Chris Middleton - President AMA Tasmania
The forthcoming Tasmanian State election is uppermost in our minds at the moment and AMA Tasmania welcomes the emphasis that government and the opposition parties have placed on health related issues.
The extra money and resources pledged to improve service delivery are a step in the right direction but it is unclear what each of the parties has planned to deal with the pachyderm on the premises that is the chronic and habitual underfunding of the public hospital system. The AMA has previously called for sufficient resources to be made available to allow public hospitals to run at an average bed occupancy rate of 85%. Without this, overcrowded emergency departments, bed access blockages and long waiting times for surgery will continue to blight the effective provision of healthcare in Tasmania.
It is important to appreciate that Tasmanians have a life expectancy which is two years less on average than their mainland counterparts. The reason for this largely relates to socio-economic factors including the fact that 24% of the population smoke as compared to 17% elsewhere in the country. Tasmanians also have less access to health care on average with about $100 less a head spent annually on their health than the average Australian. Part of the problem is that the medical workforce in Tasmania is ageing, as is the rest of the population and the State desperately needs more doctors both now and in the future. Fortunately, the number of medical students in training has increased dramatically in the last few years.
Over the next three years the total number of Australian medical graduates will increase by 41% from 2442 in 2009 to 3437 in 2012. The number of medical students graduating from UTAS is set to increase from 98 in 2009 to 115 in 2012. Alas only 65 places were available for these graduates in 2009 and at present the same number will be available in 2013. Unlike the other states, Tasmania has yet to guarantee all of these final year students the necessary positions in Tasmanian public hospitals to complete their compulsory internship without which they cannot register as doctors. Unless corrective action is taken, the result of this will be that the Tasmanian public will not have the benefit of the increased number of doctors that the ramped up training schemes were designed to deliver. The AMA will be calling upon the Tasmanian government and opposition parties to guarantee that sufficient internships will be made available to enable all Tasmanian medical graduates to complete their preregistration training.
Finally, in 2010 it should not be necessary to insist that every Tasmanian has access to clean, uncontaminated drinking water. This issue has been much in the news recently with significant anxieties expressed in the St Helens area. The AMA is of the unwavering opinion that doctors have every right, indeed a moral and civic duty to speak out on issues where they have concerns for public safety. Once such concern has been clearly articulated, the appropriate government instrumentality must take immediate responsibility for the issue and be fully resourced to undertake a speedy, transparent and thorough investigation to determine the veracity of the situation then take whatever action is necessary. There are clear cut standards for drinking water in Australia and it is imperative that every householder in the State can turn on the tap with absolute confidence.
Stay tuned to the AMA website over the next three weeks.
Regards to all,
Chris Middleton.
Tony Steven - AMA CEO
Membership:
AMA house has been a hive of activity over the past couple of months with the preparation of the renewal letters to all members for 2010 and now the non-member mail out presenting a special offer, to all doctors throughout the state. No joining fee!
This year we must increase our membership further to get our Branch to be comparable with membership numbers on the larger island to our north.
We have many new and reinvigorated corporate partners to offer members services above and beyond those available to others and significant discounts as well, for example 10% off volks wagons. Please go to our website http://www.amatas.com.au/member_benefits/ to check them all out.
Constitutional changes
Branch Council has appointed a “Governance, incorporating corporate and constitutional reform committee” with Dr. Michael Aizen as Chair and members include Prof Ray Lowenthal, Dr. Gerry McGushin, Dr. Ashok Saha. This committee has received a draft proposed new constitution which amongst many other changes includes a separated Board and Branch Council. This will simplify the ASIC requirements of the AMA and lessen the legislative exposure to most Branch Council members. We also feel it will enhance the administrative awareness in the organisation. All members are welcome to have a look at the draft as it develops and make comment. The new constitution will be put to the members at the AGM on the 24th April this year in Launceston; notice of the AGM will be out soon.
Safe hours
After the negotiations for the new IR agreement with the State Government for Salaried Doctors and some queries to AMA House we have added the 2005 Safe Hours Code of Practise to the Resources page on the website, www.amatas.com.au/resourses. The Privacy Handbook is also available there. There will be a constantly growing list of handy documents available on this page so keep a watchful eye on it.
Website
We have done a lot of work on the website over the past few weeks and you’ll see there is now provision for each Division to have their information lodged on their own page. We invite Division Executive members to send photos and information they would like to have included to the AMA office and we’ll upload it for them.
We also have a full calendar there now listing all meetings and events throughout the year. No need to worry about your memory anymore, just bookmark the AMA site www.amatas.com.au.
The website also features a specific Salaried Doctors page and an Employer Doctors page both of which will feature relevant information into the future.
National Conference in Sydney
The AMA National Conference will be held in Sydney from Friday 28 to Saturday 29 May 2010.
The eyes and ears of all medically-minded people will be on the AMA National Conference as committee reports and suggestions are converted into policy in the Rudd Government's health reform agenda.
The AMA is the only independent, professional body representing the interests of all doctors and patients nationally. The AMA's 27,000 members represent all sections of the medical profession - GPs, specialists, doctors in training, medical students, researchers and academics - from all States and Territories. More than 200 of the AMA's most respected member delegates will gather at the National Conference.
The Conference, with the theme, 'Doctors - no substitute!', will focus on some of the most important changes to health policy in a generation as the Government's various committees, commissions and inquiries convert to policy. In this time of change, the AMA National Conference is a great opportunity for members to have a say in setting the Association's policy agenda at a critical time in the health debate.
All AMA members are invited to take part in this premier event on the AMA calendar.
For further information call our National Conference Co-ordinator, Tania Goodacre, 02 6270 5481 or tgoodacre@ama.com.au
Aequis
I personally have the experience of the level of service from one of our major sponsors Aequis and I would like to say to members it is not to be missed. No one can address all the financial issues in their lives now days and get the optimum result. So like me, go and see or call Aequis on 6282 2844 you’ll be surprise what they can do for your lifestyle.
Travel studio
Of course many doctors travel either for business or privately and the AMA has an agreement with Travelscene and here in Tasmania that is the Travel Studio. Lee-Anne and the expert crew are highly trained and more importantly have a detailed and very efficient set of procedure that will defiantly ensure your travel arrangements are secure, organised and clearly laid out with all details cared for, please give Travelscene a call and say you are a member of the AMA.
Professor Alan Carmichael
Pictured left: University of Tasmania Medicine Graduates 2009
Dean’s Desk
2009 finished on a high with the graduation of 94 Medical students. With the increased numbers, a new venue was required for the signing of the Declaration of Geneva. The Theatre Royal provided the perfect backdrop for such an important occasion. Following the ceremony the students walked the streets prior to their graduation for the second Town and Gown to be held in Hobart.
2010 will be an exciting year for the School of Medicine, with a number of planned changes now coming to fruition. The School has settled into the new building and over the past few weeks the various year groups have commenced their studies. The feedback about the new teaching spaces, from both staff and students has been extremely positive.
The new structure of the School has been implemented. I am pleased to announce Professor James Vickers, Professor of Pathology and previously Deputy Head is the new Head of School. This move provides more focus on the School separating the role from that of Dean of the Faculty of Health Science, in which I remain. A new Deputy Head of School appointment will be made shortly to join the current Associate Heads to provide support to James in his busy role.
The School of Medicine introduces a new Honours program for the 5-year MBBS in 2010. Five students have enrolled to undertake studies in the School of Medicine and Menzies Research Institute. Two students will be based at the Launceston Clinical School. The School is also currently developing a MBBS-PhD program, that is generally modelled after the successful MD-PhD system in the US. This is part of a new strategy for the School to increase the number of clinical academics into the future.
Associate Professor Greg Woods and colleagues have published an important paper in the January 1 issue of the prestigious journal, Science, on the identity of the cancerous cell type that comprises the Tasmanian Devil Facial tumour disease. The research team determined, using advanced, genetic analysis techniques, that the tumour is largely identical between affected animals, confirming that the cell is ‘transmitted’ between animals. Furthermore, the research indicated that the cell is of Schwann cell origin. This research may provide new insights into the biology of the unusual cancer cells and also avenues for identification of tumours in Tasmanian Devils.
Rural Doctors - AMA Tasmania
Rural Doctor Partnerships is the Tasmanian Government’s ‘New Deal’ for rural general practitioners. It is an acknowledgement of the valuable role GPs play in delivering primary health care to rural Tasmanians. The package of measures in the Plan represents an increased investment by the state government of $2.5 million into rural general practice.
A cornerstone of Rural Doctors Partnerships is the new Rural Medical Practitioners Agreement with the Department of Health and Human Services (DHHS). Features include:
- An increase in the hourly rate
- Increased call back rates
- Quality and safety hours
- Community hours
- Maintenance of Allowances
The new Rural Doctors Reference Group will address issues relevant to both rural doctors and the DHHS, including workforce, support and the interface with acute care services. It will provide advice in respect of the development and implementation of a DHHS policy for consistent support arrangements for rural doctors and for emerging quality and safety initiatives that will improve the care of patients in rural facilities. It will monitor the implementation of the Rural Medical Practitioners Agreement (2009). Expressions of interest from interested practitioners are being sought in February.
Rural Recruitment and Retention: financial assistance is now available for the recruitment of locums and implementation of retention strategies for rural GPs. The DHHS is providing funding for locums direct to GPs with an amount to $10, 000 per practice per annum to be available. The DHHS has also committed funds of $300,000 over three years to General Practice Workforce to improve rural medical workforce retention and recruitment capacity.
For more information contact the Primary Health GP Support Unit, Private Bag 5 Launceston, 7250. Phone: 0363 364353 Fax: 0363 36 5599
Practice business - Katrina Cox
Real cost of staff turnover
Katrina Cox from mpstaff says: “Staff turnover can be a killer to your bottom line. However, as the loss is intangible many practices do not see it until it is too late.”
Healthcare and medical practice staff turnover results in significant productivity losses in businesses across Australia. So why aren’t we doing anything about it?
Doctors and specialists who have had to transform themselves into business owners will understand how difficult up-skilling and training staff can be. Some costs are clearly visible, some are not. Turnover has an effect in any business and it is not until you peel back the layers that you can see the real costs.
Here are some ideas to help you estimate the cost of staff turnover in your practice. Think about your practice and how much you lose on turnover:
1. Staff morale. When someone leaves there can be a dip in staff morale. Even if it’s not obvious staff can often become unsettled and there’s likely to be lost output and productivity.
2. Lost patients. Your support staff are the key to your business. Lose someone critical and you could lose patients.
3. Recruitment. If you do the recruiting yourself you will need to include the cost of your time at an hourly rate and how long you can afford to dedicate to the process which will include advertising (and associated costs), reading resumes, shortlisting candidates, contacting candidates, notifying unsuccessful candidates, interviewing candidates, reference-checking and finally, putting together the letter of offer and contract.
4. Knowledge. Are all your policies and procedures documented and up to date? How much information could you lose if you lose a staff member?
5. Retraining. Remaining staff will have to spend time training new staff members. Two weeks should get an experienced candidate up to speed.
6. Downtime. Your staff will have to spend time training new staff and therefore will not be able to focus on their core business.
The costs of turnover can be very high for a small business such as a medical practice. The easiest way to ensure low turnover is to find the right person for the job, first time.
mpstaff can assist you with all your recruitment needs and advice. Contact mpstaff’s Recruitment Manager, Katrina Cox, today on (03) 9348 1111 or visit www.mpstaff.com.au
[BREAKOUT] A recruitment agency specialist can not only save you money but also your valuable time by using their experience and knowledge to go through the processes to find the right person for your practice.
Opinion piece: Our epidemics of preventable disease are a disgrace
by AMA Honorary Life member Dr Trevor Beard, Menzies Research Institute, Hobart
In the 21st century it is a disgrace that we know how to visit the moon, yet we are powerless to prevent major epidemics of preventable disease such as:
• obesity, metabolic syndrome and type 2 diabetes
• hypertension and its complications (heart disease, stroke and kidney failure)
Obesity and type 2 diabetes are rapidly getting commoner. Effective action is mandatory and has never been more urgent.
We already know that our problems are self-inflicted
Until 10 000 years ago, when our ancestors invented agriculture, they could eat whatever they liked without getting fat—think what that means. The wild animals they hunted (like the wildlife today) had given them lean meat. Animal husbandry gave them fat meat. Humans became the only mammals able to drink milk in adult life, and eat artificially concentrated milk fat as cream and butter. About 5000 years ago the technology for bulk manufacture gave us salt as a food additive, and the Industrial Revolution about 300 years ago made a plethora of artificially processed foods cheap and abundant. American pan-fried bacon has 37 times more salt than fresh pork and 2½ times more salt than seawater.
Britain is testing better food labels
Processing usually changes the concentrations of fat, saturated fat, sugar and/or salt, and British shoppers can see at a glance if the food they are buying has health problems. The UK traffic lights—at present voluntary—guide shoppers with a red, amber or green light against each of the four nutrients known to be harmful in excess.
But the food industry has refused point-blank to accept red lights and invented its own label with—guess what?—no lights. The battle in Europe has reached Australia. For a summary of the arguments, visit www.saltmatters.org and click The Food Industry.
Traffic light food labels need AMA support
What is the AMA’s policy on food labels—traffic lights or the food industry’s substitute?
Australian Kellogg Corn Flakes packets already use the substitute (the %DI):
Salt is not even mentioned. The %DI reveals nothing at glance and is more likely to be ignored. It discriminates especially against less educated and less motivated shoppers. Do AMA members want the AMA to remain silent while Australian politicians endorse the food industry’s substitute for red lights?
What do you think? "Please contact AMA Tasmania office and give us your views"
SPECIFIC GUIDELINES NEEDED TO PRIORITISE ELECTIVE SURGERY WAITING LISTS
A lack of specific guidelines to help surgeons decide how to prioritise public hospital patients’ elective surgery may be compromising patient care, according to an article published in the Medical Journal of Australia.
Dr Andrea Curtis, a Research Fellow at the Department of Epidemiology and Preventive Medicine at Monash University and Prof John McNeil, Head of the Department of Epidemiology and Preventive Medicine at Monash University, and their co-authors write that new evidence-based criteria should be developed to ensure that patients on public hospital elective surgery lists are assigned to the most appropriate urgency category.
“It is essential that those who have the greatest need for surgery and will benefit most from it receive it in a timely manner and before those with lesser need,” Prof McNeil said.
“However, priority for surgery is determined … by unspecified, intuitive criteria that may vary between doctors.” “The lack of specific guidelines to help surgeons make decisions about patients’ need for surgery is a shortcoming of the current Australian system that may compromise patients’ equity of access and clinical outcomes.
“Although assignment of urgency categories applies a basic form of prioritisation, it is an informal and relatively insensitive process that does not ensure transparency and equity of access to available services, and does not take into account the numerous factors that can contribute to a patient’s urgency for surgery.”
Prof McNeil said ensuring equal access to surgery for those with equal need and the quickest access for these with greatest need should be the key goals for a new elective surgery prioritisation system. “Equity, transparency and certainty should be key elements of the prioritisation system,” Prof McNeil said.
“Overseas experiences have highlighted the importance of ensuring the scientific validity of all prioritisation tools. “This requires debate about the key clinical, social and other patient- or health service-related criteria that should be considered, development of methods for scoring these criteria and a contextual framework.”
The Medical Journal of Australia is a publication of the Australian Medical Association.
RHH Interns – Past and Present
RHH Interns have been busy recently with 2009 Interns gathering together for the Intern of the Year Award dinner and 2010 Interns attending orientation.
Over 60 medical staff attended the award ceremony held to recognise the excellence of RHH staff, to provide encouragement and to reward good all round performance by Interns. The 'judging panel' for the awards were colleagues, ie Registrars, CNMs, allied health staff and Consultants, directly involved with an Intern's day to day work.
Before announcing the winner Dr Hemmings, Medical Education Advisor, said that the 2009 Interns were an outstanding group with good clinical knowledge, communication skills and team spirit.
Dr Iswadi Damasena was named Intern of the Year for 2009. “It’s fantastic,” he said. “I could not get a better honour than being voted for by my colleagues, especially since I learnt so much from them. I loved every minute of my Internship and coming to work at the RHH. I got a lot out of it.” Sadly for the RHH Dr Damasena is returning to Perth to gain further experience in orthopaedics at the Sir Charles Gardiner Hospital. We wish him well in his career move.
Other staff recognised for their excellence were Dr Waheed Ahmad, awarded Registrar of the Year and Dr Chris Hutchinson, awarded Consultant of the Year. Interns voted for Dr Ahmad and Dr Hutchinson to recognise, and show their appreciation of, the outstanding support and education provided to them by during their Intern year.
Dr Hutchinson, who came to the RHH two years ago after moving to Hobart from Christchurch, New Zealand, with his wife and two young daughters, said that receiving the award was totally unexpected and a complete surprise. “The RHH is a good place to work and I really like living in Tasmania. Hobart is a great city and I love the fact that Tasmania has four seasons,” he said.
34 new Interns (31 of whom are University of Tasmania graduates) commenced orientation at the RHH in January. Orientation included presentations by 2009 Interns on how to best 'survive' the Intern year, assessment of Life Support Skills and time spent 'shadowing' junior medical staff.
34 new Interns (31 of whom are University of Tasmania graduates) commenced orientation, which included presentations by 2009 Interns on how to best 'survive' the Intern year, assessment of Life Support Skills and time spent 'shadowing' junior medical staff, at the RHH in January.
Allied health staff showcased their particular disciplines with interactive displays so that Interns could meet staff, become familiar with the procedure for referring patients, sample dietary supplements, and get “hands on experience” with a varied assortment of walking frames, braces, psychology puzzles and speech boards. Judging from the buzz in the room the Interns were enjoying the opportunity to gain some first hand knowledge from allied health professionals.
Our best wishes are extended to last years Interns as they begin their rotations as Residents at the RHH, or other hospitals, and to our 2010 Interns as they begin their training at the RHH.
Aequis
Getting the right work-life balance
As one year ends and another begins, New Year resolutions are made and broken! One resolution for many of our clients this year is to spend more time with family. How you can achieve this requires planning and will include looking at the financial implications of any change to your working hours. Everyone is talking about “work-life balance” but how can you and your colleagues achieve this and what does it mean.
The term 'work-life balance' describes a person’s ability to effectively manage their paid work commitments with their career goals, personal, community and cultural responsibilities, interests and obligations. Enabling this balance benefits not only individuals, but also families, employing organisations and the broader community. Many employers now recognise these benefits, and support the development of a workplace culture that acknowledges and values the importance of work-life balance.
Work-life balance is achieved when an individual’s right to an enriched life both within and outside paid work is recognised and valued.
Individuals who maintain a balance between work and other commitments are better able to manage multiple responsibilities without feeling guilty about sacrificing priorities at work or outside. They are also more likely to feel in control of their life because they have choices as opposed to feeling as if they are being forced to sacrifice work or other priorities. They may also feel more secure, happier – and thus motivated – working for an employer that supports their right to make choices between work and home life.
A good work-life balance may also improve the health and reduce stress levels of individuals through having more time to meet commitments, a reduced load in the workplace, and extra time to devote to exercise and other healthy living activities. This point is especially important to those working as health professionals.
If improving your work-life balance is important to you in 2010, then now is the time to speak with Aequis, your financial advice centre. Aequis is a true fee-for-advice business that specialises in providing advice to health professionals. To make an appointment to speak to one of our advisers contact our Rosny office on 6282 2822 or visit our website www.aequis.com.au
*Doug Davey and Aequis Pty Ltd are Authorised Representatives of GWM Adviser Services Limited ABN 96 002 071 749 Australian Financial Services Licensee Registered Office at 105 – 153 Miller Street North Sydney NSW 2060. GWM Adviser Services Limited is a Principal member of the Financial Planning Association.
This advice may not be suitable to you because it contains general advice that has not been tailored to your personal circumstances. Please seek personal financial and taxation advice prior to acting on this information.
