October 2014 - Sunshine Coast Local Medical Association
Transcription
October 2014 - Sunshine Coast Local Medical Association
October 2014 NEWSLETTER 1 NEWSLETTER October 2014 SCLMA President’s Message ......... Dr Di Minuskin As promised in last month’s newsletter, I have returned with stories from the “Big Apple”. New York continues to be one of my favourite cities in the world to visit. th. On walking throughout the city, it was incredibly moving !" #$ There is a sense of looking out for one another, and as visitors, my friends and I were welcomed wherever we %& ' ( completion. The mirrored glass exterior creates the impression that clouds are passing though the building. It towers over a lower Manhattan that has somehow managed to achieve an unlikely marriage of beautiful Art Deco buildings and edgy modern design. 0" 1 waiting time for those who 1 0 " we were both concerned that the physiotherapist could “bump” a patient off the waiting list for a specialist opinion without discussion with the referring doctor. Back home, on the federal stage, it would seem the government has, at least for the present time, sent the issue of the “co-payment” to the sidelines. This is welcome news, although I would be much happier if the mentioned as being sidelined. )" # 3 "+ '1 Ian has graciously stepped in on my behalf on a number of occasions recently when I have been 0 '678 1# ' University to present the bursary to this year’s winner, Nina Molina. Thank you Ian for helping to raise the #'678 This example again highlights the importance of consulting frontline GPs when developing these new 1 contact details of a number of GPs who would like to be involved in future discussions. There are some very exciting prospects for bridging the moat that surrounds the “Black Box” on that hill in Nambour. # # # that metaphor, but often it seems patients enter into the # " ) # system, lots of things happen, and large amounts of tests debate in Australia in regard to “medical” marijuana, and data are accumulated. But like that elusion black it was interesting to note the more liberal attitude in this 5" #1# city with its “hippy” heritage. Right across the street extracting the information when the patient returns from our hotel was a medical marijuana clinic with the to primary care! In fairness, this is a two way street, # % * + ( ) and we, as referring GPs, need to write good quality of you who are wondering what was behind the green referrals that assist the hospital in both prioritising and door, I’m afraid I have no answer! treating our patients. On the local front, we are continuing to have meetings '00 #1 integrative model between primary care and the health 9 service. There is great promise into the future, that this Di Minuskin model of care may relieve some burden on the hospital system, whilst nurturing an environment where the GP The SCLMA and hospital are seen as members of the same treatment thanks 121 Sullivan 3 Nicolaides of issues. The Musculoskeletal/Physio route that may Pathology for the result from an orthopaedic OPD referral has helped distribution of # 1 the monthly newsletter. from nonsurgical intervention. Sunshine Coast Local Medical Association Inc Telephone (07) 5443 6990 Email [email protected] PO Box 549 Cotton Tree QLD 4558 Maroochydore www.sclma.com.au 2 NEWSLETTER October 2014 NOVEMBER 2014 NEWSLETTER CONTACTS: President and Vice President: Dr Di Minuskin Ph: 5491 2911 Deadline Date will be FRIDAY 14th Dr Rob Ingham Ph: 5443 3768 Secretary: Dr Wayne Herdy & AMAQ Councillor Ph: 5476 0111 Treasurer: Dr Peter Ruscoe Ph: 5446 1466 Newsletter Editor: Dr Marcel Knesl Ph: 5479 0444 Meetings Convenor: Dr Scott Masters Ph: 5491 1144 Hospital Liaison: Dr Jeremy Long Ph: 5470 5651 Committee: Dr Kirsten Hoyle Dr Denise Ladwig Dr Byron Oram Dr Mason Stevenson Dr Nigel Sommerfeld Dr Jenny Grew Dr Scott Phipps For general enquiries and all editorial or advertising contributions and costs, please contact: Jo Bourke (Secretariat) Ph: 5479 3979 Mob: 0407 037 112 Fax: 5479 3995 The Sunshine Coast Local Medical Association welcomes contributions from members, especially ‘Letters to the Editor”. Please address all correspondence to: SCLMA PO Box 549 Cotton Tree 4558 Email: [email protected] Fax: 5479 3995 Newsletter Editor: Email: Dr Marcel Knesl [email protected] NOVEMBER. The Editor would like the newsletter to reach all readers in the 3rd week of each month. So ... ALL reporters and advertisers - please help us achieve this challenge! Our circulation via email, post and courier (Sullivan Nicolaides Pathology) reaches approximately 800 recipients! Contact Jo: 5479 3979 Mobile: 0407 037 112 Email: [email protected] Fax: 5479 3995 :" and photos. If you are a new member, send in a short bio and a photo to introduce yourself. ARE YOU A MEMBER? If you are not a member please complete the application form available on the website: www.sclma.com.au. You will need two proposers to sign your application form. If this is a problem, come along to a monthly clinical meeting to introduce yourself Enquiries: Jo Ph: 5479 3979 or 0407 037 112 Email: [email protected] Are you listed on the Member Directory on our website? Are your details correct? Directory form available on the website. Disclaimer: The views expressed by the authors or articles in the newsletter of the Sunshine Coast Local Medical Association Inc. are not necessarily those of the Sunshine Coast Local Medical Association Inc. The Sunshine Coast Local Medical Association Inc. accepts no responsibility for errors, omissions or inaccuracies contained therein or for the consequences of any action taken by any person as a result of anything contained in this publication. If the question is print, design or websites the answer is Maroochydore October 2014 Welcome to the October edition of the SCLMA newsletter. September saw me visit Fiji. Over the past 12 months a small group of us have been exploring the concept of providing oncology services to the people of Fiji. The main hospital sits in the capital Suva. Nadi (nan-di) is the city most international tourists are familiar with. It is the international gateway into Fiji. These days’ two ?"@ 1)E8 Suva is a good 4 hours by car from Nadi. The main hospital is The Colonial War Memorial hospital known to locals as CWM. Built about 100 years ago it has undergone over the years several additions and renovations. Attached to the CWM hospital is the Fiji School of Medicine which is over 20 years old and currently graduates about 70 doctors per year through 799 1 3 #2"58 " '1#7" Nursing and Health Sciences. Currently oncology patients receive their basic chemotherapy at the hospital but then have to be sent to either India or in the past Australia or New Zealand for their radiotherapy. With a population close to 1 million and a steady increase in the diagnosis of oncology patients through education and screening this creates a costly exercise for the government. So I will keep working on this endeavour. )E " " cured in lemon juice overnight. An absolute delicacy and the ideal lunch dish especially in a hot and humid climate. NEWSLETTER 3 HIGHLIGHTS: P 5: Kevin Hegarty - Health Service Link P 7: Dr Shaun Rudd - AMAQ President P 8: Dr Sandra Peters GPLO Update P 9: Dr Ian Colledge - USC Bursary P 12-13: Medicare Local Report P 18-20: Dr Wayne Herdy - RACGP (UK) Conference, Liverpool P 23: Case Study - Sunshine Coast Radiology P 28: Christmas in July 2014 - photos SCLMA CLINICAL MEETINGS 6.30pm for 7pm (over by 9pm) THURSDAY 27 NOVEMBER 2014 Speaker: Dr Brenda Heyworth Topic: A Practical Approach to Diagnosis and Treatment in Child Psychiatry Speaker: Dr Erica Baer Topic: Child Protection Reforms what has changed and what hasn’t? Sponsor: The Property Clinic (Paddy Guildford) Venue: Maroochydore Surf Club (Nina Colina, SCLMA Bursary Recipient, USC will attend to give a brief overview of her study) ENQUIRIES: Jo Bourke Ph: 5479 3979 (M) 0407 037 112 Email: [email protected] Meeting attendance: • Free for current members. • Non members: $30. ($50 for Ebb) • Application forms available on night. • Membership forms also available on the website: www.sclma.com.au While sitting at “The Wicked ( E1 I came across a beautiful French quote which simply described the #1V %81X[ " in butter and then in white wine. Bon Appetite. One World Trade Centre NYC )E salad turn to our regular wine column and indulge in the Queen # "' Regards Marcel Knesl [email protected] Telephone (07) 5443 6990 Email [email protected] Maroochydore 4 NEWSLETTER October 2014 If the question is print, design or websites the answer is Maroochydore October 2014 NEWSLETTER 5 HEALTH SERVICE LINK October 2014 The Sunshine Coast Hospital and Health Service’s (SCHHS) second annual report released on 7 October 2014, shows another record performance. The report highlights the innovations and new approaches to the provision of patient care and is available for viewing at: http://www.health.qld.gov.au/sunshinecoast/annual-reports/default.asp Total hospital activity across the SCHHS in 2013-14 increased by 5% over last year. Our emergency departments provided care to over 115,000 patients - 7,000 more than the previous year. The SCHHS also responded to the continued growth in demand for elective surgery with almost 1.000 more cases performed than in 2012-13. The report also highlights the innovations and new approaches to provide patient care. One example, I mentioned in my May column, is the recently initiated ‘non-operational pathways’ to reduce the time patients have to wait before commencing treatment. The Orthopaedic Physiotherapy Screening Clinic has seen almost 50 patients each month and the Musculoskeletal Pathway of Care (MPC) over 100 patients each month. A care plan is established in consultation with each patient and sent to their general practitioner with recommendations. This has seen a marked reduction in the orthopaedic outpatient waiting list since these pathways commenced in March. Between 1 March 2014 and 1 July 2014, the number of category 2 patients waiting has decreased by 39%. Over the past year, 63 research projects were authorised to commence in the Health Service. This represents a 23.5% increase from the previous year, with the most significant increase occurring in relation to clinical trials. The Health Service has committed over $460,000 to operationally funded research support positions to be established in 2014. New liver scan technology is now available at Nambour General Hospital. The new FibroScan 502 machine can detect and monitor cirrhosis in patients with chronic liver disease. With the number of liver referrals received by the Health Service almost doubling in the past 12 months, this technology allows for quicker assessments. The examination is rapid and easy to perform, provides immediate results and serves as an alternative to invasive liver biopsies in suitable circumstances. Kevin Hegarty Health Service Chief Executive Sunshine Coast Hospital and Health Service [email protected] Telephone (07) 5443 6990 Email [email protected] Maroochydore 6 NEWSLETTER October 2014 Dr Janusz Bonkowski NEUROSURGEON & SPINAL SURGEON Specialising in: y Degenerative disorders of the spine y Microsurgical techniques in the management of spinal pathology y Anterior foramenotomy in cervical disc disease Local Care 07 5493 5100 Dr Terry Coyne NEUROSURGEON & SPINAL SURGEON FAX Dr Coyne visits SCUPH monthly and specialises in: y Cerebrovascular surgery y Skull base surgery 07 5493 6100 scbrainandspine.com.au y Spinal surgery y Movement disorder surgery IN PARTNERSHIP WITH Consulting at: Sunshine Coast University Private Hospital Medical Suite 11 3 Doherty Street Birtinya QLD 4575 Noosa Hospital Suite 4, Ground Floor 111 Goodchap Street Noosaville QLD 4566 PROUD SUPPORTER OF Newro FOUNDATION New Ideas New Research New Hope SSunsh u n sh un shine C Coast’s oa st ’s fifirr sstt res eeside s id ide de nt nneu e u roosu eu surge sur su ggeo e on an d spi s p i nal nnaall ssuu rge ggeo eon If the question is print, design or websites the answer is Maroochydore October 2014 NEWSLETTER 7 ! "#$% & '(( (% )*' %+%, '% - % .* *( % / (* 0(**%-(( *% ,* ( *((% /1* )% ,* *2%+* 3% ( % 4** ( %/*** ( )*( ( )% 5(*(3%5 ,* "#$%+((( (%/ "#$(((% & &6 ) Telephone (07) 5443 6990 Email [email protected] Maroochydore 8 NEWSLETTER October 2014 Public Health issues have been front and centre over the past few weeks in Queensland, with work being done on Ebola preparedness and most recently this week the news of confirmed measles cases in the Noosa region. The family concerned were unimmunised and travelled home from Indonesia whilst infectious to Brisbane airport on a Jetstar flight on 16th October. A further member of the same family had travelled earlier whilst symptomatic. We need to be mindful of the potential for secondary measles infection in patients presenting with appropriate symptoms at our practices any time after 18th October and over the next few weeks. With regards to Ebola preparedness there have been a number of enquiries over the past several days about flow for potentially infected patients in the SCHHS region. The SCHHS is establishing processes and protocols for patients in line with Queensland and Australian National Guidelines. As of 4pm Monday 20th October the advice to GPs should a symptomatic patient at risk of Ebola present at their practice is as follows • Isolate the patient as soon as possible, ensure staff utilise the standard PPE which you have available (it is my understanding that most practices have a box of PPE in readiness as part of Pandemic Planning recommended by RACGP at time of initial H1N1 epidemic, otherwise whatever you have and minimise contact with the patient). • Contact the Public Health Unit at Nambour for advice as to how to proceed. There is a Public Health physician available for advice at all times (24/7). QAS will transport patients who contact them directly with a history of travel in West Africa and symptoms to Nambour Hospital. • This advice will be updated weekly after each Reference Group meeting to ensure that local clinicians are kept well informed regarding local patient flow processes. The first such advice will be disseminated by Friday 24th October. Finally any GPs who would like to discuss how we might lobby for read only access to patient records once our HHS has an electronic medical record are invited to make contact with me as there will be a meeting early in November to discuss potential barriers and proposed solutions to this idea". Dr Sandra Peters GPLO SCHHS [email protected] Medical administration, 4th Floor, Block 3 Ph 07 5470 6541 Monday, Tuesday, Wednesday 8:30 - 17:00 If the question is print, design or websites the answer is Maroochydore October 2014 NEWSLETTER 9 University of the Sunshine Coast Scholarships Presentation Ceremony 26 September 2014 SCLMA Patron, Dr Ian Colledge, Patron attended on behalf of the Sunshine Coast Local Medical Association and delivered the following address .... ‘The Sunshine Coast Local Medical Association is pleased to be able to award this bursary to Nina Molina. Nina is a fourth year honours student of this university studying B of Nutrition and Dietetics. Her research project has been ‘The nutritional quality and marketing of children’s packaged food products available in Australia’. The dietary and health outcomes of this research are of great importance for us as a community. This E# #E##678 % ## "#( ?"" 811 # 19 "# 6789 # _' ##1 # 678" + ` ' ` 1 experience in Sports Medicine. She was tragically killed in a plane crash in PNG on her way to walk the Kokada track. Not only is Nina’s research project impressive but her academic achievements are also most impressive. She has achieved a Grade Point Average of 6.95. For those of us not familiar with *38" } 01 + + has an exceptional excuse for being unable to attend today. Having recently married she is on her honeymoon. The Local Medical Association has asked Nina to present a summary of her research to our members. ? '6781}~? 81 make formal acknowledgment of this award’.’ Ian Colledge Ian with USC’s new Pro Vice-Chancellor Students, Professor Karen Nelson Telephone (07) 5443 6990 Email [email protected] Maroochydore 10 NEWSLETTER October 2014 If the question is print, design or websites the answer is Maroochydore October 2014 Telephone (07) 5443 6990 Email [email protected] NEWSLETTER 11 Maroochydore 12 NEWSLETTER October 2014 SUNSHINE COAST MEDICARE LOCAL UPDATE Letter from the Board Chair – Dr Peter Dobson The most important event over the last month has been the announcement of the boundaries for the new Primary Health Networks (PHNs) which will replace Medicare Locals across the country in July 2015. The Sunshine Coast and Gympie fall into the Central Queensland and Sunshine Coast Primary Health Network. This region includes Sunshine Coast Medicare Local’s existing boundaries and also takes in the current Wide Bay and Central Queensland Medicare Local regions. The entire region starts as far south as Glasshouse Mountains and stretches north of Yeppoon; west beyond Emerald, encompassing Rockhampton, Hervey Bay, Maryborough, the Sunshine Coast Hinterland, Gayndah, Gladstone and Bundaberg. For more detail, visit the Department of Health website: http://www.health.gov.au/internet/main/publishing.nsf/Content/phn-locator The boundary for the Central Queensland and Sunshine Coast Primary Health Network will include the entire region of the Sunshine Coast Hospital and Health Service and we will continue our strong and productive relationship with them. Sunshine Coast Medicare Local is committed to the provision of primary healthcare and will continue to work in collaboration with Wide Bay and Central Queensland Medicare Locals. We look forward to continuing to support primary healthcare services for our communities now and into the future as we develop our tender for the Primary Health Network. In the meantime, SCML will continue to deliver services to our community as per our Annual Plan. SCML is dedicated to working with GPs and other health professionals in the region to ensure that the transition to the Primary Health Network runs smoothly with no disruption to patient care. Sunshine Coast Medicare Local Update – Pattie Hudson [email protected] It’s been a busy few weeks here at SCML, with lots of community activities around Mental Health Week and Carers Week. We are continuing to strengthen our practice support team to provide GPs with the support they need, and on that note, we are pleased to welcome Dr Jonathon Harper to the SCML team as our new GP Liaison Officer. Jonathon will join Zoltan in this role with a particular focus on engagement, communication and connectivity with GPs to improve the patient journey and experience across the hospital and primary care setting. Integration between the SCHHS and primary care is our main focus. Vanessa Lynn will be assisting to support the GPLOs and will also be available to support GPs directly in the area of system support including IT support, PKIs, eHealth, eReferral, MBS items and more. Dr Jonathon Harper can be contacted at the following [email protected] Vanessa Lynn can be contacted at the following [email protected] Practice Support Services – Jane Campbell [email protected] Medicare Local offers a range of programs and services for general practice. We provide practice visits to assist you with health data management including the use of the Clinical the Clinical Audit Tool (CAT) to address and manage the prevalence of some chronic conditions and to assist in the management of patients in high risk groups such as COPD, Asthma, Osteoporosis and Mental Health. We are pleased to advise that SCML has purchased the Pen Systems CAT Licence and is available to all General Practices on the Sunshine Coast and Gympie region at no cost. Please contact us to receive your Practice Agreement, new login/ password and installation (if applicable) from one of our Field Officers in your area: If the question is print, design or websites the answer is Maroochydore October 2014 NEWSLETTER 13 SUNSHINE COAST MEDICARE LOCAL UPDATE/ cont: Field Officers • • • • South and Hinterland Region- Clinton Bazley Central Region- Lou Collins Northside and Coastal Region- Vanessa Lynn Gympie and Noosa Hinterland- Maddie Stewart After Hours Services - contact Amanda Glenwright Aboriginal and Torres Strait Islander Support Closing the Gap Program - Henry Neill & Juanita O’Rourke Care Coordination and Supplementary Services (CCSS) Program- Bec Simpson Immunisation We provide orientation and data management workshops for practice nurses as well as resources and general information to assist your practice- contact Ashleigh Warren Mental Health Services Access to Allied Health Psychological Services (ATAPS) & Rural Mental Health Services (RMHS) delivered through Artius Ph. (07) 5443 2100 Partners in Recovery (Mental Health Care coordination - Judy Muirhead Ph 1300 747 724 Regional Outreach Services Please contact Corey Costello- Czok If you have any questions or wish to organise a practice visit please contact Sunshine Coast Medicare Local Ph. (07) 5456 8100. Communication with GPs – Jess Barr Until 2014, SCML was sending communications to GPs on an ad hoc basis, however in consultation with the GPLO, we determined that a weekly eNewsletter would be the key source of information for all practices. Primary Health Matters is SCML’s regular eNewsletter. It includes information about professional development and education, health vacancies in the region, updates from the GPLO and general news from the health sector. We endeavour to include all information in the one communication to avoid the “white noise” of multiple emails. All notices for general practices - from the HHS and Queensland Health in particular - will be included in Primary Health Matters. The only general communication you should receive from SCML will be Primary Health Matters and Urgent Public Health Alerts. We use email as our key preferred means of communication. It is reliable, gives readers immediate access to links and images, and allows us to track open rates of our communications, and ensures a faster, more efficient and more professional method of communicating. We suggest that you flag the importance of Primary Health Matters with your practice staff and encourage them to forward it to everyone in the practice, especially GPs to support effective internal communication. Please contact us on [email protected] to provide us with your direct email to ensure you don’t miss any communications from SCML. We welcome your feedback on our communications processes. Telephone (07) 5443 6990 Email [email protected] Maroochydore 14 NEWSLETTER October 2014 AFFORDABLE, ACCESSIBLE QUALITY DIAGNOSTIC SERVICE BULK BILLING * Same Day appointments available for X-Ray, Ultrasound, CT, MRI and Nuclear Medicine** “Excellence in Quality and Service” *FOR ALL MEDICARE ELIGIBLE SERVICES. SOME EXCEPTIONS APPLY. * *SOME EXCEPTIONS APPLY. Buderim Caloundra Maroochydore Noosa Sunshine Coast Hospital Medical Centre 18 Mayes Avenue Unit 1, Cnr Horton & Plaza Parades Noosa Private Hospital Pav A, 111 Goodchap St Ph: 5444 5877 Ph: 5438 5959 Ph: 5443 8660 Ph: 5430 5200 If the question is print, design or websites the answer is Maroochydore October 2014 NEWSLETTER 15 WWW.PACIFICRADIOLOGY.COM.AU Radiofrequency Ablation Pacific Radiology is pleased to expand our services, now offering Radiofrequency (RF) Ablation under CT and ultrasound guidance. RADIOFREQUENCY (RF) ABLATION It is a proven means of effectively providing › Chronic shoulder pain in patients lasting relief from chronic pain, and may with non-operative rotator cuff tears be of benefit to your patients with the (suprascapular nerve ablation) following symptoms/conditions: DR BYRON ORAM › Spinal Facet Joint pain (cervical, thoracic, and lumbar regions) Radiofrequency ablation at Pacific Radiology › Sacroiliac Joint pain is performed by Dr Byron Oram, a subspecialty › Occipital Neuralgia fellowship trained musculoskeletal radiologist, › Meralgia Paresthetica highly experienced in musculoskeletal and › Mortons Neuroma › Plantar Fasciitis spinal interventional procedures. › Chronic knee pain (Geniculate nerve RADIOFREQUENCY ABLATION CAN ablation) › Post traumatic/post surgical neuroma pain BE REQUESTED ON OUR STANDARD REFERRAL FORMS For more information, call us on 54092800, or visit www.pacificradiology.com.au Telephone (07) 5443 6990 Email [email protected] Maroochydore 16 NEWSLETTER October 2014 MEDICAL MOTORING with Dr Clive Fraser “Gain on disposal?” - Selling your car high Aussie dollar it’s never been cheaper to buy a new car. And after getting a great deal on the purchase price the cost of acquisition is further reduced by claiming back the GST and the very generous depreciation allowances provided by the ATO for business users. Until 31st December 2013 the accelerated depreciation meant business owners could claim $5,000 plus 15% of diminishing value every year thereafter. This arrangement was due to end with the passage of the Minerals Resource Rent Tax Repeal and Other Measures Bill 2013. As that Bill is not proceeding it looks like the generous motor vehicle tax deductions are still available. Those deductions have been so generous over the years that it was possible that your trade-in was still worth more than its depreciated written down value. When a car is sold for more than its depreciated written down value there is said to be a “gain on disposal”. That is some of the tax previously refunded will need to be re-paid. For taxation purposes this amount can also be off-set against un-deducted funds in the capital pool. Those un-deducted funds might relate to the purchase of a previous vehicle that cost more than the Luxury Car Limit which is currently $57,466. # ' buyer, test-drives, haggling and the annoyance of those who are just looking. But dealerships make a living from what they do and + All of those cheap new cars mean that used car values are also very depressed and there are really some great bargains out there for those with the time to shop around. A case in point is a colleague’s recent purchase of a new C Class Mercedes. He found that new car smell irresistible and the new ' '<= 2012 C Class. Anxious not to lose a sale on the new car the dealer warned my colleague that there would be no good news on the trade-in price with his current car having depreciated by 50% in only two years (ie much faster than the tax write-off). !" >? + advice. Low prices, long warranties and new technology really do make the arguments for trading up irresistible. But those of us who already have wheels will have to decide what to do with our current vehicle. Of course trading your car in will always be the easiest and most convenient option. The new C Class has gone up marginally in price, but it’s loaded with more technology, automated braking and is 100 kg lighter making the superseded model yesterday’s technology. To sweeten the deal the salesman offered to help my colleague sell his car privately. If the question is print, design or websites the answer is Maroochydore October 2014 NEWSLETTER 17 MEDICAL MOTORING /CONT .... with Dr Clive Fraser .... After all the Redbook said he’d be able to ask about $9,000 more than the dealer would offer and his old car was in pristine condition, still under the manufacturer’s warranty and had only 14,000 kilometres on the dial. My colleague left his car at the dealership for the morning and took a demonstrator vehicle for the day. It’s such a good car he might just change his mind and keep it after all. Safe motoring, Doctor Clive Fraser [email protected] The dealer at their expense did a safety inspection/ road-worthy ($77), detailed his vehicle, photographed it and up-loaded the details ($115) to one of those internet sites that’s sending printed newspapers broke. All was done and now he just had to wait for the phone to ring off the hook. Two weeks later. Perhaps the market for second-hand Mercs collapsed at the moment his vehicle’s details were up-loaded, but it is still for sale as this is written. Introducing new member ..... John Evans Radiologist and Nuclear Medicine specialist, Sunshine Coast Radiology + `21? 7## 1 '_ 3 0 # Coast Radiology but also visiting other branches. He also reads mammograms for Breastscreen Queensland. `1 # _ #" )28?'2 # 12' "@29 0 1 2 1 * 0 1 0? 7}# 13 85 0 8 0' 10 # 72"' 11 3 # }}}X ' including 10 years as manager of the practice. Other activities included supervising radiologist for Breastscreen "' " " 5 # `'_ ) # "`"#69"+ 1? X1 # # '" comprehensive imaging service at sunshine coast radiology in a new hospital complex came up the offer was too 1 ` # 1 in selection of imaging techniques. CURRENT SCLMA MEMBERSHIP IS 335!! Are your details correct on the SCLMA website? Download & complete the Directory Form and fax to 5479 3995 Telephone (07) 5443 6990 Email [email protected] Maroochydore NEWSLETTER October 2014 18 ROYAL COLLEGE OF GENERAL PRACTITIONER (UK) CONFERENCE, LIVERPOOL. OCTOBER 2014. Wayne Herdy This year, instead of treading the more accustomed conference trail, I attended the RCGP Conference in Liverpool, interested to compare the similarities and differences between us and the Brits. Although a GP conference, there were a lot of messages and warnings for Australian specialists as well. Funded by a large subscription base (there were 1700 attendees), it was a very professionally run conference which puts to shame the country-cousin conferences that I have attended on my home soil. Except for the catering, which was appalling (I recall the joke about Hell being a place where, inter alia, the cooks are English). 1. MINISTER FOR HEALTH. The opening plenary session included an address from the Right Hon Jeremy Hunt, Secretary of State for Health (translated, Minister for Health). There were no surprises, but a few cautionary tales for Australia. His '"# over the next few days. Most of his messages could have come from Australia, with a change in the position of the decimal place in the numbers (and deleting his references to NHS contracts). GP shortages, not enough money (but his portfolio was one of the few that is not shrinking its budget), GP burnout, not enough undergraduates [\ the ageing demographic of existing GPs, etc, etc. The word “capacity” kept echoing through his talk and those of many later speakers. I was bemused that their near-equivalent problem with itinerant populations included Gypsies and sex workers. An interesting statistic was that there is an 18-year gap in life expectancy between the lowest and highest socio-economic groups (another speaker cited a peak 27-year difference in Scotland). I could not help but compare the 17-year gap between indigenous and non-indigenous Australian life expectancy. The NHS is having another (probably futile) attempt at addressing the problem of after-hours service delivery. Locum services just haven’t caught on, because of the funding arrangement based on capitation rather than fee-for-service. The new experiment is in “federations”, basically cooperatives allowing groups of practices to share an after-hours roster. Patients will not necessarily see their own GP, but - and my " ][\' to the patient’s computer-based record held by another practice. The UK does not have a complete SEHR, but this proposal assumes that data-sharing will occur. On the issue of the “GP shortage”, he recognized that much of the problem is maldistribution rather than shortage. He has commissioned a study to determine what numbers of GP’s are needed and, interestingly, which areas have worst GP-patient ratios. It came as Excitingly, he recognized at several points in his a surprise to me that the UK NHS is so late coming to ] ' this. From other delegates, I got mixed messages. All 80% of NHS services are provided by GPs who cost [\ just over 8% of the NHS budget (and that percentage recruiting and retaining partners, and some described ^ [\ not getting home until 10pm some nights, but most effective way of keeping patients away from more grumbled about the onerous workload of their 40-hour expensive services. week. Excuse me? Some differences were outstanding. The assumption that nurses of various calibres were established as part of the primary care team is now well entrenched, with the assumption extending to nurses not employed by the practice. The next day, the Welsh Minister for Health !]<= leave the less complex tasks for advanced care nurses. I see much merit in this concept. GPs should be doing wasting time on the simple stuff that clinical assistants can do, as long as they are doing it at our direction and under our supervision. Britain has no problem of indigenous health disparity, but they do address social inequalities. He discussed transparency as a desirable aspect of the NHS. So far, so good, but he later went on to propose that “transparency” should include publication of doctors’ incomes. The rationale was supposedly to dispel urban myths about doctors’ incomes, the perception supposedly being that they are paid much more than they really are (average seems to be around GBP100,000 pa). Even if this is true, Australians would be profoundly disturbed by the potential invasion of privacy. Yet this proposal did not raise a murmur from the audience nor attract a single comment at question time. I remain bemused by the cultural difference that Brits have come to just accept proposals that would excite outrage in Australia. If the question is print, design or websites the answer is Maroochydore October 2014 NEWSLETTER 19 ROYAL COLLEGE OF GENERAL PRACTITIONER (UK) CONFERENCE, LIVERPOOL. OCTOBER 2014. Wayne Herdy ` ` ] hospital-based community care, which appears to include a presumption that GPs would eventually be managed by hospitals. He opposed this concept, but it seemed to be accepted by the audience that hospitals had a right to adopt such a role. In what I took to be a slip, he referred to doctors as included among “other public servants”. There was no gasp from the audience, nor any challenge during question time (a vigorous question time in which he was, on another topic, called a liar). Although GPs here are not public servants, they seem to be resigned to the fact that they are indeed government employees + 2. CEO OF NHS. The plenary session on Day 2 featured Simon Stevens, the Chief Executive of NHS England, who has only just taken up his 5-year appointment. From the start of the day, I observed that his attendance attracted a higher level of security than did the attendance of the Secretary for State the previous day. He also attracted a protest by doctors in scrubs and masks at the entrance to the convention. It seems that the senior salaried public ' { ] !' |} and power than the elected representatives. Maybe he was being politically correct and Britishly polite, but he reiterated that it was time to take seriously the role of the GP. He described as “madness” the fact that in the past decade the NHS had seen an increase of 21% in the numbers of GP’s but an increase of 76% in the numbers of hospital doctors. Divisions of General Practice but with genuine involvement of virtually 100% of practices, and directing funding for elective hospital admissions. This of course is fundholding. At least it remains doctor-controlled. Workforce and workload planning needs to take into account the changing demographic of GP’s, the increasing numbers of females, salaried, part-time and sessional doctors, and individual desires for career mobility. The NHS has simply failed to keep up with social changes which the Australian system accommodates comfortably. The changes that he had in mind related to NHS contracts and remuneration, which don’t translate directly into the Australian environment. The NHS has to support new models of care. While " diversity and adaptability are presently poorly supported. While he paid lip service to independent practice, he appeared to favour a system that was ever closer to salaried practice. He spent some time discussing the emerging force of “federations”, mergers of practices, and expressed a view that larger federations might ' + ] federations are a newcomer on the NHS scene and seem to be gathering some momentum. Shades of the New Zealand experience! He predicted a need for changed relationships with patients. This gave me much food for thought, mostly trying to read between the lines what he actually envisaged that he failed to verbalize. While I grew up ~' + in a familiar but ever-changing system, I am fond of the The need to stabilize GP funding. The NHS has old doctor-patient therapeutic alliance, and I would have engaged in a series of funding experiments but not as much trouble as any traditional GP would have in given enough time for any of them to make a real +~ difference. This is a typically British solution to a example was that patients should go to a pharmacy for ] ' ' it with the same people in the same building with the instance for respiratory infections. Translating this into same infrastructure. Australian GPs are familiar with the Australian environment, that simple example raises controversies. I have to agree that most patients with "] RTIs don’t need to see a doctor, but we are currently nurse SIP to a more limited PIP, and its effect on our in a multi-levelled turf war and are reluctant to yield + any ground to pharmacies, no matter how small, and we believe that most OTC cough and cold remedies He says that GPs should have more clout in planning. don’t do much good anyway. But I don’t think that this He stated that doctors, through CCGs, already control 2/3 was all he had in mind when he listed changed patient of the NHS budget. CCG’s are Clinical Commissioning ' + Groups, devised in 2012 when they replaced Primary Care Trusts. (“Commissioning” means “purchasing”.) /cont: next page ..... Translate CCG into something like the old Australian Telephone (07) 5443 6990 Email [email protected] Maroochydore 20 NEWSLETTER October 2014 ROYAL COLLEGE OF GENERAL PRACTITIONER (UK) CONFERENCE, LIVERPOOL. OCTOBER 2014. Wayne Herdy We might have got more of a clue at the end of the day when the Welsh Minister for Health and Social Services, Prof Mark Drakeford, spent some time expounding the hypothesis that the traditional model of transferring responsibility from the patient to the therapist does not work. This strongly suggests a developing policy of making patients take some responsibility for their health outcomes. It is also consistent with evidence cited repeatedly during the conference that health interventions are only responsible for 20% of the changeable component of health outcomes, compared with 40% contribution by social and lifestyle interventions. 3. OTHER SPEAKERS. The Care Quality Commission was prominent. The CQC conducts periodic inspections of practices, comparable with our GP practice accreditation process. However, the inspections are random rather than scheduled, and over 45% of practices are inspected in any 12-month period. Practices are given 2 weeks’ notice of an impending inspection, but inspections can occur at zero notice if concerns are raised. Anybody can raise a concern. The CQC only looks at structure and administration of practices (appointment schedules and access and so on) and not at clinical competence (that is left to the GMC). They issue publications telling patients what to expect of their doctor’s practice (but not so much what to expect of the doctor). They aim to ensure quality and safety, but describe themselves more broadly as “the independent regulator of all health and social care services in England” (not the entire UK?). CQC was formed in 2009 by the merger of precedent bodies, has only been operating its present functions for about 2 years, and so far it claims that its role has been benign. However, a review of its website shows that about one in 3 inspections yields a “needs improvement” rating. A failure presumably carries penalties of loss of NHS funding. British doctors just seem to accept that the CQC has such potentially punitive force and powers. It takes little imagination to predict that such an organization could works its ways in a much more Draconian and authoritative manner. Several speakers throughout the conference reinforced what I already knew, that British GP’s just do not have the close personal relationship with their patients that we do. This outcome is counter-intuitive, since UK patients are more or less restricted to attending just one practice. Doctor shopping is possible, but not as readily facilitated as under Australian-style Medicare. Despite ` ' GP, we still have what looks like a more personal and intimate relationship with our regular patients. With all due respect to my UK hosts, I cannot help but wonder how much of their perceived inability to provide a personal relationship arises from their entrenched mentality that their GPs are really de facto public servants who work a 40hour week and do not expect to do anything above and beyond average-level care. One outstanding cultural difference struck me. British GP’s are surprisingly reluctant to raise with their patients the question of obesity and weight management. As far as I am aware, Australian GPs are not overly sensitive about asking patients to stand on scales. I attended a session on telephone triage, expecting something like 1300HEALTH. In fact, this is triage by [\ +# NHS permits GPs to perform telephone consultations, which resolves something like 60% of patient encounters within less than 5 minutes. The process substantially reduces the number of face-to-face consultations and dramatically reduces wait times for the next appointment. Surprisingly, patient continuity improves. This suggests an argument in favour of Medicare schedule rebates for telephone consultations, and a partial answer to the perceived GP workforce shortage. Other speakers raised themes familiar to Australians: GP-bashing, the need to do more and more with less and less, a 3-week wait for a routine appointment, falling job satisfaction. A session on comparison of many health systems world-wide determined that the best health outcomes will always result in systems that deliver health care at a point closest to where it is needed. Around the world, community-based primary care remains the gold ' + \ the world over are slowly recognizing the value of primary care. ` ' that the UK NHS was the best system in the world and the envy of other nations. Sorry, mates, but I just don’t see that. Their wait times are the same as ours, their consultation times are shorter, their access hours are much shorter, they have much narrower scopes of practice, and despite their bleatings I cannot see that they have the personal relationship that I have with my patients. They repeatedly cite high levels of patient satisfaction as proof of their success, but is that ' ` outcomes are better, our life expectancy is longer than theirs, achieved with a much lower percentage of GDP. I came home with the self-righteous belief that Australia still has one of the best health systems in the world. If the question is print, design or websites the answer is Maroochydore October 2014 NEWSLETTER 21 Every step could be doing you damage. We fix your feet – for life. We use new patented evidence-based Orthotic Technology! Guaranteed Outcomes • Evidence-based research in Biomechanics and Kinetic Orthotic therapy • Leading therapeutic technology including: 1. 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All EPC patients Bulk Billed www.daneverson.com.au Telephone (07) 5443 6990 Email [email protected] Phone: 1300 130 410 Maroochydore 22 NEWSLETTER October 2014 3D Traditional Mammogram 3D Tomosynthesis Mammogram The Smarter Choice in Breast Imaging The 3D mammogram identified 40% more invasive breast cancers and 29% on non-invasive cancers. • Greater accuracy for easier and earlier detection Breast Cancer poorly demonstrated Same breast cancer more obvious on 3D tomosynthesis • • More clarity More confidence Services X-Ray ¦ Cardiac CT ¦ Calcium Scoring ¦ CT ¦ 2D / 3D Mammography ¦ Interventional/Procedures ¦ Ultrasound ¦ MRI Nuchal/Obstetrics ¦ Echocardiography ¦ OPG ¦ PA / Lat Ceph ¦ Bone Densitometry ¦ Cone Beam CT ¦ Nuclear Medicine Sunshine Coast University Private Hospital (SCUPH) 3 Doherty St. Birtinya, QLD 4575 [email protected] www. scradiology.com.au For all Appointments Call 07 5430 3900 Your local imaging specialists If the question is print, design or websites the answer is Maroochydore October 2014 NEWSLETTER 23 Prostate THE CHANGING FACE OF PROSTATE IMAGING CONVENTIONAL EVALUATION OF A PATIENT SUSPECTED OF HAVING PROSTATE CANCER PROSTATE CANCER EVIDENCE BASED PRACTICE 1. Development of prostate MR imaging is an ongoing process that includes both technical and clinical aspects. 2. MRI at 3.0 T provides images with higher signal to- noise ratios and this increase in signal-to-noise ratio removes the need for the endorectal coil, leading to better patient acceptance and lower costs. 3. The recently proposed ESUR Prostate MR Guidelines and the PI-RADS scoring system represent an landmark step toward universal standards in prostate cancer detection and evaluation. 4. Anatomic high-resolution T2W imaging also correlates with tumor aggressiveness. Wang and colleagues showed that the tumor-tomuscle signal intensity ratio on the T2W images in the peripheral zone has an inverse correlation with the Gleason score. Thus, lower signal intensity on the T2W images means a more undifferentiated tumor Wang L,MazaheriY, ZhangJ, et Radiology 2008;246(1):168‒76. 5. A good correlation was recently demonstrated between washout gradient and the Gleason grade. In a study of 56 patients, using prostatectomy specimens as the reference standard, Hambrock and colleagues demonstrated that ADC can discern low-grade from combined intermediate-grade and high-grade lesions with an AUC of 0.90. Radiology 2011;259(2):453‒61. SHORTCOMINGS OF THE TRADITIONAL APPROACH 6. Recent study compared the performance of systematic and mpMR 1. Low positive predictive value of DRE (digital rectal examination). imaging/TRUS fusion-targeted biopsies in 195 patients with a previous 2. PSA levels correlate with cancer risk but no threshold provides with negative transrectal biopsy and reported that none of the high-grade an acceptable combination of sensitivity and specificity. Up to 32% of tumors were missed by targeted biopsies whereas approximately half men with positive biopsies have PSA levels lower than 4ng/ml and were not detected by systematic biopsies. Vourganti S, Rastinehad A, upto 79% of men with PSA serum levels higher than 4.1 ng/ml do not Yerram NK, et al.. J Urol 2012;188(6):2152‒7. have prostate cancer. 3. Systematic random TRUS-guided biopsies sample only a small fraction of the prostate and are known to give false-negative results in a significant number of patients, often requiring repeated biopsy procedures, which are associated with discomfort and potential morbidity. EMERGING TECHNIQUES IN EVALUATION T2W, DWI, ADC MAPS AND POST CONTRAST IMAGES SHOW A MITOTIC LESION IN THE ANTERIOR ASPECT OF THE PROSTATE GLAND WHICH WOULD BE EASILY MISSED ON DRE/TRUS BIOPSY/STAGING MR PROTOCOL. MULTIPARAMETRIC MR COULD ACT AS A SCREENING AND STAGING TOOL IN THIS CASE AND GUIDE BIOPSIES TO THE APPROPRIATE AREA www.scradiology.com.au -October 2014 REFERENCES http://radiopaedia.org/articles/spinal-myxopapillary-ependymoma Your Local Imaging Specialist Telephone (07) 5443 6990 Email [email protected] Maroochydore 24 NEWSLETTER October 2014 If the question is print, design or websites the answer is Maroochydore October 2014 NEWSLETTER 25 A BETTER WAY TO GO Attention business owners! Did you know that as a director of a registered business entity, a corporate travel policy is valid for both your business and your leisure travel? The cover can also include additional business executives and other employees on the move. While many entry-level travel insurance policies contain various exclusions that can leave travellers exposed, Corporate Travel products offer comprehensive cover for the business traveller. Depending on the plan and level of cover required, most Corporate Travel Insurance policies will cover you for: • • • • • • • • • • Emergency hospital and medical expenses (usually unlimited) Medical repatriation / evacuation Money Replacement of lost travel documents and luggage Accidental death, disability and loss of income Hire car excess Travel disruption, cancellations, loss of deposits Lost, stolen or damaged baggage Kidnap and ransom Personal liability during your travel A cost effective, single annual policy takes care of all trips by the frequent business traveller, and nominated additional travellers, within the policy period. No longer do you need to think about travel insurance every time you plan a trip. Buy once, then forget it and travel with peace of mind knowing you’re covered for just about any eventuality. The benefits go well beyond cover offered by a retail or credit card travel policy. As well as the professional service you would expect, there are significant benefits in Corporate Travel cover including coverage for preexisting conditions and cover for travellers over 65 years of age. Upper age limits vary from underwriter to underwriter. To obtain a quotation or further information on Corporate Travel Insurance, contact Jennine Sellers at Poole General Insurance Brokers. Ph: 07 5437 9900 Email [email protected] Telephone (07) 5443 6990 Email [email protected] Maroochydore 26 NEWSLETTER October 2014 If HRH Elizabeth was a wine, she would be Chardonnay > } ' + { \ the viticultural landscape. It is widely known and grown in Margaret River and Adelaide Hills shine as producers. Old and New world areas. Its spiritual home is Burgundy So I think my analogy with a HRH Liz is apt; Aristocratic, but is found in most new world areas. well presented, pure lineage, powerful, assertive, often It can be a work horse and produce quantity or it can be diplomatic, re-emergence of royal family popularity etc. But tamed and coaxed out of its shell and become some of avoiding those nasty upstart cheap overdone imitations?? the most sought after wines in the world, e.g. Premier Cru Burgundy. If raised in an austere climate, tighter acidity Wines Reviewed. with green apple and pear aromas develop. Warmer 2012 Kooyong Clonale Chardonnay Yarra Valleyclimates bring out tropical and peach characteristics; even COLOUR- light green/yellow. NOSE- Nectarines, + " + PALATE- surging quality fruit with good acidity Some unwooded Chardonnay exists but its marriage with + + ~' oak raises it to another level. Toasty buttery characteristics sheep’s cheese. develop depending on age and type of French oak used. It can undergo malo-lactic fermentation which softens the 2013 David Franz Brother’s Ilk Adelaide Hills acidity and it can have Lees contact to add nutty meaty Chardonnay- COLOUR- medium yellow. NOSEcharacteristics. ' and funky yeast. PALATE- generous fruit, mid palate It can be blended with other whites such as Semillon or citrus like acidity with a lingering taste supported by Colom bard. It is a principal grape in Champagne, supplying creamy mouth feel. Excellent drink now or cellar 5 " ' plus years. I had with spaghetti carbornara. Pinot Meniere and Pinot Noir contributions. The occasional dessert wine has been made from the botrytis effect in 2013 Holm Oak Chardonnay Tamar Valley cooler climates. Tasmania- COLOUR-elegant pale green/yellow. NOSE- white peach, apricots, hints of grass, lemon DNA analysis proves a relatively pure hereditary line. It notes. PALATE- New age style of cool climate origin, comes from the Pinot and Gouais Blanc cross. Romans ' + bringing Gouais Blanc to France and the French allowing "' ! +\ the cross breeding to happen. This has resulted in vigorous growth characteristics and relative hardiness. 30 plus 2011 Mountadam Eden Valley Chardonnay clones have been developed from the University of Dijon | + \``# allowing growth diversity. Chardonnay has been crossed spicy oak notes. Hints of citrus (grapefruit), with with other species as well. creamy cashew aromas. PALATE- Well balanced fruit with a mineral like feel and acidity. A complex Chardonnay was brought to Australia in 1832 by Pioneer long-lasting wine. I had with smoked ocean trout. +> ~ most wine geographes in Australia. Terroir and winemaking techniques have resulted 3 styles. Early picked cool climate Dr Plonk. Chardonnay with minimal malo-lactic fermentation, older oak and no lees contact results in the new Australian style. Ironically it mimics the mineral steely Chablis. More ripened fruit with new French Oak, Lees contact, full malolactic ferment have resulted in the 80’s style , often described as voluptuous and buttery Chardonnay. Jacobs Creek Chardonnay put Australian winemaking on the map with phenomenal success in England. In the 80’s there was a Chardonnay shortage. With the heavy style falling out of favor, vine pull occurred. The third style is somewhere in the middle and to me represents a more Burgundian style. A more palatable If the question is print, design or websites the answer is Maroochydore October 2014 NEWSLETTER 27 Sunshine Coast Hospital and Health Service Hospital in the H ME al in the Home (HITH) is a new Hospital servicee being offered by the Queensland Government and the Sunshine Coast Hospital and Health Service (SCHHS). HITH involves the provision of acute care at a patient’s usual place of residence as a substitute for inpatient care at a hospital. HITH is a priority commitment for the Queensland Government. The government’s Blueprint for better healthcare in Queensland, launched in 2013, encourages the increased use of HITH. Several national and international reviews have prompted the use of HITH as a model that: their care HITH consists of a virtual ward where the patient is of care. Silverchain HITH team and their partners provide 24 hour a day hospital-level care, within their home environment. Admission to these virtual beds is under the ! " via telehealth or as a scheduled clinic review. Admission criteria encompass clinical, social and service # HITH model of care include: cellulitis, pulmonary embolism, urinary tract infections, respiratory infections and venous thrombosis. Silver Chain Ph: 1300 466 346 Hospital in the home guideline including: condition at home treatment plan and conducting medical reviews an interpreter or nominated guardian $ credit and service if mobile environment for care external to the hospital ! The HITH program will focus on the transfer of care, continuum of care is provided. A discharge summary will be sent to the regular treating general practitioner on discharge from HITH. There are statewide key performance indicators to monitor the success of the programs and identify areas of improvement. Sandie Pott " %&$! Ph: 0407 762 386 ' ' ''**+/5 Great state. Great opportunity. Telephone (07) 5443 6990 Email [email protected] Maroochydore 28 NEWSLETTER October 2014 PELICAN WATERS GOLF RESORT - 19 JULY 2014 If the question is print, design or websites the answer is Maroochydore October 2014 NEWSLETTER 29 Burgundy – France ….. A relaxed and serene holiday amid beautiful valleys and scenic backdrops with a glass of world famous wine in your hand; and plenty of things to keep you engrossed while you are vacationing at this most prosperous region of France, it is none other than Burgundy! A local region of east central France and south east Paris, Burgundy is abundant in natural beauty and rich historical architecture offering beautiful roman churches, castles, and buildings. Not to forget, its world famous wines too. For Wine Lovers From the world famous wines like Vosne-Romanee, Chablis, Rully and Pouilly Fume, you get to taste them and experience a lovely walk through the vineyards while you relish the taste and magnificent landscapes. Wine experts make your wine tasting experience even better by sharing the secrets of their vineyards and wines. As the wine routes are dotted with restaurants, there is plenty for you to stir up your taste buds! For Nature lovers The Morvan National Park is the place to be if you admire nature and want to spend time with natural beauty all around you. From the beautiful singing rivers to lush green rolling hills and calm lakes, this park is a must-visit for nature admirers. Some of the must-do activities include fishing, mountain biking, horse riding, or simply getting lost in the natural beauty! History and Architecture-bring it on! Burgundy brings to you bountiful of history from the Paleolithic period to the Glorious age, showcasing the historical richness in its Abbeys and churches, Chateaux, medieval villages, and museums. Home to Gothic and Romanesque architecture, L’Abbaye de Cluny, St. Lazare, and Basilique Sacre-Coeur, Paray le Monial are not to be missed. A visit to Brancion, the most real medieval village will awe you with its beauty and mystery. Burgundy has plenty of Chateaux in parkland open for visitors all through the year. Some of the must visit include Bussy- Rabutin, Cormatin, and the military glory of Marshall. There are many museums that show case motorbikes, aircrafts, and the Resistance movement. A must do on itinerary for people of all ages! Some of them include Chateau de Savigny-les- Beaune, Bibracte, and Musee des Beaux-arts! We have highlighted the must-do things for you to ensure you get the best holiday experience in Burgundy: • • • • Visit Beaune: The capital region of wine in Burgundy that offers many mesmerizing wine tasting tours through the vineyards of Beaune. It is a best place to taste wine in the entire France. And, how could we miss it? Within a short distance of Beaune lie Chateau de Pommard and Chateau de Meursault showcasing cellars and bottles with some of the prestigious white wines. Delight for wine lovers indeed! Pamper your “old soul” by visiting some of the best medieval villages of Burgundy. The ones on list include: Montreal village, on the brink of a hill that overlooks the beautiful Serein valley and Brancion with a castle on its entrance looks picture perfect! Rent a boat and go on a Saone river cruise to enjoy the mesmeric beauty all around and enliven all your senses. www.123Travelconferences.com.au Telephone (07) 5443 6990 Email [email protected] Maroochydore 30 NEWSLETTER October 2014 TAKE FIVE ......... To ponder ...... ` ' +~ " ! BUT he knew that he was not speeding. In Washington DC, at a Metro Station, on a cold January morning in 2007, a man with a violin played six Bach pieces for about 45 minutes. Just to be sure, he went around the block and passed the same spot again driving even more slowly, but again the camera + During that time, approximately 2,000 people went through the station, most of them on their way to work. He began to think that this was quite funny, so he drove even +~ +~ as he rolled past at a snail’s pace. #" '" ' a seat belt. After about 3 minutes, a middle-aged man noticed that there was a musician playing. He slowed his pace and stopped for a few seconds, and then he hurried on to meet his schedule. About 4 minutes later : #' ' +` hat and, without stopping, continued to walk. At 6 minutes: A young man leaned against the wall to listen to him, then looked at his watch and started to walk again. Poor old man The rain was pouring and there was a big puddle in front of the pub. A ragged old man was standing there with a rod and a string hanging into the puddle. A tipsy- looking, curious gentleman came over to him and asked what he was doing. ‘Fishing,’ the old man said simply. ‘Poor old fool,’ the gentleman thought and he invited the ragged old man to a drink in the pub. As he felt he should start some conversation while they were sipping their whisky, the gentleman asked, ‘And how many have you caught?’ ‘You’re the eighth,’ the old man answered. The Grandmother of all Blonde Jokes: This blonde decides one day that she is sick and tired of all these blonde jokes and how all blondes are perceived as stupid So, she decides to show her husband that blondes really are smart. While her husband is off at work, she decides that she is going to paint a couple of rooms in the house. The next day, right after her husband leaves for work, she gets down to the task at hand. Her husband arrives home at 5:30 and smells the distinctive smell +~"' + ~ heavy parka and a leather jacket at the same time. He goes over and asks her if she if OK. She replies yes. He asks what she is doing and she replies that she wanted to prove to him that not all blonde women are dumb, and she wanted to do it by painting the house.. At 10 minutes: A 3-year old boy stopped, but his mother tugged him along hurriedly. The kid stopped to look at the violinist again, but the mother pushed hard and the child continued to walk, turning his head the whole time. This action was repeated by several other children, but every parent - without exception - forced their children to move on quickly. At 45 minutes: The musician played continuously. Only 6 people stopped and listened for a short while. About 20 gave money but continued to walk at their normal pace. The man collected a total of $32. After 1 hour: ~"' + one applauded. There was no recognition at all. No one knew this, but the violinist was Joshua Bell , one of the greatest musicians in the world. He played one of the most intricate pieces ever written, with a violin worth $3.5 million dollars. Two days before, Joshua Bell sold-out a theater in Boston where the seats averaged $100 each to sit and listen to him play the same music. This is a true story. Joshua Bell, playing incognito in the D.C. Metro Station, was organized by the Washington Post as part of a social experiment about perception, taste and people’s priorities . This experiment raised several questions: • In a common-place environment, at an inappropriate hour, do we perceive beauty? He then asks her why she has a parka over her leather jacket. She replies that she was reading the directions on the paint can and it said... “For best results, put on two coats!” • If so, do we stop to appreciate it? • Do we recognize talent in an unexpected context? Phone call • If we do not have a moment to stop and listen to one of the ever written, with one of the most beautiful instruments ever made . . .. • How many other things are we missing as we rush through life? A woman is in bed with her lover - her husband’s best friend. During sex the phone rings. Because it’s the woman’s house, she reaches over and picks up the receiver. The guy listens in only hearing her side of the conversation. She is speaking in a cheery voice. “Hello? Oh, Hi! So glad you called. Really?... One possible conclusion reached from this experiment could be this: #? >? + +[ Thanks! Okay. Bye-bye.” She hangs up the phone and the guy asks, “Who was that? “My husband, telling me what a wonderful time he’s having on his += Contributions always welcomed for this page! If the question is print, design or websites the answer is Maroochydore October 2014 SUNSHINE COAST LOCAL MEDICAL ASSOCIATION Inc. MEMBERSHIP APPLICATION NEWSLETTER 31 ABN: 56 932 130 084 Enquiries: Jo Bourke Ph: 5479 3979 Mb: 0407 037 112 Email: [email protected] Surname: NAME First Name: EMAIL: PRACTICE ADDRESS: This is for delivery of your monthly invitation and monthly newsletter by Couriers from Sullivan Nicolaides Pathology thus avoiding postage costs to the SCLMA. Practice/Building Street: Suburb: Postcode: Phone: ALTERNATE ADDRESS: (if practice address not applicable) Fax: Street: Suburb: Postcode: Phone: PRACTITIONER DETAILS: Qualifications: Date of Birth: Year of Graduation: Hospital employed / Private Practice (cross out one) General Practice / Specialist (cross out one) Area of Speciality: PLEASE NOTE: Retired doctors who wish to join the Association are required to attach a letter of good standing from their respective College. PROPOSERS: (to comply with the Queensland Associations Incorporation Act, two financial members of the Association are required to nominate each applicant for new membership. Members renewing their membership do not need proposers). 1. NAME: Signature: 2. NAME: Signature: ANNUAL SUBSCRIPTION (GST included): (Please tick) DELIVERY OPTIONS Full-time ordinary members - GP and Specialist $ 55.00 Your Monthly Invitation Doctor spouse of full-time ordinary member $ 22.00 By Email? Absentee or non-resident doctors $ 22.00 By Courier? Part-time ordinary members (less than 10 hours per week) $ 22.00 By Post? Non-practising ordinary members, under 60 years old $ 22.00 Your Monthly Newsletter Residents & Doctors in Training Free By Email? Non-practising ordinary members, over 60 years old Free By Courier? Patron and honorary members Free By Post? Payment can be made by cheque payable to SCLMA or by direct debit to the SCLMA Westpac Account. BSB: 034-243 ACCOUNT NUMBER: 11-9298 A TAX RECEIPT WILL BE SENT FOR YOUR RECORDS. Please return this form with your cheque OR details of your E.F.T. to: SCLMA PO BOX 549 COTTON TREE 4558 Please note: Membership applications will be considered at the next Management Committee meeting. The Sunshine Coast Local Medical Association has Public Liability Insurance Telephone (07) 5443 6990 Email [email protected] Maroochydore 32 NEWSLETTER October 2014 SUNSHINE COAST LOCAL MEDICAL ASSOCIATION MANAGEMENT COMMITTEE MEETING THURSDAY 28 AUGUST 2014 Maroochydore Surf Club Function Room, Maroochydore MINUTES (Accepted at Committee meeting 25 September 2014) The meeting opened 1810. Attendance: Drs Di Minuskin, Rob Ingham, Peter Ruscoe, Kirsten Hoyle, Wayne Herdy, Marcel Knesl, Jeremy Long, Byron Oram , Mason Stevenson and Jo Bourke (Observer). Apologies: Drs Scott Phipps, Denise Ladwig and Fiona McGrath. Minutes of last meeting: 24July 2014. The Minutes were accepted as a true and accurate record. Moved: Rob Ingham. Seconded: Kirsten Hoyle. Business arising from Minutes: Nil Business arising from Correspondence: • Scott Masters to contact Karl Schulz as speaker and ^ attend as President of AMAQ. Treasurer’s Report : Dr Peter Ruscoe Accounts to be paid: • ` \]` • |] • ]` • "] • "] ` • "][] • \ ] `>' • \ ]` • ~"]` ] ^ • `]` • # ]` + Dr Peter Ruscoe moved… ‘that the Treasurer’s report be noted and that the payments be approved’. Seconded: Wayne Herdy. Carried. President’s Report: Dr Di Minuskin. • There has been further discussion with HHS re direct communication with GPs. Dr Sandra Peters is working on establishing a data base of email addresses directly to GPs. • Invitation extended to HHS to discuss HHS / Primary Care interaction. This was accepted and Kevin Hegarty and Dr Piotr Swierkowski are speaking at (b) Membership Report. tonight’s meeting • > { ] • No new members particularly inspiring. He seemed committed to • Current membership is 316 copayment, whilst acknowledging our concerns. AMAQ Councillor’s Report: Dr Wayne Herdy • The AMA proposal for a copayment of $6.15 for Vice President’s Report : Dr Rob Ingham. [\ ' ! • AMA response to co-payment was “interesting”; $6.15 puzzling to those not directly informed of the in-house proposal was even sillier than the government’s $7 discussions. proposal. • Rob expressed concern that doctor shoppers are still { Meetings Convenor Report: Dr Scott Masters - Apology. Hotline is not proactive in notifying local doctors about Update from Jo Bourke • !]' prevalent individuals actively doctor-shopping. comments re venue, food and entertainment • ] Secretary’s Report: Dr Wayne Herdy '{>]{ Room; Correspondence In: • ] ] • # ]` Karl Schulz • Julie Martin USC- re nominated Bursary student • ' ] ~ • Responses (via email) from Committee members re Erica Baer. USC Bursary recipient, Nina Colina will ‘Doctors’ Finance Facility’ attend the meeting. Mdore Surf Club Function Room. • ` ] Treasurer re 2013-2014 Audit ~ `{` ] Focus Health Network & Medicare Local Reports: Dr Scott Phipps, Dr Fiona McGrath - apologies. October meeting • Discussion was had in speculation of the future of primary care liaison on this committee, with uncertainty Correspondence Out: about the status of the Medcare Local after July 2015. • {"] { | • • {" ] ? Finance Facility’ If the question is print, design or websites the answer is Maroochydore October 2014 NEWSLETTER 33 SCLMA MANAGEMENT COMMITTEE MEETING THURSDAY 28 AUGUST 2014 Maroochydore Surf Club Function Room, Maroochydore MINUTES /cont: Meeting Close: 1900 Hospital Liaison Report: Dr Jeremy Long • Timeline in place for transition towards opening of the SCUH. Negotiations still proceeding with respect to Next Meeting: Thursday 25 September Maroochydore Surf Club Function Room. outsourcing, including pathology and radiology . • The original plans are still in place and it is expected Dr Wayne Herdy, Honorary Secretary. that the hospital will open on time. • # ' for last year and its budget for the coming year. General Business: • The President expressed concern about the QHealth tendering process for outsourced GP services, which was not inclusive of all potential practices in the area, and which appeared to grant an unfair advantage to the successful tenderer. • Nurse practitioners are employed at Gympie Hospital to practise what appears to be a full scope of GP practice. The meeting discussed what level of supervision would be appropriate. It was further discussed that general practice should be consulted in the planning stage when any health service proposes to follow this pathway. • There is a proposal to extend prescribing rights to a spectrum of allied health personnel. Both the President and the Secretary gave media interviews to express the medical profession’s reservations about such a proposal. MEMBERSHIP UPDATE ...... Current membership is 335. New members half price for rest of the year. Application form on the SCLMA website Also Directory form if you would like your details published on the website. (Please check your details if you are already on the Members Directory and fax update if any changes. www.sclma.com.au Monthly newsletter available to non-members, pratice managers, allied health workers etc via email each month. Email [email protected] for this to happen. REDCLIFFE LOCAL MEDICAL ASSOCIATION NEWSLETTER Redcliffe LMA produces a similar newsletter For full details re advertising go to their website: www.rdma.org.au or email: [email protected] ADVERTISING GUIDELINES: To comply with Section 133 of the National Law and guidelines, advertising of services must not: Paragraph (a) “Create or be likely to create unwarranted and unrealistic expectations about the effectiveness of the health services advertised” Paragraph (f) “Claim that the services provided by a particular regulated health profession are better, as safe as or safer than others” Paragraph (o) “Contain any claim, statement or implication that a practitioner provides superior services to those provided by other registered health practitioners” Telephone (07) 5443 6990 Email [email protected] Maroochydore 34 NEWSLETTER October 2014 CLASSIFIEDS DR MARK DE WET, OPHTHALMOLOGIST, FRANZCO • Now consulting at Buderim Eye Centre, Private Practice, Nucleus Medical Suites, Suite 2, Section (Buderim Private Hospital) 23 Elsa Wilson Drive, Buderim 4556. Ph: 5444 7344 Fx: 5477 7037 Email: [email protected] • Mark also continues to work, part time at Caloundra and Nambour public hospital. October 2014 NAMBOUR CLINIC FAMILY MEDICINE – SEEKING GENERAL PRACTITIONER • Well established, fully accredited GP owned family practices at Nambour, Woombye and Palmwoods. • Fully computerised and modern medical centres. • Excellent peer support and friendly staff. • Fully equipped treatment rooms with full time nursing support. • Spacious consulting rooms with windows • Mixed billing • Flexible working hours; full-time, part-time or school hours. • Check out our website at www.nambourclinic.com.au. • No DWS For further information contact Rowena: Ph: 07 5441 1455 or 0412 292 666 Email: [email protected] October 2014 PSYCHIATRIST - DR PAUL CADZOW - NEW CLINIC • Dr Paul Cadzow has a special interest in psychotherapy, including Cognitive Behavioural Therapy, Positive Psychology and Psychodynamic Psychotherapy. Dr Cadzow treats conditions including depression, anxiety, PTSD, and perinatal psychiatry for patients aged eighteen and above. • Dr Cadzow has begun working at Clear Sky Specialist Centre, Suite 8, 102 Burnett Street, Buderim QLD 4556 (2 doors away from his previous practice) Ph: 5456 2190 Webpage: www.clearskyclinic.com.au Referrals via Medical Objects are preferred. October 2014 PSYCHIATRIST - DR REBECCA WILD • Dr Rebecca Wild treats a wide range of psychiatric conditions in children and adolescents, and has a particular interest in early intervention with infants '+ • Dr Wild will begin weekly sessions in February 2015 at Clear Sky Specialist Centre, Suite 8, 102 Burnett Street, Buderim QLD 4556. Ph: 5456 2190 Webpage: www.clearskyclinic.com.au Referrals via Medical Objects are preferred. Given the great potential for work with families or parents to help children get well, referrals for the whole family can be helpful. October 2014 TWO GP POSITIONS AVAILABLE ONE OF WHICH IS DWS • Ormuz Avenue Family Practice in Caloundra is a well established Doctor-owned General Practice focused on high quality GP care with mixed billing and full RN support. • We have two GP positions available, one full-time DWS position and a part-time non DWS position. This could suit a husband and wife medical family. For further information contact Dr Mary Carlisle on mobile 0414 434 735 October 2014 VR GP REQUIRED FOR PRIVATE BILLING PRACTICE • Coastal Family Health is a large 7 doctor, modern, private billing medical centre in the heart of Buddina. • Privately owned and operated, offering excellent renumeration without restrictive employment contracts. • ! approach, great Sunshine Coast lifestyle. • [ ! built rooms. • Existing patient base ready from current F/T Male GP moving interstate [email protected] or ph: 0412 577 725 October 2014 DR ROSANNE MIDDLETON, CLINICAL PSYCHOLOGIST • Dr Paul Cadzow, Consultant Psychiatrist, and Clear Sky Specialist Clinic is very pleased to announce that Dr Rosanne Middleton will be joining the practice from November 2014. • { Clinical Health Psychologist with many years experience working on the Sunshine Coast in both the public and private settings. • Dr Middleton utilises evidence-based therapies in the assessment, diagnosis and treatment of various psychological disorders, including Anxiety Disorders, Mood Disorders, Adjustment Disorders, Health behaviour change, and Grief and Loss. Accepting referrals now. Ph: 5456 2190 Fax: 5456 1853 Webpage: www.clearskyclinic.com.au October 2014 CHANGE of ADDRESS: Sunshine Coast Haematology and Oncology Clinic Dr John Reardon / Dr Hong Shue / Dr Sorab Shavaksha Please note, our rooms previously located at 32 Second Avenue, Cotton Tree … and '# are NOW CLOSED NEW ADDRESS : 10 King Street, Buderim Ph: 5479 0000 Fax: 5479 5050 If the question is print, design or websites the answer is Maroochydore October 2014 NEWSLETTER 35 CLASSIFIEDS CHANGE OF ADDRESS - DR DAVID COLLEDGE, SURGEON, GENERAL / COLORECTAL. • Dr Colledge has moved his consulting rooms to Suite 9B, Nucleus Medical Suites, 23 Elsa Wilson Drive, Buderim. • Dr Colledge is continuing to operate at the Sunshine Coast Private Hospital Buderim and Nambour Selangor Private Hospital. Ph: 5478 1449 Fax: 5444 2740 • September 2014 PROFESSIONAL OFFICE IN “ESPLANADE & SECOND”, COTTON TREE ESPLANADE - FOR LEASE OR SALE. • ' '+ ~ Clinic, available October. Contact: [email protected] or 0418 150 991 / 0419 663 550 ORTHOPAEDIC SURGEON – DR LUKE MCDERMOTT – RELOCATION • Dr Luke McDermott wishes to advise he has relocated from Suite 18 to Suite 8, Sunshine Coast University Private Hospital, 3 Doherty Street, Birtinya, Qld 4575. All Appointments: (07) 5438 8900, Fax: (07) 5302 6818. Dr Shah is happy to consult in all areas of General Paediatrics. She has special interests in Neonatal Care, Developmental and Behavioural Problems as well as Respiratory and Endocrinological Issues Accepting Referrals Now Ph: 07 5444 5177 Fax: 07 5444 5322 August 2014 August 2014 September 2014 DR AJAY VERMA - CONSULTANT SPECIALIST PHYSICIAN, • Has credentialling and admitting rights for Sunshine Coast University Private Hospital, Birtinya, from 1st September 2014. Now accepting new general medicine private inpatients at SCUPH. • Consulting Rooms - Nucleus Medical Centre, • Suite 8, Level 2, Sunshine Coast Private Hospital, Buderim 4556 Ph: 07 5479 6886 Fax: 07 5479 6889 For Inpatient referrals - Fax 07 5302 6660 September 2014 MONTHLY PAEDIATRIC DERMATOLOGY CLINIC NAMBOUR GENERAL HOSPITAL • Starting September/October - Nambour Paediatric Outpatients – Dr Leith Banney Contact 5370 3235. August 2014 LIFETIME HEALTH MEDICAL CENTRE – SEEKING GENERAL PRACTITIONER VR (F/T OR P/T) • This is a newly established Practice in Wurtulla; • Modern medical practice with excellent facilities in a well established residential area. The GP can choose to run as own business or work as an employed GP. • Non corporate, excellent % of fees; Mixed billing • Full nursing support with fully equipped treatment room • Not DWS For further information contact Julianna on August 2014 SUNSHINE COAST PAEDIATRICS IS MOVING • Drs Paxton, Scorer, and Morosini are pleased to announce that from 11th August 2014 their consulting is from Suite 9a, Nucleus Medical Suites, Building A The Sunshine Coast Private Hospital, 23 Elsa Wilson Drive, Buderim, Qld, 4556 • Existing Rooms at Buderim and Nambour will close All Appointments - Ph: 5444 5177 Fax: 5444 5322 August 2014 DR JEFF TARR OBSTETRICIAN & GYNECOLOGIST NEW CLINIC • Ochre Health Medical Centre • 9 Ochre Way Sippy Downs 4556 All Appointments: Ph: 5476 6356 Fax: 5476 5849 Email: [email protected] Website: www.drtarr.com.au July 2014 PSYCHIATRIST - DR MICHELLE LIEN CHANGE OF ADDRESS • Dr Michelle Lien is a general adult psychiatrist who provides specialist consultation on a wide range of psychiatric conditions including mood, anxiety and psychotic disorders for patients aged eighteen and above. New referrals welcomed. • Dr Lien has relocated to The Sunshine Coast Private Hospital - Cooinda Clinic • 12 Elsa Wilson Drive Buderim QLD 4556 Phone: 07 5452 0506 Fax: 07 5444 7299 [email protected] July 2014 RETIREMENT • Dr Richard John is pleased to anounce his retirement. If notes/summaries of my former patients are required by any of my colleagues, please fax requests to: Fax: 5442 3209 (Ph: 5442 1740) I’ll endeavour to reply ASAP. There may be delays due to our travels. July 2014 The Sunshine Coast Falcons ... are looking for sports minded GPs who would like to assist at home games for the 2015 season. This will be a very exciting year for the Falcons as they have just signed a 3 year contract with the Melbourne Storm as their feeder club. All queries, please call Dr Steven Lawrie at Sunshine Coast Orthopaedic Clinic Ph: 5493 3994 August 2014 DR SONIA SHAH, FRACP. – GENERAL PAEDIATRICIAN • SUNSHINE COAST PAEDIATRICS is very happy to announce that Dr Sonia Shah will be joining the Practice from 25th August 2014. • Dr Shah started her training in the UK, completing this at several Queensland training hospitals this year. She will be providing Neonatal care at The Sunshine Coast Private Hospital, Buderim and Consulting at our new Rooms at 9a Nucleus Medical Suites, at the same Hospital. "#$ %'() *)() $ '( *( + $ -/0 # *# Telephone (07) 5443 6990 Email [email protected] Maroochydore NEWSLETTER October 2014 SCLMA CLINICAL MEETING - 25 SEPTEMBER 2014 Maroochy Surf Club Function Room, Maroochydore Dr Jerome Lai, Pathologist, Sullivan Nicolaides Pathology - ‘What’s New in Lymphoid Pathology?’ Dr David McIntosh, Paediatric ENT Specialist - ‘New Advancements in the Management of Allergic Rhinitis’ Sponsors - Sullivan Nicolaides Pathology and Meda Pharmaceuticals Left: Sponsor Tjitske Bunnag and Anthony Walpole, Sullivan Nicolaides Pathology Right:Presenters Dr Jerome Lai and Dr David McIntosh Left: Presenter Dr David McIntosh with Pavla Solce, Meda Pharmaceuticals Right: Dr Pauline Waterhouse with Dr Robyn Hewland Left: Dr Marlene Clout with Dr Robyn Hewland Right: Dr Karien Treurnicht with new member Dr Jacqui Heagney and Dr Bel Zoughi Sunshine Coast Local Medical Association Inc PO Box 549 Cotton Tree QLD 4558 www.sclma.com.au