
Dr Madelyn Gramlick
Dr Scott Hahn
Dr Chaw Han
Dr Richard Hanney
Dr Christopher Harrington
Dr Sebastian Heintze
Dr Phong Ho
Dr Patrick Horsley
Dr Mirette Ibrahim
Dr Mouhannad Jaber
Dr Shefali Jani
Dr Robert Kalmar
Sanjana Kannansud
Dr Elizabeth Kennedy
Dr Surabhi Khare
Dr Haimee Kim
Dr Michael Kulisiewicz
Dr Melissa Kuo
Dr Irena Kyte
Dr Ramanathan Lakshmanan
Dr Abdul Lathif
Dr Sharon Laura
Dr Richard Lawrence
Dr Philip Le Page
Dr Jung Min Lee
Dr Jennifer Li
Dr Ivy Lien
Dr Phoebe Lovett
Dr Kwok Ping Low
Dr Fatma Lowden
Dr Thiri Lwin
Dr Trevor Ma
Dr Mojgan Mansouri
Dr Jyothi Marry
Dr Jessie McClelland
Dr Georgina McDonald
Dr Fortunate Mchechesi
Dr Gary McKay
Dr Amit Mishra
Dr Ferdinand Miteff
Dr Perla Moukhaiber
Dr Sudhir Mudunuri
Dr Adam Najem
Dr Sonali Disha Nanayakkara
Dr Agnes Ng
Dr Chitra Parab
Dr Sugeesh Pathirana
Dr David Phillips
Dr Vasantha Bhanu
Yadav Pothala
Dr Wijayati Pusparina
Dr Ashfaque Quadir
Dr Motiur Rahman
Dr Jusveer Rakhra
Dr Arpita Ray
Dr Andrea Rose
Dr Jaspreet Saini
A/Prof Smita Shah
Dr Amirreza Shameli
Ganeshwaran
Shivapathasundram
Dr Arush Singh
Dr Brent Skippen
Dr Daniel Smoothy
Dr Victoria Snaidr
Dr Mark Song
Dr Paul Stephens
Dr Lee Sutton
Dr Yasmin Tan
Dr James Tester
Dr Alexander Treble
Dr Ashleigh Udell
Dr David Van Der Poorten
Dr Carlo Vernier
Dr Sameer Viswanathan
Dr Hoang Quan Vo
Dr Jessica Wade
Dr Jordan Webb
Dr Phoebe Williams
Dr Ka Chun Arthur Wong
Dr Mon-Chiao Wu
Dr Charlotte Yin
Dr Wenjie Zhong
Dr Jingjing Zhou
The AMA (NSW) offers
condolences to family
and friends of those
AMA members who have
recently passed away.
Dr Marion Baker
Dr Michael Burns
Dr Phillip Cappe
Dr Robert Evans
Dr George Hession
Dr Gragery Rasiah
Dr Vivienne Schnieden
Dr Peter Walters
CLASSIFIEDS
GP NEEDED IN MOOREBANK FAMILY MEDICAL PRACTICE
• VR GP with Partnership available
• Immediate Start PT/FT
Contact
[email protected]
• 75% and based earnings guarantee
PINNACLE
Seeking an Integrative GP
HEALTH CLINIC
Pinnacle Health has been providing Complementary
Medicine services in Western Sydney for over 30 years.
We are currently seeking an Integrative GP to come on
board and operate their business in a room rental
agreement in our private billing clinic. What we offer:
Access to an existing client database;
Free parking for your clients;
Full administrative support (reception, appointment
management, supply ordering, health fund rebate management,
established pathology arrangements etc);
Modern rooms equipped with full telecommunications /internet;
Street frontage exposure;
Cross referral from other practitioners practicing within the clinic.
Terms and conditions are negotiable to benefit a sustainable practice. To discuss
options further or to view the premises, email- [email protected].
amansw.com.au I 39
MEMBER SERVICES
Make your membership more rewarding everyday!
Qantas Club
ip has its rewards
Medico-Legal and Employment Relations advice in Australia.
le include awards advice and updates, court representation,
A comprehensive range of legal packages and draft contracts
e. In addition, below are a list of our member service partners
AMA Member Rates (GST inclusive)
TressCox Lawyers
Joining Fee: $240.00
save
Expert legal –
advice
for $140
the medical
profession.$390.60
Members are–entitled
a
1 Year Membership:
saveto$119.30
unique duty solicitor scheme offering
one
free
consultation
(referral
required).
2 Year Membership: $697.50 – save $227.50
p has its rewards
Link your AMA AMEX to the Qantas rewards program to earn Frequent Flyer
AMA Auto Buying Service
points faster!
A free service specialising in the
For more information visit www.ama.com.au/memberservices-qantas
acquisition, funding and disposal of all or
and models
of motor
vehicles.
phone 02 9439 8822 and ask formakes
our friendly
member
services
team.
Accountants/Tax Advisers Panel
Medico-Legal
and Employment
Relations
advice
Australia.
petent,
Experienced
accounting
firmsin
who
To find
out more
give
friendly
AMA (NSW)
canupdates,
assist
you our
with
your
personal and
eyour
include awards
advice
and
court
representation,
professional accounting and taxation
A comprehensive range of legal
packages and draft contracts
needs. Select the firm most suitable for
. In addition, below are a listyour
of requirements.
our member service partners
ty at a
cards.
(NSW)
the most comprehensive Medico-Legal and Em
Benefits ofAMA
Qantas
Clubhas
Membership:
some
of the
services
• DedicatedJust
check-in
on most
Qantas
flights.that are available include awards adv
mediation
and
human
resource
• Extra checked baggage allowances on
selected consulting.
Qantas flights. A comprehensive rang
are
available
for
members
for
a
nominal
fee. In addition,
below a
• As a Qantas Club member you also have complimentary
membership
to the
to
assist
you
whatever
the
need.
Qantas Frequent Flyer program.
• And so much more...
AMA (NSW) Member Service P
W) Member Service Partners
l of all
icles.
Membership has i
Make your flight experience more enjoyable by starting it off in the Qantas Club Lounge
and save 32 per cent when you join Qantas Club with your AMA membership discount!
Assign
Medical
members services team a call on
02 9439
8822.
Assists members to source competent,
friendly and committed staff for your
business or practice.
Preferred partners
AMA (NSW) Member Reward Card
Significant savings every year with
Commonwealth Bank
Commonwealth Bank
A special merchant facility at low rates. AMA members pay
a New
special
facilityareateligible
a
noOffering
joining fee.
CBAmerchant
merchant clients
to 6
months
freeof
terminal
rental
a free
business
account
low fee
0.68%
for and
most
credit
cards.
when they sign up their merchant facility with CBA and
settle the funds to a CBA account.
BOQ Specialist Bank Limited
) Member Service Partners
participating restaurants, hotels and
ersonal
. Finance
nts, motor
of all
property
cles.
petent,
al services
our
members.
n, Risk
Insurance
y at a
cards.
ors,
on of
ge
of
sonal
Finance
s, motor
property
nt)
igence
ment
es,
services
members.
, Risk
nsurance
tions:
BOQ Specialist delivers distinctive banking solutions
tourist attractions.
to niche market segments. Our focus, experience and
TressCox
Lawyers
dedication
to our clients have enabled us to become
American
Express
Expert legal advice for the medical
Offering
corporate
affinity programs
and
experts
in a number
of professional
niches. We aim to add
profession.
Members
are entitled
to a
special
discounts
members
for credit
value
to andtobuild
partnerships
with our clients and we have
unique
duty
solicitor
scheme
offering
cardsbeen
and merchant
providingfacilities.
specialist
banking in Australia for over 20
one free consultation
(referral required).
years.
Auscellardoor AMA (NSW) Wine
Accountants/Tax Advisers Panel
Society
Accountants/Tax
Advisers
Experienced
who
Boutique
winesaccounting
at speciallyfirms
negotiated
a comprehensive
range
can Provide
assist
you
withevery
yourmonth.
personal
and of personal and
prices
for members
professional
accounting
services.
professional accounting and taxation
needs. StarCard
Select the firm most suitable for
Caltex
ons:
Specialist finance to meet the personal
and practice needs of members. Finance
solutions for practice requirements, motor
vehicles, commercial/residential property
and overdraft facilities.
Consolidate
your vehicle fuel expenses
your requirements.
onto one easy-to-read monthly statement
with
access
to the
followingReward
fuel
AMA
(NSW)
Member
Card
discounts:
off unleaded,
Significant2.5cpl
savings
every yearVortex
with 95
and
Diesel andrestaurants,
1.5cpl off Vortex
98.and
participating
hotels
Gow-Gates Group
Member services
tourist attractions.
Complete insurance and financial services
with special packages for AMA members.
Services
include:
Riskreduced
Virgin
Australia
– TheWealth
LoungeCreation,
| Significantly
rates
with no joiningDoctors’
fee and savings
of $100
per year.
Management,
Practice
Insurance
and Superannuation.
Hertz
As
the official Express
car rental partner for AMA,
American
American
Express | Corporate affinity programs and
Hertz
offers
discounted
ratesprograms
and a range
Offering
corporate
and credit cards. Whichever
discounts
on all
aaffinity
range
of six unique
ofspecial
member
benefits
year round.
discounts to members
for credit
card you choose you’ll enjoy the special benefits and extra
cards and merchant facilities.
value
we’ve negotiated for you.
Qantas
Club
Discounted rates for AMA members.
Auscellardoor
AMA (NSW) Wine
Save Qantas
up to $365
on membership.
Club
| Discounted rates saves you hundreds
Society
Fees
as dollars
follows:on
Joining
$200;
of
membership.
Joining fee $240, save $140;
Boutique
winesTwo
at specially
negotiated
One
year
$265;
years
$465.
one year membership
$390.60, save $119.30; two year
prices for members every month.
membership $697.50, save $227.50. Partner rates
(GSTStarCard
inclusive) Partner Joining Fee: $200, Partner 1 Year
Caltex
Membership
Fee: $340,
Partner 2 Year Membership
Consolidate
your vehicle
fuel expenses
ontoFee:
one $600.
easy-to-read monthly statement
MEDPRAC
25% R E B AT E
SUPERANNUATION
Mercedes-Benz Corporate Programme | Members
can
enjoy the benefits
Prosper
Groupof this Programme which includes
complimentary scheduled servicing for up to 3 years/75,000
A property advisory (buyer’s agent)
km, preferential pricing on selected vehicles and reduced
whodelivery
can source,
due isdiligence
dealer
charges.perform
Also included
access to
complimentary
pick-up
drop-off,
access to a loan vehicle
and negotiate
yourand
home,
investment
during car servicing and up to 4 years of Mercedes-Benz
properties or commercial premises,
Road Care nationwide. mercedes-benz.com.au/corporate
saving you time and money.
4www.nswama.com.au
Fees as follows: Joining $200;
One year $265; Two years $465.
Avis Budget | Avis Budget is the official car rental partner
for AMA (NSW) offering discounted rates. Contact AMA
member services for the details.
25% R E B AT E
Introduce a new member to AMA (NSW) and receive
a cheque
equal
to 25%
of the Inew
member’s
40
I THE
NSW
DOCTOR
JULY/AUGUST
2016
subscription via our Member Get Member
program. There are no limits.
Medprac
Super
Fund | Members can enjoy the
BMW
Corporate
Programme
benefits
of this Programme
which
complimentary
The perfect
super fund
for includes
doctors,
scheduled servicing for 5 years/80,000 km, preferential pricing
no entry
fees.
the
option
of charges.
onwith
selected
vehicles
and Have
reduced
dealer
delivery
managing your fund using a range of
investment managers.
with access to the following fuel
discounts:
2.5cpl
off unleaded,
Vortex
95 advice and duty solicitor
Introduce a new member
to AMA
(NSW)
and
receive
TressCox
Lawyers
| Expert
legal
s,
and Diesel
1.5cpl off Vortex 98.
a cheque equal to 25%
of theand
new
scheme
with member’s
one free consultation (referral required).
on of
subscription via our Member Get Member
e of
program. There are Hertz
no limits.
As the
officialCity
car rental
partner
for AMA,can enjoy the benefits
Sydney
Lexus
| Members
Hertz offers discounted rates and a range
of the Lexus Corporate Programme, including Encore
of member benefits all year round.
all AMA (NSW) Member Services
onAn(02)
9439
8822
Privileges.
exclusive
offer
in conjunction with Qantas
t)
is available
Qantas
Club to AMA members - earn one Qantas Point
an
areas)
gence
for everyrates
dollar
on a new vehicle purchase, only at
Discounted
forspent
AMA members.
ment
City on
Lexus.
SaveSydney
up to $365
membership.
es,
Investec Experien
Other benefits:Call AMA (NSW) member services on 02 9439 8822
or email [email protected]. Visit our websites
Receive automatic subscriptions
to the following
publications:
www.amansw.com.au
or www.ama.com.au
nn
AMA List of Medical
Services
Book benefit from its relationship
Disclaimer:
AMA and
(NSW)Fees
may financially
nn
MEMBER
The
NSW Doctor with AMA (NSW) or Federal AMA. AMA Products is a separate
with Preferred Partners. Please note: AMA Products is not affiliated
business entity.
nn
The Medical Journal of Australia
nn
Australian Medicine
nn
AMA Action (e-newsletter)
25
Introduce
a cheque e
subscripti
program. T
How we Help
you build and
preserve wealtH
A full range of specialised services
n
Surgery acquisition strategies
n
Tax deductible debt strategies
n
Investment planning
n
Medical practice structuring
n
Effective practice service entities
n
Estate planning
n
Tailored Superannuation strategies
n
Cloud-based record keeping
n
Tax planning
A team of medical accounting experts
These are the experienced medical accounting specialists who will advise and guide you
Jarrod Bramble
Partner
Specialist Medical
Services
Shane Morgan
Partner
Superannuation
Juliane Walsh
Client Service
Manager
Nicole Brown
Client Service
Manager
Phil Smith
Partner
Investment
Jodie Walshe
Client Service
Manager
Stuart Chan
Director
Specialist Medical
Services
Pauline Smith
Client Service
Manager
Michael Graham
Director
Cloud Software
Cameron Nix
Client Service
Manager
Catherine Parker
Client Service
Manager
Megan Goodwin
Client Service
Manager
Specialists in accounting services to medical practitioners since 1953
PREFERRED
ACCOUNTING
PARTNER
NATIONAL
SPONSOR
cutcher.com.au T 02 9923 1817 E [email protected]
innovative thinking. traditional values.
Let your savings
do the heavy lifting
Grow your business, retirement or
personal savings with our 180 day
term deposit.
Put your money to work with a great
interest rate of 3.00% p.a. and enjoy
a fixed return with the added benefit
of no establishment or account
keeping fees.
3.00%
p.a.
With our
180 day
term
deposit.
This offer is available on new to bank funds deposited by doctors,
dentists and vets for AUD savings between $10 000 and $5 000 000.
Apply now. Visit boqspecialist.com.au/deposit or call 1300 131 141
The issuer of these products and services is BOQ Specialist - a division of Bank of Queensland Limited ABN 32 009 656 740 AFSL no. 244616
(“BOQ Specialist”). Terms and conditions, fees, charges and eligibility criteria apply. Promotional interest rate of 3.00% p.a. for 180 days term deposits is
exclusively available for new funds to bank invested in a term deposit by clients deemed by BOQ Specialist, in its sole discretion, to be engaged in the
practice of medicine, dentistry and veterinary sciences. BOQ Specialist reserve the right to cease offering this interest rate at any time without notice.

Read the whole magazine - Australian Medical Association (NSW)

Transcription

Similar documents

Hotondo February Newsletter

21 Newsletter, Term3, Week 6 Week 34

Hotondo February Newsletter

RoboCam

Community Transport

The Old Bar Idol - Old Bar Public School

16 Term 4 Week 11 Week 51

Chris Geary - Harness Racing NSW

2009 Newsletter 4

Week 2 - Diocese of Wilcannia