Are you ready for the Auditor - AMA WA

RALIA
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MEDICUS
Journal of the Australian Medical Association WA | May 2012 Volume 52 / Issue 4 | amawa.com.au
May MEDICUS 1

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Dear Colleague
Welcome to the AMA (WA)’s annual Universal Edition of Medicus.
Every year, one issue of Medicus goes to many more post boxes (both real and virtual) than
usual.
The issue of Medicus you are currently reading has not only been sent to every AMA (WA)
member, but it has also gone to other registered medical practitioners in WA, along with
State and Federal politicians, members of the media and a range of other key opinion
makers in our great State.
This Universal Edition of Medicus therefore is a wonderful opportunity to showcase the
AMA (WA) to many more people than usual – and won’t they be surprised!
In the past year, Medicus has not only almost doubled in size, but has dramatically
improved its layout, look and range of articles.
As well as the usual lifestyle pages (wine, travel, and drive) this issue also includes detailed
news that is directly relevant to the professional lives of members – especially the cover
story on the important issue of PSR Audits.
The Universal Edition is also an opportunity for the AMA (WA) to demonstrate why all
medical professionals should be members.
Our professional approach to key issues such as industrial relations, salary and other
employment conditions, along with the financial benefits offered to members, are second
to none. In addition, our record of advocacy on behalf of members, in an enormous range
of areas, is well known.
Joining the AMA (WA) is easy – just visit www.amawa.com.au, call (08) 9273 3055 or email
membership@amawa.com.au.
Medicus is the professional and public face of the AMA in Western Australia and will
continue to record our growth and impact on medicine and medical policy.
I hope you enjoy reading this issue of Medicus as much as we have enjoyed putting it
together.
With kind regards
Associate Professor David Mountain
President
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Council
President
A/Prof David Mountain
Immediate Past President
Prof Gary Geelhoed
Vice Presidents
Dr Richard Choong
Dr Michael Gannon
Honorary Secretary
Dr Omar Khorshid
Assistant Honorary Secretary
Dr Janice Bell
Honorary Treasurer
Dr Simon Towler
Councillors
Division of General Practice (WA)
Prof Bernard Pearn-Rowe
A/Prof Rosanna Capolingua
Division of Speciality Practice
Dr Tony Ryan
Prof Mark Khangure
Division of Salaried and State
Government Services
Dr Nigel Armstrong
Prof Geoff Dobb
Ordinary Members
Dr Andrew Miller
Dr Daniel Heredia
Dr Stuart Salfinger
Co-opted Members
Prof Ian Puddey
Prof Gavin Frost
Dr Stephen Wilson
A/Prof Frank Jones
Dr Peter Maguire
Dr Dror Maor
Dr Cassandra Host
Mr Ghassan Zammar
Mr Benjamin Host
AMA (WA) Office
Executive Director
Mr Paul Boyatzis
Deputy Executive Director
Mr Peter Jennings
Executive Officers
Mr Michael Prendergast
Ms Christine Kane
Ms Clare Francis
Mr Gary Bucknall
14 Stirling Highway
Nedlands WA 6009
(08) 9273 3000
mail@amawa.com.au
www.amawa.com.au
Medicus
Editor and Director of
Communications
Mr Robert Reid
Advertising Inquiries
Phone Mr Des Michael (08) 9273 3000
Copy Submissions
Phone Ms Robyn Waltl (08) 9273 3009
or robyn.waltl@amawa.com.au
Services
Business Services Manager
Ms Noelle Jones
Financial Services Manager
Mr John Gerrard
Medical Products Manager
Mr Anthony Boyatzis
Health Training
Australia Manager
Mr Geoff Jones
The publication of an advertisement,
article or inclusion of an insert does
not imply endorsement by the AMA
(WA) of the views, service or product
in question, and neither the AMA (WA)
nor its agents will have any liability for
any information contained therein.
MEDICUS
Contents
President's Page
AMA (WA) and a new
medical school
p.4
Rights of Private Practice
p.7–8
Medical Workforce: Out of the
frying pan and into the fire
p.11-12
Cover Story
PSR Audits
p.14–17
Opinion
Making sense of after hours...
if we can
p.18-19
May 2012
Opinion
Junior Doctors: Do WA
hospitals really support our
training?
p.20
Industrial
p.29
Cost shifting and/or
privitisation
p.29
The Federal Government
undermines General Practice
yet again
p.34–36
Members Only
Benefits and On the Town
p.66-67
Classifieds
Professional Appointments
& Positions Vacant
p.68-71
May MEDICUS 3

President’s Page
A/Prof David Mountain
AMA and a
new medical school
We think it is important to clarify the AMA (WA)’s position
on the current debate happening in WA about whether there
should be a new medical school (currently proposed by Curtin
University).
Firstly we would like to make a few issues very clear. We are
not opposed to the concept of a third medical school in WA
(when the conditions are appropriate). We are not opposed to
Curtin’s ambition to be a provider of a medical course or to be
a top-ranked university. We applaud ambition and the pursuit
of excellence. And most importantly we are not opposed to
either the idea or the reality of expanded student or doctor
numbers in the future, as we have proven by our previous
advocacy for expanded medical student places.
What the AMA (WA) and national AMA have made
abundantly clear is that further expansions of medical school
numbers or further large increases in student numbers are not
appropriate in the current set of circumstances, nor for the
next few years.
What are those circumstances, and what needs to change to
support further expansion? Currently we are in the middle of
the largest expansion of the home-grown medical workforce
ever seen in Australia. In WA the number of medical students
coming through will have more than trebled over the last
10 years, with the peak just arriving (in WA). This rapid
expansion was vigorously supported by, and in no small part
due to the advocacy efforts of, the AMAs. It was a necessary
response to catastrophic Federal (and State) government
suppression of medical school places and doctor numbers to
‘contain’ demand. However the current expansion has been
extremely large and rapid, and is still coming to completion
(particularly on the East coast). It has induced very significant
training capacity issues, including shortages of trainers,
training positions, clinical content, case mix and the jobs
required for those coming through to move into.
These are not issues that are coming in the future but
which the system is struggling deeply with now. Medical
students and teachers do notice the proliferation of students
and increased numbers requiring supervision and clinical
cases. We have been struggling in many cases to provide the
meaningful clinical content and quality, direct supervision
that are the hallmark of quality medical education. Students
have noticed that at times clinical content or supervision is
stretched, as do their teachers, who are under the pump and
are thin on the ground.
Large numbers of new students have started to come
through as junior doctors. In WA those numbers of new
interns and junior doctors have been accommodated, just, in
intern and non-training RMO positions. However the system
has been responding in a just-in-time manner to this, and at
time substituted RMO positions to make intern posts. This
has been a major feature of some Eastern States’ approaches
to dealing with this issue. We have many overseas students
trained in Australia who are struggling to find intern positions
whilst we still continue to employ large numbers of junior
overseas-trained doctors. To be fair WA has managed this
transition phase better than most States, but it is a major
struggle. There are major problems coming up, as a system
that is used to providing postgraduate specialised training
(hospital and general practice) to 100 doctors per year will
soon have to find training places for 300 per year. We are
nowhere near the peak of this tectonic shift in training, given
that postgraduate training takes from 5 to 10 years and the
320 per year continues ad infinitum.
We are already seeing major increased competition
for training. Even with expanded GP training positions,
competition for those places has increased dramatically over
the last few years. Expanded training positions and improved
support, particularly by WAGPET, have been fundamental to
improving and expanding GP training into new practices and
areas, again strongly supported by AMA (WA). But there are
limits to any expansion, and they are being tested. There is
always the need to maintain quality as well as quantity.
Things will be much more difficult in the hospital training
environment in the next few years. Rapid expansions of
training positions have major constraints, including no
growth in public hospital capacity for a decade due to
government blindness, delusional policy making and very
slow implementation once the need was acknowledged.
Increased throughput and demand for clinical flow also
impinge on training capacity and quality. New training
positions must be accredited by colleges. It can be a long
process, particularly when the hospitals don’t exist yet! New
training environments in private practice, public non-acute or
regional hospitals are being used and have expanded training
opportunities. However almost everyone who actually works
in those environments agrees that we have rapidly picked
the low-hanging (and even middle-hanging) fruit in these
environments. Those thinking massive new numbers of
training positions are coming from these environments aren’t
living in the real world. In the regional hospital I have worked
at episodically over the last 10 years the numbers of students
and junior doctors have increased dramatically, and the
training opportunities are clearly at capacity.
If our current graduates find specialty training positions,
4 MEDICUS May

they need to have jobs and positions to move into eventually.
There have been no promises by any governments that these
will be guaranteed. Clearly substitution of home-grown talent
for overseas-trained doctors will occur over the next few years.
However if governments get this transition wrong and alienate
the OTD workforce, the whole system will pay the price, given
how reliant we are on the OTD workforce and its flexibility to
demand.
So into this heady, complex and high-octane mix should
we just pour on more fuel and add another 100 medical
students per year because it seems like a good idea? Well,
firstly, we don’t think it is a good idea at the moment. How
would we manage a major new expansion of training even at
an undergraduate level, let alone the flow-on consequences?
We have no idea whether we can manage the training
requirements, training positions and career aspirations of the
current wave of graduates coming through. No future funding
arrangements, detailed plans or meaningful guarantees are in
place from the State Government to allow anyone the security
of knowing that expanded training positions and career
pathways will be made available.
We believe that when you encourage people to commit to
lifelong service, study and 12–20 years of training, the least
we should do is make sure we can offer them proper quality
training, a realistic career pathway and some guarantees for
the future. Excessive and premature expansion of training
numbers within the next five years puts at risk the quality
of training, proper system planning and the viability of
the training workforce. Let us digest the current very large
increase in demand before we decide to cram more into an
already overloaded and struggling training environment.
Listen to the students, trainers, postgraduate medical faculties,
medical deans and AMAs who see how precarious the current
environment is, and allow a few years to see how things settle
before committing us all to an unplanned, under-resourced
and chaotic future.
See also Medical Workforce: Out of the frying pan
and into the fire on page 11
WA Health puts the care into
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Alternatively, call (08) 6444 5815
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Rights of Private Practice
The Association receives a number of enquiries regarding rights and obligations for State public sector full-time,
0.8 and sessional salaried practitioners operating under Arrangement A. The following is general advice and
provides a summary of information to those practitioners employed on Arrangement A.
Recently, and as a consequence of incorrect advice being
given by some managers’ to members of the Association, the
Association sought and received advice from Medicare relating
to supervision requirements for procedural trainees’ services to
bona fide private patients to attract Medicare benefits.
Private Practice –
In or using the employer’s facilities
The AMA Industrial Agreements provide that a medical
practitioner with the right to private practice shall, at the
time of being appointed, be granted a right of private practice
subject to the conditions of the Agreement. (Clause 27(2)) “A
practitioner may elect to relinquish all private practice income
retention rights” “in or using the hospitals (1) ” facilities, assign
such private practice income to the employer and receive the
Arrangement A allowance in lieu as shown hereunder.
Relevant provisions of the AMA Industrial Agreements
relating to Arrangement A clinicians include:
1 Oct 10 1 Oct 11 1 Oct 12
Consultant $86,722 $90,243 $94,304
Health Service Medical
Practitioner
Non Specialist Qualified
Medical Administrator
$58,669 $61,015 $63,761
$64,751 $67,341 $70,372
Snr Medical Practitioner $64,751 $67,341 $70,372
Medical Administrator $86,722 $90,243 $94,304
Vocationally Registered
General Practitoner
$64,751 $67,341 $70,372
(1)
Hospital in this context refers to the employer and also
includes Health Services and the Health Department itself.
Clause 28(2) prescribes:
“A practitioner who assigns to the Employer private practice
income generated from all work, whether publicly or privately
funded, carried out on behalf of the Employer shall:
a. be paid the applicable Private Practice Income Allowance;
b. authorise the employer to render accounts in the
Practitioner’s name; and
c. on each occasion the opportunity to exercise private
practice rights arises, assess the fee to be charged and
advise the Employer so that an account can be rendered by
the Employer”. That is, the practitioner determines the fee
he or she will charge for the service provided.
Clause 27(4) prescribes:
“A practitioner shall, to the fullest extent permissible by
law, exercise rights of private practice in any public teaching
hospital or in any other public sector health care facility in
which the practitioner works”.
Under these arrangements the practitioner receives, on a
fortnightly basis, a private practice income allowance as set out
in the above table.
Clause 27(5) prescribes:
“The hospital shall provide to the practitioner a copy of the
Patient Election form or other evidence of an election to be
a private patient which would satisfy Medicare Australia or
other applicable health insurers of the election to be a private
patient for those private patients admitted under the care of
the practitioner.”
Clause 27(6) prescribes:
“A Practitioner who does not comply with the terms and
conditions under which facilities are made available to the
practitioner for the purpose of engaging in private practice
forfeits the ability to exercise rights of private practice”.
That is, as a quid pro quo for receipt of the allowance, the
practitioner is obliged to seek to maximise their rights of
private practice within the hospital and assign that consequent
income to the employer.
In accordance with the Industrial Agreements, if the
employer determines the practitioner is not exercising rights
of private practice to the fullest extent permissible by law in
the context of their specialty/role, the employer can seek to
withdraw the exercise of rights of private practice in which
case the practitioner would not qualify for the Arrangement A
allowance.
Such a decision, however, may be challenged pursuant to
Clause 27(8) and Clause 55. Dispute Settling Procedures may
be invoked. In accordance with sub-clause 55(5), the status
quo that existed prior to the dispute arising must remain in
place whilst such procedures are followed; i.e. Arrangement
A should continue. Note: In some cases (e.g. emergency
medicine), the capacity to earn private income is minimal. The
amount earnt is irrelevant to the right to elect Arrangement A.
The failure by hospitals to provide patient election forms
and properly administer their obligations does not affect the
practitioner’s rights to Arrangement A.
Personal responsibility not assigned
It should be noted the practitioner still retains (and cannot
assign) their personal medico-legal responsibility under the
Commonwealth Health Insurance Act for ensuring, where
applicable, the proper referral is in place and determining the
correct item number(s). The practitioner is also responsible for
determining the individual fee(s) he or she wishes to charge a
particular patient as set out in Clause 28(2)(c) above.
Continued on page 8
May MEDICUS 7

Continued from page 7
Employer Responsibilities – Doctors should
request quarterly statements
Clause 28(3) prescribes:
“The employer in acting as agent for the practitioner shall
ensure that no account is rendered which could place the
practitioner in breach of the Health Insurance Act 1973 (Cwth).
The employer shall, if requested, provide to the practitioner on
a quarterly basis a statement detailing total amount of accounts
rendered and amounts collected (exclusive of GST) in the
practitioner’s name”.
Unfortunately, as has been demonstrated previously, the
employer, through Health Corporate Network, has not always
ensured that doctors have not been exposed legally.
The AMA strongly advises practitioners to ensure that all
facets of this advice are complied with. The Association would
strongly advocate that the practitioners insist on receiving a
quarterly statement as provided for in Clause 28(3) so that they
can reconcile their activity to ensure that bills which do not
comply with the requirements of the Health Insurance Act are
not being sent out in their name. There have been instances
where items relating to a different specialty have been raised in
a doctor’s name.
Indemnity
Salaried practitioners under Arrangement A are covered by
Government Indemnity in relation to medical negligence
claims for both public and private patients. Practitioners
employed in the metropolitan area under Arrangement B
are not covered by the State for private patients. The scope
and quality of that indemnity was substantially improved
a few years ago as a consequence of strong lobbying by the
AMA. That indemnity does not, however, cover inquiries
or investigations by, for example, the Health Insurance
Commission, Coroners Court or the Medical Board. Doctors
are advised to maintain additional complimentary private
MDO cover for such purposes and for access to independent
legal advice when required. The Professional Development and
Expense Allowance secured by the AMA, which is payable
fortnightly and, as at 1 October 2011 in metropolitan Perth,
equates to $23,468, is designed to assist in meeting such costs
(as well as AMA subscriptions).
Tax Issues
It should be noted that the ATO has issued a number of
rulings in the Eastern States indicating that any income raised
in a practitioner’s name needs to be declared on their tax
returns and, providing that where that income is assigned to a
hospital pursuant to a contractual obligation, a corresponding
offset can also be claimed. It is likely that the principles
underpinning such rulings will similarly apply in WA. It
is, however, important that practitioners consult their own
accountants regarding taxation requirements.
Trade Practices Considerations
It should also be noted that under the Trade Practices Act (now
called the Competition and Consumer Act 2010), individual
clinicians cannot be dictated to in terms of the fees that they
charge their private patients. Doctors not in a legal partnership
of natural persons should not collectively agree on fees to
be charged nor should a hospital direct a practitioner as to
what the practitioner should charge. An individual doctor
must determine their own general fee and should instruct the
employer as to what their fee will be, generally in the absence
of the doctor determining a different fee for the individual
patient. A standing instruction could be issued to the employer
by the individual. A copy of the standing instruction should
be retained and confirmation from the employer should also
be sought that the employer will comply with the doctor’s
instructions.
Concerns could also arise if hospitals sought to develop
initiatives which unfairly competed with external private
practice, which could offend the anti-competitive provisions of
the Act.
Health Insurance Act
It is emphasised that the practitioner remains fully accountable
under the Health Insurance Act and must ensure that, where
relevant, a valid arm’s-length referral exists and the correct
item numbers are used to ensure that the Commonwealth
is not paying Medicare benefits when they should not be.
All practitioners are urged to become familiar with referral/
itemisation requirements if they are not already and should
consult both the CMBS and AMA List of Medical Services
and Fees for further information.
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AMA members receive an 0.85% discount on the standard
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10 MEDICUS May

Medical workforce
Out of the frying pan and into the fire
1. The following should inform the debate on increasing
medical student numbers in WA:
a. In 2005 107 students graduated from the then WA
Medical School
b. In 2012 321 students graduated from WA’s two
medical schools – 281 of these students were
Australian residents who remained in WA for their
internship
c. Based on already established student places, from
2015 there will be above 320 graduates per year
d. For the number of intern positions to increase, WA
will have to find and pay for additional placements
and supervision
e. There is increased competition for training
positions at PGY3 level and above; and this will only
become more competitive with the bulge of doctors
currently progressing through the system
2. Based on current figures, from 2015, graduate numbers
will be triple that of 2005 – most of these graduates will
be seeking training posts.
3. By 2020 the impact of this tripling effect will have
flowed through to independent practice. This means
WA will be producing more than triple the number of
fully trained GPs and other specialists than in 2005.
4. The tripling of medical student numbers nationally will
leave some States struggling to provide good intern and
training positions. If graduate numbers escalate again,
further difficulties will arise.
5. A new graduate is only halfway through their training
pathway, with their training post-graduation being
predominantly financed by the State Budget.
The rapid increases in medical graduate numbers
over recent years has placed pressure on a system
that is already struggling to provide the level of
teaching and training required to ensure the next
generation of doctors are efficient, cost effective and
provide quality care.
The increase in student numbers (refer Fig. 1) has been
unprecedented and designed to address the caps on low
medical student numbers of previous years, excessive
reliance on importing practitioners from overseas, and
provides more Australian students an opportunity to
practice medicine and meet the needs of our growing
population. However, not surprisingly, there have been
significant challenges in keeping up with these increases.
The output of medical schools, since the University of
Notre Dame’s (UND) initial 74 graduate output in 2009,
has continued to increase. The University of Western
Australia (UWA) and UND have accumulatively
increased graduate numbers by over 200%.
Strong lobbying of the State Government has been
needed to ensure all domestic graduates are guaranteed
intern positions, and seek to secure adequate funding
and resources for pre-vocational and vocational training.
However challenges still remain and as the system
struggles to catch up with the growth in student numbers,
there is a hotly debated push to increase these figures.
Curtin University has been lobbying hard to establish
a new undergraduate medical school. The advocacy of
an undergraduate course is understandable, given the
UWA recently moved away from this model and the UND
has only ever offered a postgraduate degree. However,
many people in the health sector are concerned about the
proposed numbers and timeframe. Due to this the AMA
(WA), over the last two years, has repeatedly requested
detailed justification for Curtin’s proposal. In particular,
the Association has, in discussion with various Ministers,
the Director General and Curtin, advised the need to:
1. Ascertain the flow-through effect of the current
increase in student numbers of more than 200%, with
due consideration being given to the entire educational
vocational continuum.
2. Provide a sound evidence-based justification for the
numbers proposed.
3. Provide a properly integrated, funded and resourced
package that provides the requisite staff, resources and
infrastructure in order to:
a. Support the education of additional medical
students
b. Support the pre-vocational and vocational education
of these additional graduates
c. Increase the capacity for employment of medical
graduates and junior doctors.
Continued on page 12
Fig. 1
Table: Numbers of graduates 2005-2012
Description 2005 2006 2007 2008 2009 2010 2011 2012
Number of WA graduates 105 111 124 128 218 262 270 281
Number of international
0 2 7 5 11 15 23 40
WA graduates
TOTALS 105 113 131 133 229 277 293 321
Source: Post Graduate Medical Education Council 2010 and current figures
May MEDICUS 11

Continued from page 11
350
300
250
200
150
100
50
0
Fig. 2
Graph: Growth in graduates 2005-2012
Total WA Medical Graduate
(including International Graduates)
WA Medical Graduates
2005 2006 2007 2008 2009 2010 2011 2012
4. Dedicate adequate quarantined funding that is for
09 2010teaching 2011 and 2012 supervision purposes. Whilst some
funding has been provided, it remains insufficient.
The need for funding is compounded by the fact the
State Government has not committed to expanding or
funding additional places.
Curtin has advocated it needs a hundred students;
a number, apparently, based on the economics of
establishing a medical school and not the figure required
to meet future needs.
By 2015, UWA and UND will graduate in excess of
320 medical students each year. When these students
reach completion of their specialist training, around
the end of this decade, WA will be producing triple
the 2005 number of fully trained independent
medical practitioners.
Even when comparing 2010 to 2015, there may be an
additional 40 graduates from UWA and UND who will be
seeking intern positions, which is separate from the Curtin
proposal. These positions, and the required increase in
supervisors and training positions, will have to be funded
from somewhere.
Curtin’s proposal for 100 additional graduates, if
successful, raises questions as to whether WA health
can absorb this increase, as well as provide the required
funding and resources to ensure quality training. This is
the same as the total number of interns employed at Sir
Charles Gairdner, Osborne Park, Joondalup, Swan District
and Geraldton Hospitals. For 100 Curtin graduates to be
trained after graduation, WA would have to duplicate the
current number of such clinical opportunities; including
the additional positions, all the supporting facilities, and
appointment of senior staff to supervise. Funding would
also be a critical issue. Finally, would there be enough
patients for them to see?
The important issue remains “what is the required
number of medical students to meet future need and
how do we ensure a high level of training is preserved
and graduates have access to good careers?” – the
number of medical schools is really a secondary argument.
There has been no independent needs analysis –
this should be commissioned by the Department of
Health or by the Minister for Health’s office.
Need should prevail over politics. A proper business
case is required to determine the number of positions
required. The capacity, funding and resource needs of
the system; what will be the downstream effect, and; how
Total WA Medical Graduate
(including International Graduates)
medical graduates training and vocational needs will be
accommodated WA Medical Graduates needs detailed assessment.
Curtin’s proposal does not address the 12-plus years
needed to produce an independent practitioner. The
proposal only relates to the number of raw graduates, who
cannot practice independently.
A thorough analysis of the increases already in the
pipeline needs to be done as it is important to know the
downstream consequences, and whether any current
proposed increase in medical trainee numbers will
lead to access block to vocational training and career
opportunities.
In March this year HWA released a report, Health
Workforce 2025, Doctors Nurses and Midwives March 2012,
suggesting, based on various assumptions:
“Workforce shortages – highly significant in the
case of nurses (109,000 or 27%) and less so for
Doctors (2700 or 3% for doctors overall-more work
is required to quantify shortages at the individual
specialty level)” and goes on to note; “bottlenecks,
inefficiency and insufficient capacity in the training
system, especially for doctors.”
HWA also advocates workplace reform to boost
productivity; the full nature and consequences of which
are not clear. In essence, HWA asserts, one of the main
problem areas is resolving current training problems for
medical graduates brought about by the rapid expansion in
medical numbers, which are now starting to flow through
the system.
Comparison of raw numbers with medical school places
interstate is not appropriate. Most medical schools in other
states have a substantial number of fee-paying student
places, which are not accessible to Australian citizens.
To date, the debate does not appear to have taken into
account, for example, that by the end of this decade WA
will be producing over three-times as many fully trained
GPs and other specialists than in 2005 and medical
practitioners will be looking for jobs.
Do we need to increase graduate numbers at this
stage, and if not; when and how will we increase
these numbers? Should we first address the training
and downstream challenges, the recent increases
have placed on the system? We need to answer
these questions, as well as analyse the hard evidence to
determine how best to meet future requirements.
What do you think?
12 MEDICUS May

AMA Medical Products: EDAN
AMA Medical Products has been appointed as the
exclusive distributor of the EDAN range of patient
monitors, cardiotocographs (CTG) and computer-based
electrocardiograph solutions in Australia, New Zealand and
the Pacific region.
EDAN is a global market leader in the supply of CTG
solutions with a comprehensive range of foetal and maternal
monitors and doppler ultrasound devices. Their commitment
to the supply of world-class electronic medical equipment has
also lead to the development of an extensive range of patient
monitors, which includes pulse oximeters and vital signs,
bedside and transport monitors.
EDAN is one of the world’s fastest growing medical
diagnostic companies; supplying medical solutions to over
130 countries, including the USA, Canada, Germany and
Brazil. EDAN employs over 1,000 people globally; one third
of who are dedicated purely to research and development.
This distributorship has resulted from AMA Medical
Products’ success in generating a high level of awareness of,
and increased familiarity with, the EDAN range, which has
led to a large number of these devices being placed in Western
Australian hospitals, general practices and the mining sector.
Through the careful selection of experienced distribution
partners, AMA Medical Products will supply the EDAN
range to health care providers throughout Australia, New
Zealand and the Pacific region.
AMA members and key customers will now have access
to the entire, high-specification EDAN range at competitive
prices.
For more information on the EDAN range please contact
AMA Medical Products on (08) 9273 3022 or
sales@amawa.com.au
AMA Medical Products team with the EDAN range. Left to right: Jamie
Straw, Sales Manager; Anthony Boyatzis, General Manager; and Natalie
Millard, Customer Service Consultant-Distribution.
May MEDICUS 13

PSR Audits
Who will look after you when
Medicare calls?
Increasingly Western Australian doctors are being subjected
to Professional Services Review (PSR) and Medicare audits.
These audits include mental health, practice nurse and chronic
disease management items.
The AMA (WA) has assisted a number of members to
manage this process and ensure due process is followed in
relation to these audits:
“I have just received a call from the PSR and they want
to come and talk to me about my use of practice nurse
items. They want to meet with me in two weeks and
audit some of my patient files.
Is that ok? How do I respond?
They also want to see my practice colleagues.
Should we agree to meet with them? How do we
prepare? Are you able to help us?”
This is just one example of a significant number of calls the
AMA (WA) receives each year from concerned and anxious
doctors who are subject to a PSR or Medicare call.
The AMA’s immediate response when they receive this type
of enquiry is to provide guidance on proactively managing
the audit. In the first instance, this is done by ensuring the
audit occurs at a time that is convenient for the practitioner
and which allows for an adequate preparation period so as to
minimise stress and practice pressure. The AMA will then
assist the member to thoroughly prepare for the audit.
The practitioner must have adequate time to seek
appropriate advice from the AMA and their medical defence
organisation. Practitioners must also have time to ensure their
medical records are adequate and contemporaneous.
The AMA is there every step of the way to assist you to
prepare for the meeting with the PSR or Medicare auditors;
this includes being present at the meeting.
Medical Records
It is a key requirement of Medicare that all medical
practitioners providing a service for which a Medicare Benefit
is payable must ensure they have contemporaneous and
accurate medical records. For a medical record to be adequate,
the contents of that record need to:
1. Clearly identity the name of the patient
2. Contain a separate entry for each attendance by the patient
for the service, and the date on which the service was
rendered or initiated
3. Provide adequate clinical information so as to clearly
explain the type of service rendered or initiated
4. Be sufficiently comprehensive that another practitioner
who is relying on this information can effectively undertake
the patient’s ongoing care.
Regarding over-servicing or the correct usage of item
numbers, any medical practitioner who is the subject of a
Medicare investigation, and ultimately the PSR, can have a
high degree of confidence in the quality and content of their
practice notes if they are consistent with the gold standard.
That is, the notes are accurate and contemporaneous.
The outcome of any review or audit is likely to be
determined by the quality and content of the patient records.
Many PSR audits do not question the medical practitioner’s
clinical management; rather, it is the failure to maintain
adequate and contemporaneous notes that exposes them.
There have been cases where medical practitioners have
failed to maintain adequate clinical notes, which has led to
a finding against them. In such situations the practitioner
has been required to pay back those amounts Medicare has
deemed to have been claimed inappropriately. Underpinning
Medicare’s position has been the fact that the notes don’t
justify the claims. Repayments can mean thousands of dollars,
but emotionally the cost can be even greater.
Following a finding of inappropriate practice, the
outcomes can be significant, including disqualification of
the practitioner’s entitlement to claim certain Medicare
rebate numbers for a period of time and, in the worst case, an
14 MEDICUS May

extended break from practice may be imposed.
Medicare Australia takes an uncompromising position with
respect to medical records, that being, inadequate records
equate to the inability to justify a service.
Back in 2011, practitioners would have received information
packs from the Department of Human Services (DHS)
about the requirements to produce documents to substantiate
Medicare billing, effective from April of that year. The AMA
was very active in this particular area to ensure that both
Medicare and the PSR:
• Document and apply sound processes in their investigation
• Make those processes clear to medical practitioners in
advance
• Provide procedural fairness to the medical practitioners
they investigate
• Tell medical practitioners explicitly what services are being
investigated and why
• Provide clear and proper channels for medical practitioners
to respond to investigations.
As a result of the AMA’s strenuous lobbying on this matter
Medicare audits contain stronger safeguards for protecting a
patient’s privacy. The Health Insurance Act 1973:
• makes it clear that the clinical information only has to be
produced if there is no other information to substantiate a
claim
• permits clinical information to be provided to a medical
practitioner employed by the DHS
• requires the DHS to have regard for the types of
documents, other than patients’ records, that could
substantiate claims
• allows the practitioner to consult with professional bodies,
such as the AMA, on those matters and for a representative
from such a body to present during the audit process.
Although the AMA supports reasonable audit strategies
to maintain the integrity of the Medicare arrangements, it
insists those strategies must protect patient privacy and the
confidentiality of the doctor–patient relationship.
As a consequence, the AMA continues to meet
regularly with the DHS to ensure that
its compliance strategy accounts for
the Medicare Benefits Schedule
(MBS) and the realities of a
modern medical practice.
Through these meetings,
the AMA has called for a
comprehensive review of
all elements of General
Practice Care Plan
Audits, and it is working
to improve the quality
of information the DHS
provides in letters sent to
doctors who are the subject of
an audit. For example, the AMA
has requested the DHS to clearly
set out the details of any concerns they
have to the practitioner, outlining any benefit in
question that may not be payable.
In addition, the AMA has been working with the
The outcome of
any review or
audit is likely to
be determined
by the quality
and content
of the patient
records.
Department of Health and Aging (DoHA) and the PSR over
the last nine months to make significant improvements to
the operations of the PSR. As a result, the PSR will now give
practitioners under review more information about the nature
of the services they provided that are being investigated,
and the meetings with the PSR Director will be held at a
neutral venue. The PSR, as a consequence, published on its
website a comprehensive guide to the PSR process to ensure
practitioners under investigation have information about the
process and their rights. This also assists practitioners in
verifying that processes and procedures are properly observed.
Continued on page 17
May MEDICUS 15

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Continued from page 15
The Health Insurance Amendment
(Compliance) Act 2011
The Health Insurance Amendment (Compliance) Act 2011 (the
Act) was passed by the Australian Parliament and began
operation on 9 April 2011. It relates to Medicare services
provided on or after this date.
Key features of this Act are:
• The DHS can now issue a notice to health professionals,
or a person in charge of professionals’ records, if there is
a reasonable concern a Medicare benefit has been paid
that exceeds the amount that should have been paid. This
notice will require a health care professional to produce
documents to substantiate services. An administrative
penalty with a base rate of 20% for unsubstantiated
amounts that total more than $2,500 has been introduced.
This penalty is automatically decreased where a health
professional voluntarily cooperates with an audit but can be
increased where a health professional does not cooperate.
• Health professionals can seek a review of the decision from
the Department of Human Services to recover funds for a
Medicare service that has not been substantiated.
The Act only applies to professional services
provided on or after 9 April 2011
There are a number of health professional guidelines, which
form part of the series in the Health Professionals section
of the Medicare website, and which are designed to help
the doctors to understand the documents they can use to
substantiate services if they are asked to participate in a
Medicare compliance audit. These include:
• Substantiating that a patient attended a service
• Substantiating that a specific treatment was performed
• Substantiating that a valid referral existed (Specialist or
Consultant Physician)
• Substantiating that a valid request existed (Pathology or
Diagnostic Imaging)
• Substantiating that a patient had a previous condition at
the time of service
• Substantiating proof of malignancy where required for
MBS items.
The current Compliance National Programme’s areas of
interest include:
• Bulk bill incentive items
• Care plans
• Health support programs
• Diagnostic Imaging and Pathology
• Prescribing
• High-risk providers.
If Medicare knocks on your door
regarding any of the above, as a
member, your first response
should be to immediately
contact the AMA for
assistance. When the
auditors call, this will
be the best move
you make from a
professional and
emotional standpoint.
Medicare
audits contain
stronger
safeguards
for protecting
a patient’s
privacy.
May MEDICUS 17
May MEDICUS 17

Opinion
Making Sense of After-Hours...
... if we can
by Dr Steve Wilson
Chair, AMA (WA) Council of General Practice
The whole structure of after-hours GP services has changed
so much in the last couple of decades. Once the proud duty of
most family physicians, it is now largely the inescapable duty
of amazing rural colleagues. The Royal Australian College of
General Practitioners (RACGP) also many years ago insisted
GPs cannot do after-hours work unless they are VR, thus
wiping out an entire workforce which also gained valuable
experience. Much after-hours work is performed almost
exlusively by OTDs who access A1 rebates for working the
most unsociable hours. Welcome to Australia!
At an AMA GP Breakfast last year attended by metropolitan
GPs, almost all full-time and/or practice principals, the afterhours
section was chaired by now–Vice President Richard
Choong. When he asked if we wanted to take on true afterhours
work in addition to our current workload, of more than
60 attendees, not one hand shot up. After-hours issues are
complex, but any clinician with passing knowledge of GP
workforce/financing will have a good understanding.
The fact is many GPs like myself are so flat out with current
worloads there is no capacity to take on much, if any, afterhours
work, and less desire, even if we felt the moral obligation.
There are even fewer financial incentives. Indeed, in a GP
Opinions survey two years ago, money was NOT the issue at
all for GPs, young or old, but lifestyle, saying they wouldn’t get
out of bed at 0200 hours for even $300.
So what are the solutions? DoHA has taken what I see as an
extraordinarily metrocentric approach to trying to deal with
after-hours. An After Hours GP Helpline has been operating
nationally now since 1st July 2011. About one fifth of all calls to
Healthdirect Australia are being referred to the GP Helpline.
Half of these callers are advised to see their GP the next day,
15% are referred to 000 or an Emergency Department (ED),
and another 8.5% were referred to ED because no after-hours
services were available in their area. No surprises there. Many
of these would be outer-metro or semi-rural patients of cities
and regional towns, and it is simply not economically viable
or often safe for Deputising Medical Service doctors to attend
these regions.
More comprehensive statistics are available mid-year when
the AMA’s After Hours Technical Working Group meets in
June. AHTWG will be asked to consider options for adding
videoconferencing to the Helpline, with this to start from 1
July 2012. The AHTWG will also be providing input to the
Stage 2 Medicare Locals After-Hours Guidelines, and on the
evaluation framework for after-hours primary care.
Of course this all ties in with the Personally Controlled
e-Health Record (PCEHR). The current arrangements for
GPs extracting an Event Summary from the National Health
Call Centre Network (NHCCN) after a patient has contacted
the After-Hours GP Helpline are considered inadequate and
burdensome. Given we’re waiting with bated breath for the
launch of the PCEHR, for which none of us who contribute
will see any government-driven specific remuneration, there
is concern that more streamlined measures have not yet
been developed for event summary conduits. The AMA has
raised its misgivings with the NHCCN in consultation with
Medibank Health Solutions (the provider) and specifically
my colleagues and I on AMACGP have been asked to provide
feedback on interactions with the After-Hours GP Helpline,
accessing the event summary, any noticeable changes in
demand for after-hours service since the introduction of the
Helpline and issues around the evaluation framework.
Notably, doctors contracted by Medibank are being paid
over $220/hr without any costs; nice work if you can get it. Yet
GPs providing after-hours support (such as rural, regional and
true outer-city GPs, and GPs attending aged care facilities in
unsociable hours) are getting paid nothing for providing the
service AND they often know the patients in
question. Concern has also been raised
by the AMA regarding the lack of
experience of some of the doctors
on the call centre service, their
credentialling and the process
for approving applicants.
Currently the minimum
credential is three years’
postgraduate experience,
however quite rightly the
RACGP says it should be 10
years.
Furthermore, Medicare Locals
are meant to provide the future
organisational capacity, yet there is little
or no information at all from the NHCCN,
After
hours
issues are
complex
who seem as in the dark as we are as to how this will all roll
out. Simultaneously, the after-hours Practice Incentives
Program (PIP) money for general practice disappears from
July 2013, and there will be even less incentive for existing
practices to be involved. It could spark an increase in
attendance to EDs, for those Australians who are fortunate
enough to have the ability to do so.
This may also lead to substantial bypassing of private
providers whose after-hours services may then be non-viable,
Continued on bottom of page 19
18 MEDICUS May

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Continued from page 18
as we all know patients will sit for six hours in an ED for a free
service rather attend an after-hours clinic at a cost.
Take heart that six out of seven after-hours patients are still
managed in general practice, so we haven’t dropped the ball.
However if only 11% contacting the Helpline actually end up
seeing a GP, then how cost-effective is the service? AMA must
push for a scrupulous disclosure of the actual cost per service,
as we did with WA’s HealthDirect. The federal executive
advises me that “evidence suggests there will a non-sustainable
increase (12% per annum) in presentations to hospitals,
especially at paediatric level. Essentially it is a cost-shifting
exercise 6 MEDICUS to the April States because of the inadequate funding of the
Primary Care GP space by the Commonwealth.”
To add further madness to this area, remember that
accredited GP clinics currently have a mandatory after-hours
responsibility – it is an essential criterion under RACGP
standards. If from 1 July 2013 Medicare Locals are responsible
for after-hours care (and for a region much larger than
individual practices, I add), the practice should no longer be
held responsible for a standard when a third party (Medicare
Locals) is responsible. We need a firm directive from the
RACGP on this, or practices could lose accreditation and
hence PIP funding.
May MEDICUS 19

Opinion
Do WA Hospitals really support
our training?
by Dr Dror Maor
Co-Chair, Doctors in Training Committee
Access to a high-quality training environment and educational
resources is an issue of great importance to all junior doctors.
It is vital that we receive a proper learning experience so that
we can continue to develop into the consultants of the future.
Proper training facilities, adequate clinical supervision,
appropriate channels for feedback and protected time for
education and training. They are all crucial issues for
Australia’s junior doctors as medical student and graduate
numbers grow, placing more pressure on a hospital system that
is struggling to support the delivery of high quality clinical
training.
Currently Australia’s public hospitals are still fundamental
to educating and training doctors. The way these hospitals
function has however changed over the years. Patients
are being admitted and discharged at muvh higher rates,
outpatient clinics are mainly about service delivery and much
of the “routine operating” occurs in the peripheral hospitals
now. With this in mind the AMA wants to know if hospitals
are striking the right balance between the provision of care to
patients and training the next generation of doctors.
The AMA is conducting a national, confidential, online
survey of junior doctors throughout Australia on the quality of
the training, education and supervision that they are receiving
in their training hospital. This is the second survey of its type,
with a similar survey in 2009.
There is no doubt that all junior doctors must be
appropriately supported and supervised during their formative
training years – and that the breadth of their experiences must
prepare them for independent medical practice so that the
Australian community recieves the appropriate health care it
deserves.
The 2009 AMA Training and Education Survey delivered
a mixed report card on the quality of the public hospital
training environment, highlighting that more resources were
needed to ensure that the quality of medical training in our
public hospitals was maintained and improved. The results of
this survey will enable the AMA to assess what changes have
taken place since 2009 and which West Autralian hospitals are
performing well and which ones are not. This information can
then be used to lobby hospitals and governments. There is also
no doubt that with the recent increase in medical graduates
the demand for training jobs is only increasing and will
continue to do so over the coming years further emphasising
how important quality training posts will be.
The anonymous, five minute survey – which runs from 18
June to 20 July – is open to all junior doctors.
If you would like to participate please go to:
www.ama.com.au/dit-training-survey-201
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May MEDICUS 21

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22 MEDICUS May

Negotiating your contract
AMA (WA) regularly assists members in negotiating contracts, with practices and hospitals, all over
Western Australia. In this article the Association looks at some of the key issues to consider.
Who are the parties?
Is the contract between you (in an
individual capacity) and a hospital or
practice? Or is the contract between
your practice and a hospital? In either
case, ensure that the parties are correctly
identified, and the relevant details
(addresses and medical registration
numbers, for example) are inserted.
What is the term of the contract?
A contract should not be so short that
there is insufficient certainty for the
parties to the contract; neither should a
contract extend for too long, where agreed
terms may no longer reflect contemporary
practice. The appropriate balance between
these factors should be determined by the
parties to the contract. A large number
of contracts reviewed by AMA (WA) are
between three and five years’ duration.
What are the obligations of each party?
Ensure that the contract provides a
reasonable framework for the services
that you provide, and what the hospital
promises to do in return. The contract
should go into sufficient detail so
that expectations are clear, although
the document should not be overly
prescriptive, such that it does not allow
you sufficient flexibility of practice.
What kind of legal relationship –
independent contractor or employee?
The contract must accurately describe
your legal relationship with the practice
or hospital. In On Call Interpreters and
Translators Agency Pty Ltd v Federal
Commissioner of Taxation, 1 the Federal
Court reaffirmed that “[t]he relationship
is to be found not simply from the
contractual terms agreed to but by the
system operated thereunder and the work
practices which establish the ‘totality of
the relationship’.”
In other words, your contract may state
that you are an independent contractor, yet
the true legal relationship may be one of
employer/employee. Some of the indicators
of being an independent contractor
include how much control you have over
work that is undertaken, who bears the risk
for that work, whether an invoice is raised
(and GST charged) and whether work can
be delegated.
Can parties terminate the contract?
A contract should allow a party the right
to terminate contractual agreements, with
reasonable notice provided. Three months’
written notice is provided for in most
contracts, although this may be negotiated
depending on the length of the contract
and other relevant issues.
Is there a restraint of trade clause?
Restraint of trade provisions in a
contract are terms that restrict doctors
from providing medical services to
other practices during the period of the
contract and/or for a set period after that
contract has expired. Such a term may
state that “for three months following
the termination of this agreement, the
practitioner may not provide medical
services to another organisation within
one kilometre of the practitioner’s current
practice”.
In 2010, the Supreme Court of New
South Wales in Symbion Medical Centre
Operation Pty Ltd v Alexander 2 held that
such restraint of trade clauses may not be
enforceable, depending on the particular
facts at hand. The court cited McHugh
Holdings Pty Ltd v Newtown Colonial Hotel
Pty Ltd, 3 which stated that: “whether a
restraint is reasonable depends upon two
questions: first, whether the covenantee
has a legitimate protectable interest, and
secondly, whether the restraint is no
more than reasonable for the legitimate
protection of that interest.”
In other words, the question to be
asked is whether a corporate entity (with
commercial interests) may enforce a
restraint of trade clause against a medical
practitioner (who arguably has a different
interest – the provision of medical
services).
What is covered in the schedules?
Many contracts for medical practitioners
have key terms in the schedule to the
contract, which may include practitioner
information, salary and other benefits. It is
important to ensure that the information
in the schedules reflect what has been
agreed between you and the practice/
hospital.
Is the contract duly executed?
On the execution (signing) page of the
contract, you should ensure that the
parties are accurately described, and that
each party has signed at the appropriate
location. There should also be a date on
the execution page, regardless whether the
date is elsewhere in the contract – the date
you sign the contract should be the date on
the agreement. Lastly, do also ensure that
a final copy of the executed agreement is
provided to you as soon as practicable.
Summary
It is important to obtain professional
advice before entering into any agreement,
and to understand each of its terms and
conditions before signing. After the
contract is signed, realise that this written
agreement is merely a framework for
establishing a working relationship in what
can be a dynamic environment.
While having a well-drafted contract
can help define roles, responsibilities and
set out dispute resolution mechanisms,
it is worth remembering that ultimately
the success of any agreement depends
on the ongoing relationship between the
relevant parties. Where the relationship is
good, minor disagreements can be dealt
with quickly and professionally, but a
deteriorating relationship can turn minor
disputes into intractable problems.
AMA (WA) members who need advice on
a contract, please contact the Association
on 08 9273 3000.
1. On Call Interpreters and Translators Agency Pty Ltd v
Federal Commissioner of Taxation (No 3) [2011] FCA
366.
2. Symbion Medical Centre Operation Pty Ltd v Alexander
[2010] NSWSC 1047.
3. McHugh Holdings Pty Ltd v Newtown Colonial Hotel Pty
Ltd [2008] NSWSC 542.
May MEDICUS 23

A dvertising F eature
Advice for Doctors on the safe
transfer of UK pension assets
New regulations governing the transfer of United
Kingdom pensions out of the country can potentially
have a significant affect on the retirement incomes
of expatriate doctors now working in Australia.
According to a financial adviser who specialises in
United Kingdom pension transfers, the new rules, which
came into effect for the new British tax year on April 6, can
result in heavier tax penalties and consequently, a smaller
retirement nest egg for some expatriates.
McKinley Plowman & Associates, United Kingdom
Pensions Transfer Manager Colette Pieniazek said
obtaining the right professional advice about transferring
or investing pension assets could save a doctor thousands
of dollars in tax and ultimately a far more comfortable
retirement.
Mrs Pieniazek, who immigrated to Perth from Britain
over eight years ago, said while doctors had a lot to gain
from transferring their pensions into Australian Qualifying
Regulated Overseas Pension Scheme (QROPS) funds, it
was critical for them to understand how the latest changes
would affect them.
She said the new rules required for the receiving
QROPS scheme to report members’ withdrawals to HM
Revenue & Customs (HMRC) for ten years after their
pension was transferred to Australia.
Under previous regulations the Australian pension
scheme was only required to report withdrawals for five
UK tax years from the date of residency here.
Mrs Pieniazek said the rule changes would be
retrospective, so expatriates who had already transferred
their British pensions into Australian QROPS funds would
also need to be aware of the longer reporting requirements
and their taxation implications.
“This means that if you make a withdrawal from
your transferred UK pension within this time period
and it is outside prescribed UK limits then you will face
an unauthorised tax charge of 55% by HMRC,” Mrs
Pieniazek said.
“It is absolutely vital that those who intend to either
retire or plan to draw on their former UK funds within the
next ten years seek professional advice now.”
Mrs Pieniazek said with the right professional advice
immigrants could safely transfer their pension to Australia
in a tax effective way and be better off in retirement.
She said McKinley Plowman and Associates was now
providing doctors with a free no-obligation report on
the different financial and tax outcomes of leaving their
pension in Britain or transferring it to Australia.
She said transferring British pensions to an Australian
Qualifying Regulated Overseas Pension Scheme
(QROPS) offered many benefits including a tax-free
income in retirement, flexible investment opportunities,
potentially higher returns, freedom from exchange rate
fluctuations and long-term asset protection.
Unlike the British pension funds, Australian funds
allowed pension holders to pass on their entire fund
balance to a spouse or beneficiaries after death.
Mrs Pieniazek said it was important to begin the
pension transfer process, which usually took up to four
months, as soon as Australian residency was obtained.
Pension transfers made within six months of obtaining
residency did not incur Australian tax; however those
made after this period were subject to a 15% tax.
This tax applied to any capital gain made by the
UK pension between the time an individual moved to
Australia and the time the pension funds arrived here.
“Also, Australians can take 100% of their super tax free
at age 60, whereas UK laws only allow for 25% to be taken
as a lump sum.”
For more information email:
pensions@mckinleyplowman.com.au
T: (08) 9301 2200 F: (08) 9301 2201
McKinley Plowman & Associates
Level 2 / 5 Davidson Terrace JOONDALUP WA 6027
Correspondence PO Box 635 JOONDALUP WA 6919
www.mckinleyplowman.com.au
1 24 MEDICUS MEDICUS March May

AMA (WA) MEMBER BENEFITS
ANNUAL BALANCE SHEET
The benefits of AMA membership are clearly seen, whether your subscription is $516 as an Intern or
$1,596 as a Specialist #
DEBIT to AMA (WA) Member CREDIT to AMA (WA) Member Essential Optional
Annual Membership Subscription fee
Intern: $516
Registrar: $906
Magazine subscription to Medicus,
Medical Journal of Australia and
Australian Medicine
$515
BENEFITS
AMA Schedule of Medical Services
and Fees
AMA (WA) Innovation Seminar Series
attendance
CBA Home Loan – based on a
$500,000 loan
HBF – annual hospital and
essentials cover
Qantas Club – based on a one-year
membership fee
Virgin Lounge – based on a one-year
membership fee
Hertz – based on a two-day car hire, a
minimum saving of
Fleet First – a likely saving per vehicle
purchase
Godfrey Virtue Lawyers –
20% saving on legal fees
$404
$200
$4,500
$803
$310
$299
$120
$2,500
$175
WASO – 10% saving on concert tickets $120
Powerbuy – discounts on popular IT
brands and services (eg Apple Mac
laptop)
Bose – 10% discount on Bose
equipment
Support from experienced industrial
practitioners from our Workplace
Relations and Medico-
Legal department
A voice for your profession
Priceless
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Average dollar saving $6,732 $3,514
When the benefits outweigh the small cost, it makes sense to join. Call 9273 3055 or join on-line at
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# Note that AMA membership subscriptions are fully tax-deductible for practising members.
May MEDICUS 25

AMA (WA) 2012
Awards Night
& CHARITY
GALA DINNER
Saturday 7 July 2012 AT 6.30pm
State Reception Centre
Kings Park
The AMA (WA) will host the 2012 Charity
Gala Dinner and Awards Night in
recognition and support of the Dr YES
Youth Education Sessions.
This unforgettable evening will honour the achievements
of outstanding Western Australians who have made
significant contributions to medicine in WA.
Please join us for a magical
night of celebration,
entertainment and prizes.
Tickets are strictly limited.
Book now for this exclusive event by contacting Liz Gray
on 9273 3027 or email liz.gray@amawa.com.au.
AMA Members $195 per head
Corporate Tables (10) $2,050
Dress Black Tie (Optional)
The evening will include feature performances by
The West Australian Doctors’ Orchestra (WADO)
as well as one of Australia’s most talented comedians,
star of the stage, screen and television, Peter Rowsthorn.
26 MEDICUS May
Supporting the
health of Western
Australia’s Youth
through Dr YES

AMA (WA) Benefits and
Services Access Policy
One of the main roles of the AMA (WA) is to protect and
support the individual and collective needs of our members’
workplace, industrial and medico-legal interests.
The AMA (WA) is not a government-funded organisation.
The work done on behalf of members is funded by the
collective annual subscriptions of the Association’s
membership. These funds are directed into activities and
services that directly benefit members and align with the goals
and objectives of the Association.
Membership subscriptions allow the Association to employ
skilled and experienced staff who protect members’ interests,
defend their rights and improve their workplace terms and
conditions. There are no resources available to help doctors
who have not joined the Association.
Clearly, most WA doctors are aware that non-members
benefit from many of the Association’s activities. These
include important representations such as the improved pay
and conditions that come from AMA (WA) negotiated salaried
agreements and securing government funding for improved
private practice infrastructure.
However, non-members are not eligible to receive AMA
benefits and services. These include the invaluable service of
one-on-one assistance when a member encounters problems in
the workplace. At some time in their career, most WA medical
practitioners face a workplace dispute or problem of some
sort. This could be a bullying colleague or manager, an error
in pay or leave entitlements, an unjust accusation, issues with
management directives, undergoing Medicare review, private
practice partnership issues or a range of contractual disputes.
Only AMA members have the security of knowing they can
access the Association’s expert staff and extensive resources to
deal with such a problem.
As the Association does not provide assistance to nonmembers,
it is in your interests to join before a problem arises.
In the same way that no one expects to buy insurance for
a car that has already been written off, there should be no
expectation that the AMA (WA) will assist in resolving a preexisting
problem. If you join in good faith and a workplace,
industrial or medico-legal issue subsequently arises, you will
receive the Association’s full support – even if you have been
a member for only a short time. There is no waiting period for
problems that arise after you join.
New members joining with pre-existing
problems:
The AMA (WA) Council, while encouraging all medical
practitioners to join the Association and enjoy the benefits that
membership provides, is committed to imposing strict limits
on the access to membership services of those who seek to join
the AMA with pre-existing problems and unresolved disputes.
The AMA (WA) Benefits and Services Access Policy
provides guidelines which ensure that the highest standard of
workplace, industrial and medico-legal advice is provided on
an equal basis to all financial members.
1. Non-members are not eligible for assistance.
2. Non-members are not eligible to access any member
benefits or services.
3. Where a medical practitioner joins the AMA and a
problem develops after the date of joining, then the
member shall be entitled to advice and assistance
immediately.
4. Where a medical practitioner joins the AMA, that member
is eligible to access all member benefits other than the
Fellowship Examination discount on the membership
subscription (which requires 3 years’ prior membership).
5. Where a non-member seeks advice about an existing
problem or a member seeks assistance in relation to a
problem that arose prior to the time they joined the AMA,
no assistance will be granted (save that advice may be given
in exceptional circumstances), subject to the provisions of
Point 6 below.
6. In the interests of progressing the objectives of the AMA,
a special exemption may be granted at the discretion of an
authorised Executive staff member whereby Point 5 may be
waived in whole or in part.
New members with pre-existing problems and
disputes will be offered the following options for
assistance:
1. Initial advice through consultation with an AMA (WA)
Executive Officer.
2. Referral to an appropriate outside agency, if one exists.
3. Full or partial assistance may be provided at the discretion
of an authorised Executive staff member in special
circumstances where more than one member is affected
by a workplace, industrial or medico-legal problem, or
where other circumstances are evident (e.g. mental health),
depending on the nature of the issue.
For Point 3 above to be considered, it is incumbent upon the
non-member to disclose the nature of any existing problems
or disputes at the time of making application to membership.
Failure to do so may result in any subsequent approach to an
authorised Executive staff member, under the provision of
Point 3 above, failing a discretionary ruling.
Unfinancial Members
Unfinancial members are not entitled to any workplace,
industrial or medico-legal assistance or access to any memberonly
benefits or services until such time as they pay the annual
subscription and any arrears.
May MEDICUS 27

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Industrial:
Cost Shifting and/or Privatisation
The State Government has for some time been seeking to
change the manner in which services are provided in public
hospitals. This might involve increasing private activity or
privatising existing public activity; such changes need to be
very carefully considered and, if appropriate, legal advice
sought.
The Association has previously provided detailed advice
in relation to the Ambulatory Surgery Initiative (ASI) and
Privately Referred Non In-patients (PRNI), and secured a
commitment to improved additional indemnity coverage for
such initiatives.
Given previous adverse publicity and investigations by
external authorities, the Association would urge practitioners
to exercise due diligence and seek appropriate advice from
the Association and their Medical Defence Organisation
in relation to any information provided by hospitals before
considering participating in any such initiatives.
Medical practitioners should be wary of management
which seeks to insist there is an obligation to participate in
revenue-raising arrangements in order to maintain access to
Arrangement A.
Whilst the Association strongly supports clinicians and
hospitals legitimately maximising income, great care needs
to be taken to avoid replicating problems that have arisen in
the past by overenthusiastic or naive management embarking
upon schemes which subsequently result in significant adverse
publicity, investigation and emotional distress. Once such
situation occurred a few years ago in relation to a trust fund
enquiry at one of our major hospitals.
If what is being proposed is a change in traditional private
practice activities for the Department, or if eligible patients
may not be given the choice of electing to be treated for free
as public patients, or if there is a lack of independent external
confirmation of the lawfulness or otherwise of what is being
proposed, clinicians are strongly advised to seek independent
external advice.
Health Service Governing Councils
The expertise and leadership of five former presidents of the
Australian Medical Association (WA) have been recognised
by their appointment by the State Government to the newly
established Health Service Governing Councils.
Health Minister Kim Hames said he had reached into the
medical community to access the wealth and experience held by
AMA (WA) former presidents.
“Governing Councils will bring together a wealth of
knowledge and experience from across the community, clinical,
corporate and government sectors,” Dr Hames said.
“Each council will play a key role in planning the future for
WA’s public health services, and ensure effective community
and clinician engagement in local health services planning,”
he said.
Several AMA (WA) past-presidents have been appointed
by the State Government:
Professor Bryant Stokes (Chair, South Metropolitan
Governing Council); Dr Simon Towler (Member,
South Metropolitan); Associate Professor Rosanna Capolingua
(Chair, Child and Adolescent Health Service Governing
Council); Professor Gary Geelhoed (Member, Child and
Adolescent Governing Council); and Professor Geoff Dobb
(Chair, Southern Country Health Service Governing Council).
A number of other AMA (WA) members were also
appointed to the new Governing Councils:
Professor Fiona Wood (South Metropolitan); Professor
Julie Quinlivan (North Metropolitan); Dr Michael Levitt
(North Metropolitan); Dr Michiel Mel (Southern Country);
Dr Ian (Val) Lishman AM (Southern Country); Dr Phillip
Montgomery (Northern and Remote Country Health
Service Governing Council); and Dr Shane Kelly (Child and
Adolescent Health Service).
The AMA (WA) has called for more information to be
provided by the State Government on how Governing Councils
will work and how their recommendations will be dealt with.
AMA (WA) past-presidents Professor Bryant Stokes, Associate Professor Rosanna
Capolingua, Professor Gary Geelhoed and Dr Simon Towler
May MEDICUS 29

Switch to Best Practice and switch
on automatic SMS reminders/replies
Your appointment reminder cards may disappear in their jeans pockets going through
the wash but today’s patients can’t forget appointments when you remind them via their
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For just a few cents and virtually no effort, new automatic SMS reminders (and confirmation
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Benefits of SMS in Best Practice Management
• Integrates seamlessly into the Best Practice Management
Appointment module.
• Patients can be reminded within minutes of making a new
appointment on their Mobile phone.
• Seamless two-way SMS communications, allows Patients to
confirm an appointment via SMS with a simple YES reply.
• SMS messaging simplifies Patient communication, it saves
time and money while greatly reducing the risk of No Show
appointments.
Features
• Interchangeable Practice SMS templates allow tailored
messages with a single click.
• Complies with National Privacy standards of an opt in or
out system.
• Exclude SMS Appointments reminders for Appointments
made within a certain number of days.
• Practice allocated mobile number (additional costs apply)
• Delivery reports - Confirmation the Patient received the
SMS (2 delivery reports = 1 SMS Credit).
• Only quality Tier 1 Australian SMS Providers used.
Cost Prepaid
• 1000 SMS credits = $200 +GST (20c Per SMS)
• 2500 SMS credits = $400 +GST (16c Per SMS)
• 5000 SMS credits = $700 +GST (14c Per SMS)
• 10000 SMS credits = $1200 +GST (12c Per SMS)
• 25000 SMS credits = $3000 +GST (12c Per SMS)
Practice allocated mobile number = $50 +GST Setup Fee / $300 +GST per year (subscription based)
30 MEDICUS May
For more information contact us: T: (07) 4155 8800, SMS: 0427 767 833 or E: SMS@bpsoftware.com.au

DiT Working Party
Part Time Employment – Is this really
possible for junior doctors?
With the move to graduate entry programs at various medical
schools, there are more Doctors in Training (DiTs) who
are seeking to be engaged on a part-time basis due to family
commitments or even just seeking to establish a better worklife
balance. Whilst WA Health has Family Friendly and Work-
Life Balance policies in place, it is the application of these
policies by the health services that is more problematic. The
AMA (WA) has increasingly been receiving enquiries from
DiTs regarding the ongoing difficulties in obtaining part–time
employment.
Over the last couple of years it has been obvious, despite
WA Health’s policy, resident and registrar positions are not
advertised as part-time and when attempts by two junior
doctors were made to be employed as a part-time practitioner
against a full-time position, applicants have met with concrete
walls, even when two doctors have applied as a ready-made
job-share. A number of doctors have had to resort to taking the
matter to the Public Sector Standards Commission or Equal
Opportunity Commission to at least get a trial of a job-share
arrangement established. Essentially a NATO situation – No
Action, Talk Only!
The issues are further exacerbated when looking at relevant
training programs and identifying which colleges will enable
their programs to be completed on a part-time basis, and how
this can be implemented within WA Health.
The DiT Committee has determined that this issue needs to
be further investigated and remedies established. As a result,
a Working Party has been formed to examine the issues and
identify where changes are required, and what positions need
to be advocated with which bodies. If changes are required
to the Industrial Agreement, then we have the opportunity to
identify those changes now in preparation for the next round of
negotiations, which will commence in early 2013.
If you have experienced difficulties in accessing part-time
employment and have identified potential solutions, or you
have some thoughts regarding this issue, then the Working
Party would greatly appreciate receiving your feedback. This
information can be provided to the Working Party via Clare
Francis, who can be contacted at clare.francis@amawa.com.au
or on 9273 3000.
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May MEDICUS 31

THE AMA WORKING
FOR THE PROFESSION
• Development of draft guide for doctors on how to use
the PCEHR (Personally Controlled Electronic Health
Record)
• Continuing the call for GPs to be financially supported
for the extra clinical services they will be providing to
patients with PCEHR
• Exploring workforce planning and clinical training issues
in relation to the proposed new Curtin Medical School
• Providing advice and assistance to address public sector
hospital misinformation regarding rights of private
practice for State public sector full-time, 0.8 and sessional
practitioners operating under Arrangement A
• Clarified information regarding supervision requirements
for procedural trainees’ services to bona fide private
patients to attract Medicare benefits
• Advice in respect to retrospective billing
Case Study :
Explanation of GP Registrar Entitlements
Dr David Kehoe* contacted the Association after
experiencing difficulty with being paid his annual leave.
Dr Kehoe is employed as a GP Registrar Year 2 i.e.
GPT2. He had proceeded on a period of 2 weeks of annual
leave straddling two pay periods. In the two pay periods
in question Dr Kehoe’s % of billings had exceeded the
minimum wage as defined within the National Minimum
Terms and Conditions (NMTC). Dr Kehoe had sought
to raise the issue with the Practice Principal and Practice
Manager at XYZ General Practice but to no avail as they felt
that as the % of billings exceeded the minimum wage that no
additional payment was required.
As a member of the AMA Dr Kehoe was able to access
the following:
• Assistance in reviewing his weekly earnings for ordinary
hours calculated since the commencement of term and thus
determining his average.
• Assistance in discussing the AMA’s assessment with the
Private Practice concerned including providing specific
clarification to the Private Practice on how to interpret the
NMTC document (which can be difficult for practices to
interpret).
How did AMA membership benefit Dr Kehoe?
As a result of the assistance, advice and advocacy on his
behalf Dr Kehoe was paid his annual leave entitlement and
clarification was able to be provided to the Private Practice
which assists in their ongoing employment and supervision of
GP Registrars and ensures that they are seen as an Employer
of choice.
Case Study:
Junior Doctor’s Pay Dispute
Dr Jane Weston* had been rostered for 76 hours during a
fortnight in which a public holiday fell but had not been
required to work on the public holiday. Although her
employer paid her correctly in accordance with the clause
relating to observed Public Holidays, they failed to pay her
in accordance with the Payment of Overtime clause which
required them to pay her for 4 hours at the overtime rate of
150%.
As a member of the AMA Dr Weston was able to access
the following:
• Assistance in raising the matter with both the HCN and
the Health Industrial Relations Service
• Requiring the employer to comply with the overtime
provisions of the Agreement
How did AMA membership benefit Dr Weston?
The AMA ensured that the error was rectified and Dr
Weston received the outstanding amount of pay
• Lobbied State Government to immediately stop
Treasury grabbing money from Special Purpose
Accounts (SPAs) used by doctors for teaching,
training and research
• Advising members regarding their rights to
undertake additional work external to their
contract of employment with a public hospital.
• Providing members with advice on filling out the
AIMS form in light of qualified privilege being
under review
• Assisting members in understanding their
HCN payslips, identifying significant errors
and representing individual members in gaining
recompense
• Providing members and their staff with
information on changes to the Nurses Award and
Health Professional Support Services Award to
ensure that members are complying with Fair
Work Australia requirements
• Assisting members in performance managing
their employees and, where necessary, assisting
with termination of employment
• Assisting members in dealing with unfair
dismissal applications before Fair Work Australia
• Advising members as to what they should do if
they receive documents about a patient from a
Nurse Practitioner
32 MEDICUS May

• Representations to RPH for the review of Patient
Examination Guidelines.
• Establishment of a Doctors in Training (DiT)
Committee Working Party to focus on the current
difficulty in accessing part-time employment within
WA Health
• Lobbying for simplification of the travel claim
process when accessing Professional Development
Leave
• Achieved the cessation of blanket SMS messages
to Registrars’ personal mobiles at 6.30am to advise
them to release their Interns from duty to attend
education sessions.
Case Study :
Overseas Trained Doctor Seeks
Permanent Residency
Doctor Justine Hahan*, an overseas trained doctor, was
working in Kalgoorlie as a Senior Medical Officer for
the WA Country Health Service and wished to obtain
permanent residency status for herself and her family.
She was originally required to justify her application for
permanent residency because she had a young child who
had a disability.
The Federal Government’s initial decision was to reject
permanent residency status given her child’s disability even
though this would leave the Health Service extremely short
staffed and the Goldfields’ community without ongoing
and much needed medical services. Dr Hanan contacted
the AMA to see what could be done.
As a member of the AMA Dr Hahan was able to access the
following:
• Assistance, advice and direct representation in raising the
matter with both the Australian Immigration Department
and key Ministers.
• Support and information to validate her claim for
residency.
How did AMA membership benefit Dr Hahan?
As a result of the representations made to both State
and Federal Governments along with the Immigration
Department as part of a concerted campaign to have Dr
Hahan granted permanency. The outcome was that Dr
Hahan and her family now have permanent Australian
residency.
Case Study:
Medicare Practice Audit
A practice was contacted by Medicare requesting a meeting
with the Practice Principal. Medicare advised they wished
to discuss and audit patient files relating to Practice Nurse
and Chronic Disease items. The practice was also advised
that some of the other doctors at the practice would be also
audited.
As a member of the AMA the Practice Principal received the
following assistance:
• Communications with Medicare
• Preparation for the audit
• Attendance at the audit meeting by an AMA representative
and
• Past audit meetings with the practice.
How did AMA membership benefit
As a result of the AMA’s assistance, the Practice Principal
and his colleagues were deemed to be in good standing with
all audit requirements being met.
*Names have been changed to help maintain the anonymity
of the member.
• Surveying WA doctors on impact of FIFO on regional
health services and submitting input to public hearing
• Successful representation to the Stokes Review
regarding concerns and changes to the 4 Hour
Rule. This was achieved through the acquisition of
comprehensive and extensive member feedback
• Provision of an online Salary Calculator and
Understanding Your Payslip guide for members
• Individual assistance to members regarding their
contract or term rotations
May MEDICUS 33

The Federal
Government
undermines
General Practice yet again
Just when GPs thought they had some respite from the
financial undermining of their practices, they have woken to
find that the nightmare continues with yet another savaging
by the Federal Government’s budget cuts. It wasn’t enough
to throw hundreds of millions of dollars into super clinics
recognised to be a failed market model, or the massive cutback
to the GP mental health items undermining GPs’
capacity to care for vulnerable patients who required access
to urgent mental health care. This Federal budget again
gouged millions out of General Practice and yet expects GPs
to perform even greater miracles in public health and chronic
disease management. The Federal AMA President, Dr Steve
Hambleton, is absolutely right when he says that the Federal
budget cuts to Practice Incentive Payments (PIP) to GPs
will have a double-negative impact on the health system by
penalising GPs for not meeting new higher targets for Cervical
Cancer Screening and Specialised Diabetes Care, and
removing incentives for immunisation. He also emphasised
that these measures, along with changes to e-health (PIP),
have the potential to pose serious public health risks by
undermining successful preventative health programs that are
providing health benefits to many Australians.
The Federal Government has, in successive terms,
harangued the medical profession and screamed from the rooftops
about championing preventative health as well as being a
world leader in electronic health. All well and good. However,
they appear determined to abrogate their responsibility for
ensuring that these laudable objectives become reality by
undermining, rather than resourcing and supporting, GPs and
their practices. As the Federal AMA President has presciently
stated, “the Government will …also place an even greater
burden on the engine room of the Australian health system –
hardworking GPs in suburbs in towns and across the country.”
The grab from General Practice by the Federal
Government is a claw-back of spending from GPs to fund its
own areas of perceived
priority, which include
a stumbling e-health.
The scrapping of the GP
Immunisation Incentive
Scheme is public health
vandalism, and the initial
financial assessment of its impact
could mean practitioners losing up to $4,500, not to mention
the important public health/ preventative health measure that
is being undermined. All this is part of a range of controversial
changes to the Practice Incentive Program which are expected
to save around $83.5 million dollars over the next four years.
This program, which has enabled General Practice to ensure
that more than 90% of child patients are fully immunised,
putting Australia amongst the world leaders in immunisation,
is now under threat. The herd protection threatened for a
small saving.
The penalties continue under the Federal Government’s
new arrangements. GPs will be penalised if they fail to
meet new, higher targets of Cervical Cancer Screening and
Specialised Diabetes Care. GPs will have to ensure that 70%
of eligible female patients are given pap smears, a 5% increase,
as well as preparing care plans for at least 50% of diabetic
patients, which is up from the previous 40% required. And
just when the profession has convinced the Government that
telehealth was a cost-effective way of managing the patient’s
health care, the Federal Government budget has responded
by introducing major changes to this initiative, including
scrapping the telehealth Support Initiative from July next year
Continued on page 36
34 MEDICUS May

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May MEDICUS 35

Continued from page 34
and withdrawing telehealth incentive payments from mid-
2014. Further, the Government is requiring that telehealth
consultations must now be conducted over a distance of at
least 15km to be eligible for rebates.
As if that was not enough, General Practice was faced with
the Government’s preparedness to coerce Practitioners into
taking part in the Personally Controlled Electronic Health
Record (PCEHR) system. The Government announced that
General Practices must choose to participate in PCEHR if
they are to continue in receiving e-health PIP funding. To put
it mildly, that is nothing more than a cheap form of blackmail.
The Federal Government is not providing any new funding
for the new clinical service that GPs are asked to provide in
helping patients prepare a shared health summary as part
of the PCEHR. Indeed, it could be argued that a
good idea whose time has come has been badly
managed by the Government to the point
that GPs should not go near it, but even
now, more so now given GPs themselves
are effectively being expected to fund
the implementation of something
that is administratively problematic.
As Dr Hambleton says, “this double
whammy represents a substantial
road block to effective implementation
of the PCEHR and threatens
Australia’s efforts to be world leader in
e-health.”
Did the Government consult with the
AMA or the profession over its plans revealed
in the budget? No! The Government knew these
massive cuts were in effect hitting General Practice in the hip
pocket and also quality patient care. These savage cuts follow
other cuts in recent budgets to items such as Joint Injection
Rebates, the Mental Health rebates, the loss of Medicare
Practice Nurse Rebates and earlier cuts to the Immunisation
Incentive Scheme as well as the insane decision to remove GP
After-Hours PIP. GPRA, in its media release entitled “GPRA
appoints Dr Ginni Mansberg as Ambassador for i-heart
my GP campaign,” advises that it’s launching its campaign
on 19 May 2012 to coincide with the second anniversary of
World Family Doctor Day, which celebrates the importance
of General Practitioners and Family Doctors. It’s a good
idea and is aimed at encouraging the public to share positive
stories about why they ‘heart’ their GP on the website www.
iheartmygp.com.au.
Members of the public can also join the conversation on
facebook (www.facebook.com/iheartmygp) and on twitter
(twitter.com/iheartmygp)).
Interestingly, the media release states that the campaign
has already caught the eye of the Federal Health Minister,
who has allegedly recorded a short video outlining why she
‘hearts’ her GP, alongside other politicians. One wonders why
the Health Minister would consider that such a great idea,
when her Government has delivered such a financial battering
to GPs and their patients around the nation. GPs, being
undermined the way they have, will not appreciate then
being told by the perpetrators that they ‘heart’
their GP.
The Government needs constant
reminding that General Practice is
the cornerstone of the health care
system and are the linchpin of
primary care’s service delivery.
This Federal budget
again gouged millions
out of General Practice
and yet expects GPs to
perform even greater
miracles
Over 29,800 GPs undertake well
over 100 million consultations
a year, and are the first point of
contact when a person has a health
problem. This Government needs
to know that General Practice and
its patients do not ‘heart’ what they
have done to General Practice and have
continued to do in this budget.
Federal President Dr Hambleton has written
to the Minister for Health and Ageing, raising grave concerns
about the impact of the cuts announced in 2012–2013
Federal Budget to the PIP program, and has expressed
disappointment that the engine room of the health system,
General Practice, is once again the target of funding cuts.
It is hoped that Minister sees sense and is prepared to get
the Government to overturn these ill-conceived budgetary
decisions. However, the Government’s track record shows that
GPs should not hold their breath.
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May MEDICUS 37

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38 MEDICUS May

A NEW Burns Telehealth
service will be coming online on 1 July 2012
by Winthrop Professor Fiona Wood
Although the incidence is falling, in the last 25 years over
25,000 patients have required admission to the Burns Service
of Western Australia. Despite our efforts in the area of
prevention, burn injury is all too frequent. In 2011 Western
Australia had 291 children and 336 adults who required
inpatient hospital care in the burns units. In Royal Perth
Hospital (RPH) burns clinics there were 4,858 visits, 1,875
nursing-in-the-home visits, 244 video conference reviews
and 341 photo reviews, whilst in Princess Margaret Hospital
(PMH) burn clinic there were 2,822 clinic visits, 164 video
conference reviews and 606 photograph reviews.
Every intervention from the time of injury will
influence the scar worn for life.
With this in mind, over the last decades the Burns Service of
WA has been involved in burn care education across the board.
We have seen survival rates improve and the extent of injury
reduce. The goal of all those working within the burns service
is to ensure that the quality of the scar is worth the pain of
survival.
The aim of all burn care is rapid healing to minimise the
risk of long-term scarring. In all but trivial injuries the capacity
for regeneration is swamped, triggering cellular mechanisms
which result in scar formation. Burn injuries are notorious
for aggressive scars, which compromise the individual
functionally, cosmetically and psychologically.
The key to rapid healing is accurate assessment. However,
we know that a burn injury will evolve and can extend, with
associated swelling, stiffness and infection, and of course pain
management can be a challenge.
With the development of the burn education and telehealth
program we have seen how we can support clinicians with
their assessment of the burn wound – striving to answer the
question, “Will this wound heal without surgery?” – such that
if surgery is required, it can be undertaken in less than a week
post-injury, which can dramatically reduce the risk of scarring.
What do we know about the early assessment and
treatment of burns?
We know:
• Good first aid will reduce the extension of injury and
reduce the need for intervention.
• Early topical antimicrobial dressing for the first 48 hours
will reduce the infection risk and the associated delay in
healing and increased scar risk.
• Assessment at 48 hours is more accurate in predicting the
likely healing time.
• The majority of burns can be treated with good dressing
care.
• Timely referral to the Burns Unit is essential to improve the
outcome for those who need more complex interventions.
Since every intervention from the time of injury will
influence not only the short-term life disruption, but ultimately
the scar worn for life, everyone in attendance is part of the
burn team. Due to the importance of comprehensive and
informed early intervention we are reaching out to provide a
supported assessment service linked to a triage tool. The aim
of this service is to streamline and improve all burn injury
outcomes.
All burn injuries will benefit from clean, cool, running water
at 15 to 18 degrees to reduce the surface temperature. Ice is
contraindicated as it will superimpose a cold injury on the heat
injury. Where water is limited, spray the surface, or cool, wet
cloths changed every two minutes can be used. The maximum
effect is achieved with 20 minutes of cooling within the first
hour, but there is a significant effect from cooling within the
first three hours. The cooling assists with cleaning, and any
blisters should be deroofed where possible.
Pathway One: Patient’s burn meets referral criteria
Patients who meet the “Assess: Referral Criteria” (refer Fig.
1 on page 9 ) are not suitable for Telehealth and should be
referred immediately:
Adult Patient Referral
Call RPH switchboard on 9224 2244 and ask for the
on-call Plastic Surgical Registrar/Burns Consultant.
Alternatively contact Burns Clinical Nurse Consultant on
0424 155613 or the Burns Unit on 9224 2154.
Child Patient Referral
Call PMH switchboard on 9340 8222 for the on-call Burns
Consultant or Registrar, or the PMH Burns Unit on
9340 8257.
Continued on page 40
May MEDICUS 39

Continued from page 39
Pathway Two: Patient’s burn DOES NOT meet referral
criteria
If the patient does not require transfer the Burns Telehealth
service will assist you.
At this stage a photograph, after cleaning and debriding the
wound, prior to the dressing can be taken and submitted to
Burns Telehealth for later review. Without the need to wait to
be connected for immediate advice, analgesia and dressings
can proceed to minimise patient discomfort and stress.
The most cost-effective dressing for the first 48 hours is an
antimicrobial dressing.
The dressing should stay intact for the first 48 hours with
analgesia, elevation and mobilisation. Prophylactic antibiotics
are contraindicated due to the rapid development of resistant
organisms in the open wounds.
For information on dressing protocols, including the evidence base
for the use of antimicrobial dressing, please go to the Burns Service
on the RPH intranet. This information will be consolidated on
the new burns webpage, which will be launched on 1 July 2012.
Notification of the new site, with the URL, will be disseminated
once the site is finalised.
Submitting the photograph taken prior to dressing and basic
details of the burn to Burns Telehealth will allow a virtual
ward round to take place, which will provide support within 24
hours regarding the ongoing care of the patient.
The objective of the “Assess Referral Criteria” for referral and
the Burns Telehealth service is to reduce morbidity from burn
injury across WA. By supporting all care providers and patients
with burn care that focuses on facilitating rapid response and
healing the service aims to reduce the scar worn for life.
You will find a burns action postcard in this issue of Medicus.
Please use this postcard as a reminder in your workplace as to
the most effective response to burns presentations.
Initial Presentation
Assess against referral criteria
Transfer
Telehealth
Debride, clean, photo,
dress wound.
Admit to your facility or
send home
Email photos and
clinical information.
Receive specialist advice
within 24 hours
40 MEDICUS May

Cool, Assess, Dress
Telehealth
COOL
Remove clothing and constrictive jewellery.
Cool the burn for 20 minutes with running
water.
Cover loosely with a wet towel.
Keep patient warm.
QUICKER HEALING; LESS
SCARRING
Healing within 10 days of injury is best; if there
are few signs of healing or you have other
concerns email a photo so we can help. Surgery
at 5–7 days post-burn is optimal.
DON’T DELAY – DRESS
Silver dressings are recommended for the first
48 hours. First choice: Acticoat.
After 48 hours switch to calcium alginate
dressing and Fixomull if wound looks clean.
Do not use Fixomull alone.
Review and change dressing at 2 days and 5
days post-burn.
Give appropriate simple analgesia.
If patient has a fever or is systemically unwell
please call us.
FIG 1.
ASSESS: REFERRAL CRITERIA
> 5% total body surface area in children
> 10% total body surface area in adults
Any full-thickness burn
Circumferential partial- or full-thickness burns
Possible non-accidental injury
Infected burns
Pain control issues
Inhalation burn
Chemical burns
Electrical burns
Special-area burns; i.e. face, neck, hands, feet,
genitals, perineum, joint, airway
Burns with concurrent injuries or co-morbidities
Patients who meet the referral criteria are not
suitable for Telehealth. Please refer immediately.
Adults:
Call RPH switchboard on
9224 2244 for the on-call
Plastic Surgical Registar/Burns Consultant.
Children:
Call PMH switchboard on 9340 8222 for the
on-call Burns Consultant or Registrar.
May MEDICUS 41
May MEDICUS 41

Opinion
What’s a WAMSS?
by Benjamin Host
President, Western Australian Medical Students’ Society
The Western Australian Medical Students’ Society (WAMSS)
has come from humble beginnings. In 1946, some 65 years
ago, the first Medical Students Society was created, “with
its prime aim and first action to agitate for the foundation
of a Faculty of Medicine at UWA”. 1 Ten years of hard work
and lobbying saw the achievement of this primary goal with
the creation of the Faculty of Medicine in 1956. The society
then underwent a change of name and constitution in order
to better represent the students of this new faculty. Their
mandate became to advocate for and support those medical
students who were forced to spread their studies between Perth
and Adelaide, the only available option at the time. WAMSS
was born.
Since then, there have been hundreds of people involved in
the leadership and activities of WAMSS. All of our
predecessors have contributed to the evolution
of our society into the highly regarded
and successful body that it is currently.
When you look back through the
records at those who have been
involved over the years, it becomes
abundantly clear – we really are
standing on the shoulders of giants.
Today, WAMSS provides
representation and support for
UWA medical students in all
their endeavours. This is achieved
through our 60-strong committee,
numerous subcommittee members,
and countless others who contribute in an
unofficial capacity. It is through this incredible
engagement with those we represent that WAMSS
is able to deliver amazing programs and events from our
diverse range of portfolios.
Academic events such as Student Grand Rounds, advanced
clinical skills workshops and our Emergency Medical
Challenge are highlights of the year for any academic-minded
medical student. (Aren’t we all?) Our commitment to social
justice encompasses our wellbeing campaign, the Students
Passionate About Mental Health program, our environmental
officer and LookOut, WAMSS’s charity arm. Through these
undertakings we are able to raise money and awareness, and
provide education about these important issues.
Our suite of sporting events helps to provide an outlet for
the healthy competitive spirit within all medical students.
Our interyear, interfaculty and intervarsity sports programs
WAMSS provides
representation and
support for UWA
medical students in
all their endeavours
provide something for every sportsperson and fan. The
WAMSS social calendar is unrivalled at the university,
including our river cruise, cocktail party and quiz nights. This
culminates in our annual medical dinner, a glittering affair to
celebrate our graduating sixth-year students.
Our global health portfolio, Interhealth, directs a multitude
of projects with an international perspective. From providing
much-needed medical supplies to far-flung areas through the
LINCS and Zonta Birthing Kit projects, to aiding refugees
and asylum seekers with our new Crossing Borders for Health
initiative, and raising money and awareness for HIV/AIDS
victims in southern Africa through our (now-national) Red
Party, our reach is truly global.
In addition to the fantastic programs and events
we deliver, most important is our advocacy
for all UWA medical students.
Through our education portfolio,
we provide representation at all
levels. Educational issues and
improvements in teaching,
medical workforce concerns,
student professionalism and
wellbeing, as well as the
formulation of policy are but
a few of the areas of focus for
WAMSS’s actions on behalf
of our members. WAMSS is a
part of governance within the
faculty and university, sitting on
Faculty Curriculum and Development
Committees, the Faculty Board, as well as
the UWA Guild Education Council. We have
clout at a local level, but our impact is far more widereaching.
Our work in association with the AMA (WA) as part
of the AMA Council and Doctors in Training Committee, as
well as the Australian Medical Students’ Association, allows us
to take our advocacy to a national level.
The weight that the voice of student doctors carries is
clearly apparent and does not go unnoticed. Throughout
all our efforts, WAMSS will continue to provide the
representation and support that all medical students deserve.
Reference:
1. Taken from the first WAMSS Secretary report, 1957.
42 MEDICUS May

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OOpinion
How are you feeling?
Mental health amongst medical students
by Ghassan Zammar
President, Medical Students’ Association of Notre Dame
There have been increasing concerns voiced by Australian
universities regarding the mental health of their students
and the impact that unrecognised or untreated mental illness
can have on the individual and on the wider community.
It’s not uncommon for any medical student to experience
psychological distress or know of someone experiencing
significant mental health issues throughout their studies.
Therefore it is not surprising that a study published in 2010
involving over 6,400 Australian university students showed
that the prevalence of significant mental health disorders had
reached almost 20%. This was considerably higher than the
general population. 1 Studies conducted on medical students in
2, 3, 4
the USA and Canada have revealed similar findings.
Many of us are aware that mental health disorders such
as anxiety and depression can put students at higher risk of
developing behavioural problems such as alcohol and drug
abuse. 5 However in spite of efforts from various public health
organisations and mental health experts, the high prevalence
of distress in medical students not seeking professional help
may indicate that we expect, or even accept, significant
psychological distress as part and parcel of being a student. 1
Furthermore, there is growing apprehension that mental
health issues among the student population may further
escalate as universities attract more people from disadvantaged
backgrounds. 6 These concerns are based on analysis showing
students undergoing significant financial strain during
study are three times more likely to report high levels of
psychological distress. Other factors contributing to the higher
rates of mental health problems between medical students may
include time pressure, study workload and diminished social
interaction with friends and family. 7
This year, more than 50% of the new student cohort at
Notre Dame Fremantle is from interstate. Moving from home
can create an initial sense of isolation and put further strain
on students who do not have their usual support network of
family and friends close by. After receiving feedback from
our members, MSAND developed the Interstaters’ Survival
Guide in 2009, along with the Med100 Survival Guide, which
is updated annually. These guides are designed to provide
helpful tips and reduce the stress often experienced by first
year medical students during their transition into student life.
Ironically, however, tackling mental health within the
medical student demographic has always been difficult, as
we often attach greater stigma to discussing mental health
disorders such as depression. A recent survey of medical
students published in JAMA found some surprising results.
Firstly, medical students suffering from severe depression
believed that their peers would have less respect for their
opinions if they were to know about their illness. 5 Students
also worried that faculty members would view them as less
capable of undertaking practical duties and that telling a
school counsellor about their depression would affect their
grades. 5 This reinforces the concern that even medical
students suffering from mental illness may often have distorted
and excessively negative views on how they are perceived by
their peers.
From my personal experience, medical students don’t
generally like to take on the ‘sick role’ and burden their peers
(who themselves are under considerable stress) with their
problems. However it’s important for us to understand that
suffering from mental illness such as anxiety or depression
is not a sign of weakness and should not be ignored. I must
encourage fellow medical students in supporting their
colleagues and recognising any signs of mental distress that
others in your class may be experiencing. Don’t be shy to ask
“How are you feeling?”
As exam time quickly approaches
in a few weeks, we also need to
be aware of student burnout.
Understanding our own
study limits and keeping
physically fit is key to
preventing emotional
tackling mental
and physical exhaustion.
Burnout during exam health within the
time can affect up
medical student
to 50% of medical
students and lead to
demographic
depression or even
has always been
suicide. 8 It’s also important
that students identify their difficult
own stressors and develop
the right techniques to deal with
the pressures commonly experienced
throughout medical school.
An excellent resource to look at is Keeping Your Grass
Greener, which was developed by the Australian Medical
Students’ Association in conjunction with the New Zealand
Medical Students’ Association. This comprehensive guide is a
must-read for all students during their time in medical school
Continued on page 46
May MEDICUS 45

Continued from page 45
and covers such topics as managing exam stress, financial
planning, and knowing the signs and symptoms of mental
distress. The guide also provides a list of organisations that
students may want to explore if they feel they are suffering
from any mental health issues. The list of websites includes
SANE, Headspace, Lifeline and Beyond Blue. For more
information go to www.amsa.org.au/keepingyourgrassgreener
and make sure you complete the How Green is Our Grass?
evaluation survey.
For medical students studying at Notre Dame, the
university offers free and confidential counselling services, in
which students can discuss with a professional counsellor any
personal or study-related issues that are impacting on their
mental wellbeing. The School of Medicine staff are extremely
helpful and can offer students a wide range of services which
may be utilised.
Of course above all this,
it’s vital for students to
always have their own
GP to turn to if they are
suffering from mental
distress or simply having
difficulties handling the
pressures that life has
thrown at them. Like any
other form of illness, the
earlier you begin treatment
the more effective the outcome.
Because at the end of the day, as
future doctors, it’s imperative we look
after ourselves before we can look after our patients.
It’s vital for
students to
always have
their own GP
to turn to
References
1. Stallman H. Psychological distress in university students: A comparison with general population data. Aus Psychologist. 2010; 45(4): 249–257.
2. Givens JL, Tjia J. Depressed medical students’ use of mental health services and barriers to use. Acad Med. 2002; 77(9): 918–921.
3. Rosal MC, et al. A longitudinal study of students’ depression at one medical school. Acad Med. 1997; 72(6): 542–546.
4. Dyrbye LN, Thomas MR, Shanafelt TD. Systematic review of depression, anxiety, and other indicators of psychological distress among US and
Canadian medical students. Acad Med. 2006; 81(4): 354–373.
5. Schwenk T, et al. Depression, Stigma, and Suicidal Ideation in Medical Students. JAMA. September 15, 2010; 304(11). http://jama.ama-assn.org/
content/304/11/1181.full.pdf+html accessed March 2012.
6. Trouson A. Mental health issues among students to escalate. The Australian (online) August 10, 2011.
accessed March 2012.
7. Dahlin M, Joneborg N, Runeson B. Stress and depression among medical students: a cross-sectional study. Med Educ. 2005; 39(6): 594–604.
8. Dyrbye LN, et al. Burnout and Suicidal Ideation among U.S. Medical Students. Ann Intern Med. 2008; 149: 334–341.
Medicus
Article Submission Dates
In order to distribute Medicus in a timely fashion, and to meet our
commitment to readers, all article submissions are required by the
following date:
Issue
Submission Date
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Closed
July 6th June 2012
August 6th July 2012
September 6th August 2012
October 6th September 2012
November 8th October 2012
December 6th November 2012
for 2012
If you would like to submit an article
for inclusion in Medicus please
contact Robyn Waltl,
in the first instance, via email
on robyn.waltl@amawa.com.au
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professional listings.
For Display Advertisement timelines
and submission requirements please
contact
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46 MEDICUS May April

Locum
adventure
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AMA (WA) is the premier organisation
representing the medical profession
and is also a leader in medical
recruitment services.
We currently have 6–12 month general
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throughout Australia.
RECRUIT
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Telephone +61 (0)8 9273 3033
Fax +61 (0)8 9273 3043
Email recruit@amawa.com.au
AMA Recruit, 14 Stirling Hwy, Nedlands WA 6009
www.amawa.com.au
00206807 Locum adventure 2012 1.indd 1 3/04/12 12:58 PM
May MEDICUS 47

Medicare Locals
One issue that has dominated debate for some time within the
wider medical community is likely to make another appearance
very soon – and almost certainly near you!
Political watchers believe that as the next federal election
moves closer, so will mention grow louder of the disaster that
we know by the name Medicare Locals.
And it will be the Federal Government that will try and
get all the positive political coverage that can be generated by
mentioning the two words “Medicare” and “local.”
By themselves, both of these words normally elicit a nice,
cuddly feeling.
Combined into the one term ‘Medicare locals’ the feeling
is meant to be especially warm and heartening – and
vote-attracting.
But establishing Medicare Locals – or health care
organisations – may prove riskier than many spin masters
employed by the Government believe.
With the federal election due by early next year, the
Government will almost certainly use Medicare Locals as an
indication that its health reform agenda is working well.
At a cost of $477 million over four years plus base annual
funding of $171 million, Medicare Locals were aimed to
streamline primary healthcare and ease the pressure on the
Australian public hospital system.
As many would already know, the AMA (WA) is not
a natural friend of Medicare Locals. Many months ago,
we identified them as an incredible waste of that valuable
resource, cash, and not only were they bureaucratic but also
confusing.
Many of the Medicare Locals will look anything but local
and in fact will cover a huge area or a confusing mix of city
and rural areas.
To quote AMA (WA) President Associate Professor
David Mountain almost a year ago, Medicare Locals are a
“clear attempt to disenfranchise GPs and their key role in
co-ordinating care.”
Importantly, A/Prof Mountain argued that Medicare
Locals were not only going to build an expensive barrier
between medical practitioners and patients but are seen by the
Government as a vehicle to impose NHS-style fund holding.
Examining the websites of some of the Medicare Locals
in WA is an insightful experience. Many are expansive, even
attractive to look at. However the amount of information is
virtually nil. Early days, yes, but there is no sign that the sites
are being populated with relevant information. One of the
former Division which has now become a Medicare Local does
not generate much confidence; the last annual report available
on its website is dated 2009.
As has been pointed out before, Medicare Locals are
certainly not local and have no connection with medicine, so
the name itself will go down as one of the most misleading in
Australian public policy.
Let us not forget that Medicare Locals – incredibly – were
designed to be the main foundation of the Federal Labor
Government’s Health Reform program under former Prime
Minister Kevin Rudd and current PM Julia Gillard.
There is still the opportunity to make a substantial cut to
Federal spending by ending what is already a disaster and close
Medicare Locals down before they do too much damage.
Sometimes the vision is splendid, for the verbiage used to
describe Medicare Locals has been appealing, but a good
speech is too easily written and even sometimes well delivered.
The key is actually delivering something substantial and
ensuring that the rhetoric meets the reality.
The inspiringly delivered “I have a dream” moment, in
other words, has to be met by good delivery of an improved
health service on the ground for ordinary Australians. But
there is no evidence that Medicare Locals have resulted in a
better health service, or that the public health outcome has
been improved.
For all intents and purposes the result has been little more
than a disaster meeting a joke. But no one is laughing.
Future political science tomes will include Medicare
Locals in the same political history lesson as the wastage and
bumbling bureaucratic disasters of “pink batts” and “building
the education revolution.”
All badly handled, all a massive waste of money and all a
disaster for the long-suffering people of Australia.
48 MEDICUS May

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May MEDICUS 49

No medical checks
for 75 and 78 year-old drivers
Transport Minister Troy Buswell has announced drivers aged
75 and 78 no longer need to have a medical check to renew
their driver’s licence.
The decision to amend the Road Traffic (Authorisation to
Drive) Regulations 2008 was made after Office of Road Safety
research revealed older drivers were not disproportionately
represented in crash statistics.
The amendment came into effect on 7 April 2012 and the
Department of Transport is writing to licence holders aged 75
and 78 to advise of the changes.
Drivers aged between 80 and 84 will still need to undergo
a medical test, and those aged 85 and older will still need to
pass an annual seniors’ on-road practical driving assessment.
All drivers, regardless of their age, are required to notify
the Department of Transport if they have a medical condition
or impairment that affects their ability to drive.
If your patient has received a medical form (M1074) in
the mail and is unsure of what to do, please advise them to
contact the Department of Transport’s Driver and Vehicle
Services on 13 11 56.
The changes to legislation do not alter the responsibility
of the Director General under the Road Traffic (Authorisation
to Drive) Regulations 2008 and the Road Traffic Act 1974 to be
satisfied with a person’s ability to drive a vehicle safely.
Sections 101 and 101a of the Road Traffic Act provide
protection for people, including medical practitioners, who
act in good faith to provide opinion or information that a
person is, or may be, unfit to drive.
If you have questions or feedback please contact the
Department of Transport’s driver assessment section
during business hours on 9216 8382 or email
driver.assessment@transport.wa.gov.au
Australian Salaried Medical Officers Federation Western Australian Branch
ELECTION NOTICE
Fair Work (Registered Organisations) Act 2009
Nominations are called for:
- Branch President
- Branch Vice-President
- Branch Secretary
- Branch Assistant Secretary/Treasurer
- Branch Councillors (8)
• A copy of the election notice and
nomination form will also appear on
the Branch’s website.
• Nominations, which must be in writing
and comply with the registered rules
of the organisation, may be made at
any time from 8 May 2012. They must
reach the Returning Officer at her
office or postal address not later than
5:00pm on 29 May 2012. Nominations
cannot be withdrawn after this time.
• Nomination forms are available
from the Returning Officer or
the registered Offices of the
Organisation. The use of these forms
is not compulsory, provided that
nominations comply with the rules.
• Ballot: If a ballot is necessary, voting
material will be posted on 19 June
2012 to eligible members at the
address shown in the Organisation’s
records. Members should notify
the Organisation of any change
of address. The ballot will close at
10:00am on 10 July 2012. Note: A
copy of the AEC’s election report can
be obtained from the Organisation or
from Gary Bucknall at the AMA (WA)
on 9273 3000, after the completion of
the election.
HOW TO LODGE NOMINATIONS
By Post: PO Box 2205 Midland
DC WA 6936
By Fax: 08 9250 7155
By email: hasluck@aec.gov.au
By Hand: Australian Electoral
Commission, 11/53 The Crescent
Midland WA 6056
Changed Address?
Advise the Union now.
Kim Nichols | Returning Officer
Tel: 08 9250 7628
7 May 2012
50 MEDICUS May

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May MEDICUS 51

Dr YES and the Clinical Senate
– Let’s Talk About Sex
Important issues for the health of young people, including
sexuality, reproductive health and STIs, were raised by Dr
YES representatives at a recent key meeting of the WA Health
Clinical Senate.
The Clinical Senate consists of more than 80 State
clinicians who meet quarterly to debate important issues in
health. Recommendations and decisions are presented to the
Director General of Health, Kim Snowball, and through him,
to the Health Minister Kim Hames.
The Clinical Senate has been the birthplace of many major
health decisions and reforms, and to be asked to present is a
great privilege.
The subject of the latest meeting of the Clinical Senate
– “Let’s Talk About Sex” – involved a number of key WA
organisations involved in the issue.
As an established and successful youth harm-minimisation
program Dr YES was requested to provide an insight into its
strategy and methods, especially in the areas of sexual health
and issues affecting young people.
Current and past Dr YES coordinators combined to provide
a complete overview – from the beginnings of the awardwinning
program to why it works so well.
Presenters included Mr Michael Kirk, Mr Dylan Beinart,
Ms Sophie Doherty, Ms Johanna Scaffidi, Ms Malindi Haggett
and Mr Chance Drummond.
Further information about the key role played by the
Clinical Senate, and current and past presentations, can be
found on the Senate’s website at:
www.clinicalsenate.health.wa.gov.au/debates/mar12.cfm
The presentation was
well received, with
encouragement and
discussion for potential
future avenues arising
as a result.
Recommendations
regarding youth sexual
health were formed in the
afternoon focus groups, and
we look forward to hearing
how they are received.
The Clinical
Senate has been
the birthplace of
many major health
decisions and
reforms and to be
asked to present is
a great privilege.
Dr YES volunteers Malindi Haggett, Dylan Beinart, Michael Kirk and
Sophie Doherty (left to right)
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52 MEDICUS May

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May MEDICUS 53

Obesity Surgery WA
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approach to people with obesity and obesity related
problems.
We undertake pre-operative and post-operative counselling,
consultation with our dietician, physicians review and
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We also offer the opportunity for personal exercise
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• Nurse Liaison and patient co-ordinator
New members
The AMA (WA) welcomes the new members
who joined during April 2012
Kongit A M Ali
Mary Barnes
Liezel Bredenkamp
Amy Comins
Cheng Keat Goh
Arya Gupta
David Hernstadt
Daniel Hunt
Mirza Kecanovic
Michael Kern
Shelley Kirkbright
James Little
Evan Ng
Jennifer Pontre
Philip Scott
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Kingsley Wong
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54 MEDICUS May
54 MEDICUS April

AMA in the
Media
Housing drives need for FIFO
The inquiry was told families in Perth
were under new pressures with doctors
reporting a high rate of induced births to
fit with mine workers’ rosters.
“Every Monday I take calls from mine
sites and there’s a lot of fairly unhappy
people there,” WA AMA president Dave
Mountain said. “We need to know what
the long-term effects are.”
The West Australian, 18 April 2012
Inquiry hears FIFO putting strain on
services
The Federal Government inquiry today
heard from several groups including the
Australian Medical Association.
The Association’s WA president David
Mountain says FIFO workers are paying a
high cost.
“There’s high rates of mental illness;
distress; anxiety; drug and alcohol use;
family breakdown; and children who are
distressed because of a lack of two parents
in the family.”
ABC News Online, 17 April 2012
Porter blames GST row for cuts
Australian Medical Association WA
president David Mountain called for
health services to be exempt from the cuts.
He said infrastructure projects such as a
planned stadium should be delayed before
cuts were made to the Health Department.
Associate Professor Mountain said that the
cuts were impossible to achieve without
there being a substantial negative impact
on health services.
The Australian, 18 April 2012
More land needed for regional
workers
Australian Medical Association of WA
president David Mountain told the [FIFO]
inquiry the cost of running a medical
practice in communities next to mines had
even forced some practitioners to consider
leaving. “If you’re in a town where the
mining companies are buying up property
and using up the rental accommodation,
then the rents are up to $2,500 and you
cannot attract staff ... even the GP’s going
to struggle if they’re renting,” Associate
Professor Mountain said.
WA Business News, 19 April 2012
Hospital beds can’t keep up with
population
Australian Medical Association WA
president David Mountain said the report,
compiled by the Australian Institute of
Health and Welfare, showed a neglect of
the hospital system by the government over
the past decade.
“The actual number of beds had
increased this year only by 0.1 per cent,
and we’ve been dropping significantly
over the previous four or five years,” Dr
Mountain said.
Perth Now, 30 April 2012
AMA pleads for returned hospital
birthing services
The Australian Medical Association
(AMA) says it is essential the Health
Department moves to reopen Katanning
hospital’s birthing services as soon as
possible. “It would be unfair on the women
in the town to only be able to deliver one
in every two days, so they have to close the
service at the moment but it’s absolutely
essential that they get on and find someone
to join the service in the town,” he said.
www.abc.net.au, 2 May 2012
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May MEDICUS 55

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56 MEDICUS May

PhotographyP
How to Photograph Silhouettes
by Denis Glennon
Silhouettes can be a delightful way to convey mystery and mood
in photos. They often make shots stand out because of their
combination of minimalism and the story they tell. Well-executed
silhouette images frequently cause viewers to pause and take a
second look, because they don’t give a clear picture of everything.
Instead, they leave a portion of the image to the viewer’s
imagination, to wonder about.
Think of the last time you wandered through an art gallery and
lingered for that longer look at a painting, sculpture or photograph.
What prompted you to pause and ponder? Was it not, the notimmediately
knowable, the veiled, the abstract elements that stirred
your interest? Is this the elusive element we term ‘art’?
Silhouette photography is rewarding to explore. It’s not difficult
to get good results if you use a few simple steps.
An imperative in taking silhouettes is to place your subject (i.e.
the profile you want to be blacked out) in front of a source of light,
and to ensure your camera’s exposure is set for the brightest part
of the scene (i.e. the background) and not for the subject.
Doing this ensures your subject will be very underexposed (i.e.
very dark, ideally pure black).
What we’re attempting to do is a bit counter-intuitive to
everyday photography, because we are ‘forcing’ the camera to
‘think’ that it is the really bright parts of the scene that it should
be capturing when we press the shutter button.
Simple Steps to Stunning Silhouettes
1. Pick a subject with a distinctive shape – one that can,
occasionally with a little reflection, be recognised without
relying on colour, texture, shadows, highlights or tones. People
or objects against a setting sun or sky are good subjects.
2. Switch off camera’s flash – you do not want any light on the
front of the subject.
3. The light must be shining from behind your subject. Position
yourself or your subject so that all of the strong light is shining
from behind the subject.
4. Focus before you take the shot. For the best impact you will
want the subject to be crisply sharp. You have two choices to
achieve this: (i) manually focus, i.e. pre-focus on the subject
before you meter the shot, or (ii) use an aperture (f-stop) that
will give you the greatest depth of field, i.e. f/16 or higher.
Both choices work equally well.
5. Compose the shot so that (i) your subject is in front of and
ideally hiding the dominant light source and (ii) it has a clear
and uncluttered background. An unclouded sky is a good way
to start.
6. Stick to one or at most two silhouette shapes. If you decide
on two, keep them well separated in the composition so that
the viewer does not tire trying to decipher what it is you are
endeavouring to convey in the photo. When photographing
people in silhouette try introducing gesture and stance rather
than photographing them straight on.
7. Shooting silhouettes in ‘auto’ mode: Today’s digital cameras
are smart critters! When you press the shutter button halfway
down, they focus on what you are pointing the camera at
and compute the ‘best’ exposure level at the same time. This
computation almost always concentrates on your subject,
which is the opposite of what you want in silhouettes. You
need to ‘trick’ the camera’s metering system. To do this, point
the camera at the brightest part of the scene, press the shutter
button down half-way, hold it down, recompose the photo so
that your subject is where you want it and finish taking the
shot. You have overridden the computer in your camera so that
it records the brightest light as a mid-tone and everything else
will be recorded as very dark shadows, i.e. dark silhouettes,
exactly what you want.
8. Have a go at shooting silhouettes in ‘manual’ mode. Take a few
shots in ‘auto’ mode and have a look at the aperture, shutter
speed and ISO settings the camera’s computer selected. If
your subject is not dark enough, try a higher f-stop or faster
shutter speed and review the result. Play with the settings until
you get the image you think will make a viewer stop and take a
second look!
A silhouette image can sometimes happen by accident in sunset
or sunrise shots. The technique can however create beautiful
images when used deliberately but, as you will discover, it is not an
exact science. It takes a little practice, experimentation and even a
little luck to capture a truly spectacular silhouette photograph.
May MEDICUS 57

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*Offer available from BMW Financial Services (a division of BMW Australia Finance Ltd, Australian credit licence 392387) on a consumer loan over 60 months
at 8.02% pa (9.06% pa comparison rate). On a drive away price for a BMW X5 xDrive30d with Performance Edition Package and no optional extras of $99,900,
deposit of $5,000, monthly repayments of $1,294.40 and a final payment of $47,454. Total amount payable is $130,118. Cannot be combined with any other offer.
Fleet, government & rental buyers excluded. Fees & charges are payable. Terms, conditions & approval criteria applies. While stocks last on new vehicles ordered &
delivered by 30/06/2012. ^Comparison rate based on monthly repayments for a 5 year secured consumer loan of $30,000. WARNING: This comparison rate is true
only for the example given & may not include all fees & charges. Different terms, fees or other loan amounts might result in a different comparison rate. For further
details contact Auto Classic or Westcoast BMW.
58 MEDICUS May
BMW2517_277x190_Auto Classic + West Coast_FA.indd 1
4/04/12 2:42 PM

DDrive
BMW 335i Sedan
by Dr Peter Randell
I remember the excitement when one of my fellow registrars
at RPH took delivery of a BMW 2002tii in 1972. Here was a
small, quality German sedan with high performance (by thencurrent
standards; it would be thrashed by a Corolla now) and
sports-car-like handling. This was the precursor to the now
long-lived 3 Series on which the company has always placed
great importance, as they can anticipate selling about 400,000
3 Series worldwide each year.
You will be battling to pick the 2012 from earlier models,
but picking it as a 3 Series is easy. There is an air of quiet
sophistication in the smooth contemporary lines, with precise
shut-lines on all panels and a quality interior. The driver sits
in, not on, a well-shaped leather seat, with clear instruments
under a reflection-preventing hood. The seats are electric,
of course, and have three memory settings so that others in
the family can hop in and in seconds have seat/mirrors set
to their preference. In the midline is a second, only slightly
smaller, hood around a large monitor. This tells the pilot all
information demanded by the usual BMW iDrive selector at
the driver’s left hand. Media, radio, telephone, navigation,
office, BMW service, vehicle information and settings can each
be called up by rotating and depressing the central cylinder.
After a short time, it does become quite intuitive.
The sports steering wheel has a thick and grippy leather
surface, and the gear selector is best left to its own devices, so
slick is the eight (yes, eight) speed auto box. The essence of
this top-of-the-3 Series range is the engine. BMW has been
winning international awards with its six-cylinder engines for
years, and this version is a ripper! It has a single-scroll, turbocharged,
straight-six engine with variable valve timing, yet is
more efficient and more powerful than the twin-scroll engine
it replaces. There is very little lag between giving it heaps of
welly and experiencing a solid shove in the back. The figures
are impressive: 225kW and 400Nm, while returning 7.2 litres
per 100kms… but not if you enjoy the performance! (5.7
seconds after take-off you can be cracking the 100kph mark.)
For those into their mechanical music, the exhaust note is
delicious under hard acceleration, without being hoonish.
Don’t think BMW is rank performance without panache –
the delivery is silken and the ride is slinky, with neither excess
roll on corners nor any pitch/squat under go/slow instruction
from the driver. It is a joy to DRIVE properly and rewards
with accurate feedback through fingertips, feet and bottom. A
part of the excellent adhesion to the road comes from a clever
electronic diff lock, which has help from all the safety built
into the central processing unit in the computers driving this
21 st -century precision machine. There is constant conversation
between brakes, engine and suspension, with the complete
safety kit; ABS, EBD, BA, vehicle stability control, cornering
brake control and dynamic traction control. Should the car
consider an accident imminent, seat belts tighten, windows
are closed, as is sunroof, and if metal meets metal or flies off
into the scenery, the brakes will be applied for 1.5 seconds to
minimize prospects of a second meeting of the masses… when
all six airbags may join in. Any following vehicle would have
been warned that there was trouble ahead, as the tail lights go
in to a frenzy of flashing (dynamic braking lights – there is a
name for everything to the marketers!)
When in more contemplative mood while driving, there is
an excellent Harman Kardon stereo system feeding through
16 speakers. Voice recognition controls the Bluetooth phone
system, and there is a premium navigation system with
Internet access. At night, good lighting shows the way from
foot well to puddle lights, mirror-mounted side indicator lights
and penetrative bi-xenon headlights. Reading lights are LEDs,
and the headlights are dusk-sensing. Further sensors are
mounted in front and rear bumpers to tell distance to damage!
If this is not enough toys for you, start ticking the options
boxes.You can choose active cruise control to maintain a
steady distance between you and the car in front (works very
well,applying brakes if you encroach or they brake suddenly),
rear window and rear side window shades – great for Australia
– and tyre-pressure monitoring. This latter feature may save
you from a rollover .
This is the sixth time since 1975 that a new model of the 3
Series BMW has been released, and it would seem to be their
best. It is still a relatively small sedan by current standards, and
certainly has the high quality that the 1975 2002tii showed…
but so it should, as BMW today also produces the Rolls Royce
Phantom, that pinnacle of quality. You might say this is their
‘baby RR’ – it has maintained the excitement factor evident
in that earlier 2002tii while keeping up with all the advances
available to a thoroughly modern machine.
RRP from $91,900. Vehicle supplied by Auto Classic.
May MEDICUS 59

TTravel
Machu Picchu
The lost city.
Machu Picchu is, with good reason, on the bucket list of many
travellers. Machu Picchu has UNESCO World Heritage status
and is a pre-Colombian 15th-century Inca site located in the
Cusco region of Peru, South America. A visit to Machu Picchu
is the highlight of the upcoming AMA (WA) Post Conference
Tour 2012 in October and November.
Located 2,430 metres above sea level, Machu Picchu is
situated on a mountain ridge above the Urubamba Valley and
is often referred to as the ‘lost city of the Incas.’ Believed to
have been built as an estate for Inca emperor Pachacutec at the
height of the Inca empire, the site was brought to international
notoriety by American historian Hiram Bingham. Machu
Picchu is one of the most intriguing destinations on the planet,
and visitors do not need to be hikers or climbers to experience
its spectacular views and scenery. Machu Picchu is separated
into three areas – agricultural, urban and religious – and the
structures are arranged so that the function of the building
matches the form of the surroundings. Agricultural areas take
advantage of the natural slopes, whilst religious areas overlook
the lush Urubamba Valley thousands of metres below. Visitors
to Machu Picchu describe the experience as magical and
emotional.
There are a number of ways to experience the awe of
Machu Picchu – from hiking the Inca Trail as a six-day trek to
experiencing the luxury of the Orient Express Hiram Bingham
train from Machu Picchu. The AMA group will be taking the
latter option, with a private booking on the Hiram Bingham
train and a day tour experiencing the wonders of Machu
Picchu. The train journey itself is a fantastic experience
featuring amazing views of the landscapes of the Sacred Valley
of Urubamba and the Amazon rainforest. The elegance and
opulence of the Hiram Bingham train assure a magical journey
– never to be forgotten. Expert local guides will be on hand to
take the AMA group to highlights of Machu Picchu, such as
the Main Plaza, the Circular Tower, the Sacred Sun Dial, the
Royal Quarters and the Temple of the Three Windows. Free
time is important to ensure that visitors can experience the site
at leisure and have the opportunity to climb to the best places
to view the magnificence of Machu Picchu.
Whilst in Peru, the AMA group will also experience
Cuzco – the site of the historic capital of the Inca Empire.
Also a designated UNESCO heritage site, Cuzco showcases
many layers of Peruvian history with highlights including
Sachsayhuaman – a seemingly impregnable fortress on
a hill overlooking the city,
Quoricancha, the Temple of the
Sun, and colonial-era baroque and
renaissance churches and mansions.
Cuzco sits at an altitude of 3,400
metres above sea level and was
the political, military and cultural
centre of the Incan empire, which
stretched up and down the Andes
from Ecuador through Bolivia and
all the way to Chile. Cuzco was the
empire’s holy city, and many of the
city’s buildings trace its religious
transition over the centuries.
In Cuzco, the AMA group
will stay at the luxurious Orient
Express Hotel Monasterio – a
former monastery dating from
1592, now a national monument.
The Monasterio is an architectural
treasure built on Inca foundations,
60 MEDICUS May

TravelT
with a beautiful chapel adorned with extraordinary gold
ornaments and original religious artworks lining the
building’s interior. It is the perfect base from which to
explore the fascinating city of Cuzco; its unique local cuisine,
historical buildings and shops selling high-quality local
handicrafts, silver jewellery and fine Alpaca wool products.
For more information about the AMA (WA) Conference
and Post Conference tours to Argentina, Peru and Chile,
contact Chris Kane on 9273 3060 or chris.kane@amawa.
com.au
May MEDICUS 61

62 MEDICUS May

WINE MAKERS WITHOUT BORDERS
Wine
Has anybody heard of the group Wine Makers Without Borders?
They describe themselves as “an organic and demographic group
taking their wines with a no-borders philosophy to the people.”
It started “with an article by a wine writer Max Allen about
Vermentino and Sardines, in which Max espoused the virtues
of this crisp white wine and most sustainable of fishes”. Writing
in the Weekend Australian at the time, Allen threw down the
gauntlet to the Vermentino producers, saying they should gather
their eskies and a BBQ at local shopping centres to hand out
tastes of this superb food-and-wine match, both relatively new
to Australian audiences. Some of the Vermintino producers took
up Allen’s challenge, creating “Vermentino and Sardines – The
Musical,” travelling to Adelaide, Melbourne and Sydney to show
the wines to willing crowds of food-and-wine lovers. Amongst
these Vermentino producers were Yalumba, De Bortoli, Mitolo
and Brown Brothers. As they said, “we were, in many ways – wine
makers without borders: standing in city laneways, streets and
markets to give people a taste of something new.” It didn’t finish
there. There was follow-up with ‘rareredsandpizza’, then the
‘HEARTYPARTY’, which included a giant paella, and “Oysters
in the House” in October 2011 at the Sydney Opera House, which
saw rockstar wine makers converge with rockstar oyster growers.
So, from a Max Allen challenge, a group of wine makers has
formed with a common philisophy to take
their wines to the people rather than the other
way around.
The Wine Makers Without Borders crew, as
they are called, are an interesting lot, including
such labels as Oliver’s Teranga, Arete, Wirra
Wirra, La Linea, Mitolo, Yalumba and
Running with Bulls. One crew member is
probably relatively unknown to many of the
readers of this page: Ochota Barrels. Ochota
who, you say? All will be revealed.
After travelling to some of the world’s
best wine and surf regions, Taras and
Amber Ochota had their light-bulb
moment and decided to make super
premium wine in South Australia, their
home. Their plan was to concentrate
on the “zenith variety of Mclaren Vale
(Grenache) and the Barossa Valley
(Shiraz), find an exceptional vineyard
site in each region and create plush,
small-batch, single-vineyard wines.”
Taras and Amber work at the
winery situated in Lenswood, in
a cool climate with north-facing
Burgundian-cloned Chardonnay over
a rock base of quartz and ironstone,
at a steep 550 metres above sea level.
Taras is a graduate in oenology from
Adelaide University and developed
his skills in wineries including MSV
and Two Hands in the Barossa
Valley. Prior to this, Taras worked
at the renowned Nepenthe vineyard in the Adelaide Hills. He has
more recently been working as a European Flying Wine Maker,
specifically focusing on the Italian regions of Puglia and Sicily,
for the Swedish wine importing company, Oenoforos. He has also
regularly undertaken vintages in California, making wines with
producers including Bonnacorsi, Arcadian, Kunin, Schrader,
Outpost and the famous Hitching Post label Hartley-Ostini,
featured in the movie Sideways. This label enables the creative
flair of Taras and Amber Ochota to have full expression, as the
2010 releases will attest.
The 2010 Ochota Barrels Fugazi Vineyard Grenache is named
after the hardcore punk band from Washington DC. Quirky?
Yes, but don’t let that stop you from buying the wine. This wine
is made by someone who fully understands this variety. It is
handcrafted from 63-year-old dry-grown bush vines, cold-soaked
for four days for wild yeast fermentation, then gently handplunged.
It was 40 days on skins with 40% whole bunches, and
basket-pressed to season in Barriques for 15 months. It is unfined
and unfiltered. The grapes came from the region between Blewitt
Springs and Onkaparinga river gorge in the higher eastern part
of Mclaren Vale. The wine is described as having notes of sage,
rosemary and thyme infused with cranberry and orange peel.
The palate entry is full, rich and round, laden with long textural
components resembling cherry skin and wild berries. This reflects
the textural focus of Taras’s wines.
Taras has added to the Grenache, offering a Shiraz known
as 2010 Ochota Barrels Shellac Vineyard Syrah, which comes
from Roennfeldt Road in the northwestern Barrosan commune
of Marananga. Why Shellac, you ask? Simple. It is another punk
band’s name – never heard of it and all the better for it. This wine
certainly doesn’t reflect the assault on the senses that one would
expect to come from obscure punk bands. Taras managed to
negotiate a small portion of this vineyard for himself, and picked
it earlier than the rest of the vineyard, which has resulted in a very
interesting, earthy wine. It is described as having notes of espresso
coffee bean, dark chocolate, spiced leather and Dutch liquorice.
The ironstone in the vineyard’s deep red soil, whole-bunch
fermentation, and “extended time on skins” contribute to the
immediate density, with a mineral-like textured entry creating the
wine’s foundation. The palate is richly layered, with concentrated
black and blue fruits running through a savoury spectrum. Again,
it is a wonderfully structured wine with a superb length and is a
reflection of the northern Rhone-style wine-making approach.
Ochota makes two additional wines: the 2011 Slint Vineyard
Chardonnay and the Ochota Barrels Strange Little Girl Arneis.
All these wines are worth searching out.
May MEDICUS 63

PROGRAM
OVERVIEW AND
REGISTRATION FORM
NOW AVAILABLE
ONLINE
Sharing stories …
… sharing successes
Developing strong commitments to improve the health and wellbeing
of Aboriginal people in rural and remote communities.
• Clinical updates
• Hands-on learning workshops
• Cultural specific sessions
• Research projects
• Networking opportunities
Visit www.ruralhealthwest.com.au/go/aboriginal-health
64 MEDICUS May
Rural Health West’s main funding sources are the Australian Government Department of Health and Ageing and the Western Australian Department of Health (WA Country Health Service)

F
Food
The Quince
by Sophie Budd
Taste Budds, www.tastebudds.co
Such an old-fashioned fruit that is so under-used these days. In fact I only see it sat on the shelves when it has been turned in to
paste for us to enjoy with cheese! The ‘Golden Apple’ of Greek mythology is the quince. In its raw form it is rough and woolly
with a tart, almost inedible flavour, yet when cooked the quince melts into a soft, sweet sumptuous delight. Head to your local
veggie shop to pick up some of these seasonal fruits, and try this Quince Tart Tatin recipe.
Crust
1 1/2 cups all purpose flour
1 1/2 tablespoons sugar
1 teaspoon salt
1/2 cup (1 stick) chilled unsalted butter,
cut into 1/2-inch cubes
3 tablespoons (or more) ice water
1 1/2 teaspoons cider vinegar
Quince Tart Tatin
Method
1. Put the flour, sugar and salt into a bowl, then rub in the butter to form fine bread crumbs. Mix the
water and vinegar in a bowl and add to the crumbs. When it forms moist clumps, bring it together.
(You may need to add a little more water.)
2. Roll into a ball, then flatten and wrap. Refrigerate for an hour.
3. Put the water, sugar and honey into a pan and bring to the boil. Keep an eye on it and reduce to a
thick, dark syrup. Run a wet brush around the side of the pan if needed and cook for eight minutes.
Add the butter and cinnamon. Pour into a round cake tin or baking dish and leave to go hard.
4. Lay the quince slices in the dish, roll out the pastry and lay over the top, cutting slits for the steam.
Bake in a 200 o C oven for 30 to 40 minutes or until golden brown.
5. Allow to cool slightly and serve with cream.
Homemade Custard
You need
500ml whole milk
565ml cream
1 vanilla pod (slit)
6 tablespoons sugar
8 large egg yolks
Filling
1 cup sugar
1/4 cup water
1 tablespoon honey
5 tablespoons unsalted butter,
room temperature
1/2 teaspoon ground cinnamon
8 small quinces (about 1 1/2 kilos), peeled,
cored and cut into 1-inch-wide wedges
Method
1. Bring the cream, milk and vanilla pod to the boil.
2. In a big bowl beat the yolks and sugar until white
and fluffy.
3. Slowly pour in the liquid, whisking well.
4. Pour back into the saucepan and, on a low heat,
slowly cook the custard, letting it thicken. Stir
constantly.
May MEDICUS 65

In addition to the valuable services the AMA (WA) provides members, the Association
also secures significant savings with a host of exclusive benefits.
For more information, visit www.amawa.com.au/membership/memberbenefits.aspx
Penguins formal wear
Penguins formal wear is a
suit hire option. Designed
in Europe; their clothing is crafted from the finest of fabrics
and can be accessorised with an extensive range of coordinating
fashion. Penguins are offering dinner suit or tuxedo hire, with
shirts and ties, to all AMA (WA) members at a cost of $75;
usually $135.50, this is a saving of approx 50%.
Triumph Menswear
Triumph Menswear is Penguins
retail outlet and all AMA (WA)
members are entitled to 20%
discount on all purchased items.
The Lexus Corporate
program will provide AMA
(WA) members to a new
standard of luxury.
The program includes:
• Scheduled servicing to 3 years or 60,000kmsDiscounted
dealer delivery and corporate pricing
• Airport valet service
• Complimentary service loan cars or pick up and delivery
• Plus much more ...
To find out more about exclusive offers for AMA (WA)
members contact Craig Nylander - Corporate Development
Manager at Lexus of Perth on 93409000.
Camera Electronic
The Camera Electronic corporate
programme will provide you with
the following benefits when you or your spouse next purchase
any photographic equipment including:
• Complimentary loan • Reduced repair charges
equipment if your camera is • Reduced Rental charges
ever in for repair
• All Photography classes
• Complimentary trial periods workshops discounted
of up to one week before • Corporate finance rates to
purchasing new equipment approved customers
• Preferential Corporate
Pricing
To find out more about exclusive offers for AMA(WA)
members contact Saul Frank – Director, Camera Electronic
– 0417 220 876, plus join our newsletter to see our regular
special offers and workshops. Join via the sidebar at
www.cameraelectronic.com.au
Ae’lkemi
Ae’lkemi mixes old world
opulence with visually seductive and playful surfaces and
textures. Alvin Fernandez, Head Designer of ae’lkemi, is
focused on unique hand-prints and organic textile processes
that represent femininity. All of ae’lkemi’s
designs feature the distinct hand finishing they
are known for. Ae’lkemi is offering all AMA
(WA) members 15% off floor stock.
Innovative solutions for severe hearing loss
W.A.’s largest hearing implant group specialises in helping
those with severe, profound and complex hearing loss:
• Implantable devices include
cochlear implants, electro-acoustic
combination devices, middle ear
implants and bone anchored
hearing aids
• Trials of new technology
Tel: (08) 6380 4944 | www.esiaimplants.com.au
Email: enquiries@esiaimplants.com.au
• Inter-disciplinary team of
surgeons, audiologists, speech
pathologist and psychologist
• Use of international best practice
and evidence based research
conducted at the Institute.
66 MEDICUS May

To win a double pass to one of the following events, simply go to
www.amawa.com.au/membership/onthetown.aspx
Entries must be received by COB Tuesday 12 June 2012
Tchaikovsky’s Fifth
7.30pm, Friday 15 June
Perth Concert Hall
From Disney to destiny!
Join the West Australian
Symphony Orchestra
for a concert featuring
Dukas’ famous symphonic
poem featured in the film
Fantasia. Tchaikovsky’s
Fifth colourfully depicts the
composer’s ideas of fate,
and is a favourite among
audiences world-wide. The
elegant and supremely
talented saxophonist
Amy Dickson debuts with
WASO in a new work
specially composed for her.
How To Succeed In Business Without Really Trying
Double pass for the opening night – 15–23 June
The Regal, Subiaco
Hot on the heels of
the smash-hit 50th
anniversary Broadway
revival starring Daniel
Radcliffe, the Western
Australian Academy of
Performing Arts brings
you the hilarious musical
comedy, How To Succeed
In Business Without Really
Trying.
Winner of seven Tony
Awards, including Best
Musical, Frank Loesser
has packed How To
Succeed full of funny and
memorable tunes: Coffee
Break, The Company Way, A Secretary Is Not A Toy and
Brotherhood of Man will have you rolling in the aisles.
Taste of WA: Winter Tasting
Double pass, 21 June from 6pm
The Oxford Hotel, Leederville
Taste wines from regional
producers right here in Perth!
You will have the opportunity
to compare wine styles from
various regions; explore
regional wine varieties and
educate the palate; taste exclusive new release wines; meet
the winemakers and talk with them about their wine styles;
and, purchase wine direct from the producer.
Come enjoy some heavier wine styles, such as, oaked
Chardonnays, reds and fortified wine. This is a great chance
to network with the industry!
A Royal Affair
In cinemas 26 June
Denmark, 1766, and
Caroline Mathilde is
married to the mad and
politically ineffectual King
Christian VII. Ignored by
the wild King who chooses
to live scandalously,
Caroline grows
accustomed to a quiet
existence in oppressed
Copenhagen. When the
King returns from a tour
of Europe accompanied
by Struensee, his new
personal physician,
Queen Caroline finds
an unexpected ally
within the kingdom. The
attraction between the two is initially one of shared ideals
and philosophy, but it soon turns into a passionate and
clandestine affair.
As the Court plot their return to power and the downfall of
the Queen and Struensee, the consequences of their affair
are made clear and the entire nation will be changed forever.
Megane RS
AMA Membership Discounts
Available on the Melville
Renault Range.
1.9% Business Finance on
Renault Passenger vehicles.
Conditions Apply. See website for details.
MELVILLE RENAULT
164 LEACH HWY, MELVILLE • PH.9330 6666
www.melvillerenault.com.au DL13660
May MEDICUS 67

CARDIOVASCULAR
Professional Notices
HAND SURGERY
Perth Cardiovascular Institute
• Dr Jay Baumwol
• Dr Andrei Catanchin
• Dr Matthew Erickson
• Dr Susan Kuruvilla
• Dr Michael Muhlmann
• Prof Gerry O’Driscoll
• Dr Jamie Rankin
• Dr Matthew Best
• Dr Michael Davis
• Dr Athula Karu
• Dr Kaitlyn Lam
• Dr Anne Powell
• Dr Sharad Shetty
• Dr Gerald Yong
We are pleased to announce the addition of Dr Jay Baumwol to our
practice. Dr Baumwol is a consultant cardiologist at Royal Perth Hospital
and a member of the West Australian Advanced Heart Failure and
Cardiac Transplant service. His interests include general cardiology,
echocardiography and the management of heart failure. Jay will be
practising from our Nedlands and Rockingham clinics. To make an
appointment for Dr Baumwol phone 6314 6809.
The group provides a comprehensive cardiac testing service at
nine conveniently located sites: Nedlands (Hollywood Private
Hospital), Joondalup Health Campus, Bentley, Duncraig,
Esperance, Midland, Mt Lawley and Rockingham.
Services offered include:
• Cardiology consultations
• Echocardiography
• Exercise Stress Testing
• Monitor Fittings (Ambulatory BP, Event and Holter)
• ECG.
Visit www.perthcardio.com.au for more information on our services.
For Cardiology appointments: 1300 4 CARDIO.
For Testing appointments: 1300 HEART TEST.
General Enquiries: 6314 6833 • Fax: 6314 6888
Email: info@perthcardio.com.au
GENERAL SURGERY
Mr Harsha Chandraratna MBBS FRACS
General Surgeon with sub-specialists interest in:
• Disease of the liver, pancreas and gallbladder
• Management of obesity
within a multidisciplinary setting including
bariatric surgery –oswa.com.au
• Pilonidal problems
• Laparoscopic surgery including
appendicectomy, cholecystectomyand hernia
• Emergency surgery
Consulting and operating at St John of God Hospital Murdoch
and Subiaco.
For all appointments
Tel 9332 0066 • Fax: 9463 6202
Lewis Blennerhassett MBBS FRACS
Dr Blennerhassett is a Plastic Surgeon with post-graduate
fellowship in hand surgery certified by the American College
of Surgeons. Expertise in all aspects of acute and chronic hand
disorders, both paediatric and adult, is provided.
For all appointments please Tel: 9381 6977.
Emergencies phone 0438 040 993 – all hours
Mr Peter Hales
Whose interests are:-
• arthroscopic surgery of shoulder, elbow, wrist and hand
• wrist and hand, arthritis and instability
• acute hand trauma
Operating at Bethesda Hospital he has now joined Perth
Orthopaedic and Sports Medicine at 31 Outram St, West Perth.
All appointments and enquiries
Tel: 9212 4200 • Fax: 9481 3792
Mr Paul Jarrett FRACS
Hand and Upper Limb Surgeon provides
a comprehensive service for elective and
traumatic conditions for the hand, shoulder and
upper limb at Murdoch Orthopaedic Clinic for
Workcover and Privately Insured patients.
Please call 9311 4636 for appointments.
I am happy to be referred public patients at
Fremantle Hospital where I hold weekly clinics.
Mr Craig Smith MBBS FRACS
Hand, Wrist and Plastic surgeon has his main practice at 17
Colin Street, West Perth in association with Specialised Hand
Therapy Services. This means that consultation, hand therapy
and splinting are all available at the one location. His areas of
interest include all acute or chronic hand and wrist injuries or
disorders as well as general plastic surgical problems.
He continues to consult in Bunbury and Busselton.
For appointments or advice please call 9321 4420
Mr Angus Keogh FRACS - Upper Limb Surgeon
My interests include traumatic and degenerative
conditions of the upper limb including hand
surgery, arthroscopy including small joints,
complex elbow and wrist instability. I consult
in private rooms at St John of God Subiaco
and St John of God Murdoch. I consult weekly
at Sir Charles Gairdener Hospital – please call
08 9346 1189. Please call 08 9489 8782 for
appointments. Workcover accepted.
68 MEDICUS May

HAND & PLASTIC SURGERY
Dr Robert Love MBBS FRACS (Plas) Dip ANAT
All hand surgery, microsurgery and plastic surgery
• Dupuytren’s Contracture
• Arthritides, Carpal Tunnel
• 24hr Emergency
• Requests for advice welcome
17 Richardson St West Perth and SJOG Murdoch
Tel: 9321 3344 • Mobile: 0409 132 602
INFECTIOUS DISEASES
Dr Desmond Chih MBBS FRACP FRCPA
Infectious Diseases Physician and Clinical Microbiologist
All aspect of adult general infectious diseases and diagnostic
microbiology including
• Fever of unknown origin
• Bone and joint infections
• Surgical infections
• Skin and soft tissue infections
• Travel related infections
• Tuberculosis
• Antibiotic resistance
Consults at Joondalup, SJOG Murdoch (Inpatient) and Myaree.
All correspondence to 74 McCoy Street, Myaree 6154
Tel: 08 9317 0999 • Appointments: 08 9317 0710
Fax: 08 9467 2826
Email: Desmond.Chih@wdp.com.au
NEUROLOGY
Dr Nai Lai MBBS, FRACP, Neurologist
Offers General Neurology including EMG services
Hollywood Specialist Centre. Suite 34, 95 Monash Ave, Nedlands
Tel: 9389 9444 Fax: 9389 7518
For inpatient consults Tel: 9346 3333
Mount Medical Centre
Suite 26, 146 Mounts Bay Road, Perth
Tel: 9322 2714 • Fax: 9486 1198
ORTHOPAEDIC SURGERY
Mr Peter Honey, MBBS, FRACS - Orthopaedic Surgeon
Hand, Wrist, Elbow, Shoulder and Knee Surgery.
Special interests: • Joint replacement surgery of
the hand, wrist, elbow, shoulder and knee
• Arthroscopic wrist, elbow, shoulder and knee surgery
• Treatment of sporting injuries (including knee
ligament injuries)
• Treatment of simple and complex upper limb
fractures and dislocations
• Tendon transfer surgery (L’Episcopo, Eden Lange, transfers for
scapular winging)
• Paediatric upper limb surgery, including correction of congenital
deformity. Appointments and enquiries: 4 Altona Street, West
Perth, 6005. Tel: (08) 9481 2856 • Fax: (08) 9481 2857
Urgent advice or referrals: 0418 948 652
Perth Shoulder Clinic, situated at Bethesda Hospital in Claremont,
provides a comprehensive service for the treatment of shoulder
disorders including:
* Arthroscopic surgery for shoulder instability and rotator cuff pathology
* Shoulder Arthroplasty including revision arthroplasty
* Surgery for fractures about the humerus, scapula and clavicle
* On-site physiotherapy
Sven Goebel operates at Bethesda
Hospital and SJOG Hospital Subiaco as
well as Joondalup Health Campus where he
is able to see public patients.
OPHTHALMOLOGY
Dr Michael Wertheim MBChB FRCOphth FRANZCO
Comprehensive General Ophthalmologist
Consults at: South Street Eye Clinic,
Suite 10/73 Calley Drive, Leeming 6149
Early and Urgent appointments available
Operates at: Eye Surgery Foundation, West
Perth (Private patients), Kaleeya Hospital,
East Fremantle (Public patients)
Special Interests: Cataract Surgery,
General Ophthalmology, Uveitis.
For appointments Ph: 9312 6033 or Fax: 9312 6044
Grant Booth operates at Bethesda
Hospital and SJOG Hospital Subiaco as
well as holding a public appointment at
Royal Perth Hospital.
For appointments or advice contact:
p. 9340 6355 f. 9340 6356 reception@perthshoulderclinic.com
Perth Shoulder Clinic, Bethesda Hospital
25 Queenslea Dr, Claremont 6010
www.perthshoulderclinic.com
PSCadvert-ver3.indd 1
May MEDICUS 69
3/4/12 6:16:12 PM

Professional Notices
ORTHOPAEDIC SURGERY cont.
Karl Stoffel MD, PhD, FMH
(Tr & Orth), FRACS
Professor of Orthopaedics and Trauma Surgery
provides a comprehensive service for elective
& trauma conditions for the hip, knee, lower
limb and all orthopaedic trauma at Murdoch
Orthopaedic Clinic for Workcover, DVA and
Privately Insured patients.
Please call 9311 4639 for appointments.
I offer a no-gap service for all major health funds and will be very
happy to see Private, Worker’s Compensation and Department of
Veteran Affairs patients at Murdoch.
PSYCHIATRY
Dr Raj Sekhon
Dr Raj Sekhon is pleased to announce that he has commenced
private psychiatric
practice in Rockingham. Raj is a local UWA graduate (1996) and
is a Fellow of The
Royal Australian and New Zealand College of Psychiatrists
(FRANZCP), with an interest in all aspects of general adult
psychiatry.
For referrals or other advice please
Ph: 9528 0996 • Fax: 9528 0850.
Sentiens Day Hospital
Please refer all private mental health patients to Sentiens
Day Programs. Our patients usually have depression, anxiety,
bipolar, borderline personality disorder, drinking problems,
relationship problems, stress, PTSD, OCD and sometimes
eating disorders and schizophrenia. We offer group programs
in CBT (also evening), DBT skills, creative therapy, alcohol
management, mindfulness, carer’s support, self-esteem, health
and wellness, recovery, stress management, drug related
metabolic problems, anxiety management, life skills, assertive
skills, online assessment via PsychAssess and PsychScreen and
online monitoring using HealthSteps.
Refer to Dr Dennis Tannenbaum (Clinical Director/Consultant)
or directly to Sentiens via phone for referral advice:
9481 1950 or Fax: 9481 1952.
See Sentiens.com for PDF referral.
www.HealthSteps.net.au
RADIOLOGY/NUCLEAR MEDICINE
Hollywood - T: 9386 7800 F: 9386 7888
Suite 14, Hollywood Medical Centre
85 Monash Avenue, Nedlands 6009
Palmyra - T: 9333 7800 F: 9333 7888
Palmyra Professional Centre
Suite 3, 279 Canning Hwy, Palmyra 6157
Leeming - T: 9312 7800 F: 9312 7878
76 Calley Drive, Leeming 6149
We provide a personalised, comprehensive and professional
digital imaging service. Patients benefit by a short or no wait
time appointments, low radiation dose equipment, familyfriendly,
comfortable clinics and affordable examination fees.
Oceanic Medical Imaging offers a wide range of general
and specialist medical imaging utilising the latest imaging
technology.
Our services include:
• PET-CT
• 64-slice cardiac capable CT
• Nuclear Medicine Studies
and Therapy
• Ultrasound
• Digital general X-Rays
• Digital OPG
and Cephalometry
• Stress ECG suite with
Myocardial Perfusion
Imaging
• CT/Ultrasound guided
injections
• Bone Densitometry
• DEXA whole body fat
assessment
Arriving Soon - NEW MRI at Palmyra Clinic
oceanicimaging.com.au
Envision Medical Imaging
178 Cambridge Street (opp.
SJOG Hospital Subiaco)
Tel: 08 6382 3888 • Fax: 08 6382 3800
Web: www.envisionmi.com.au
Web: www.envisionreports.com.au (WebPAX online images
and reports)
Envision Medical Imaging is an independent Radiology practice,
located directly opposite St John of God Hospital Subiaco on
Cambridge Street, with free parking behind the building.
Services include:
Ultrasound: including injections
MRI: GP referrals accepted
X-ray: low dose
CT: general and cardiac imaging
Nuclear Medicine scans
Dental: Cone Beam and OPG
*Same day appointments available
Imaging Specialists include: Michael Krieser
Brendan Adler, Lawrence Dembo,
Bernard Koong, Conor Murray, Eamon Koh, Jeanne Louw,
Tonya Halliday.
70 MEDICUS May

GP required
for family practice in
Willetton Southland
Medical Services
SOR, VR Referral, good
remuneration.
Contact the Practice
Manger on
08 9332 8888
Full-time or part-time
GP required
Hours negotiable.
We are a busy 6 doctor (3 male, 3
female) private billing, non-corporate
practice in Bedford. Full time Nurse
and pathology on site. Friendly and
well staffed.
Phone Steve, Carl or Jeremy
on 9271 9311 or
email salisburymed@iinet.net.au
Skin Cancer
Diagnosis and Management
Do you want to practice quality medicine
and spend more time with your patients?
Do you have a passion for skin cancer
diagnosis and management? If the answer
to both questions is yes, we would like
to speak with you.
PT is fine, hours negotiable.
Contact Sian via email:
skinspectrum@gmail.com
Now Leasing
Medical Centre/Consulting Rooms,
East Victoria Park
• 360sqm (approx)
• Capacity to accommodate numerous practitioners
• Opposite The Park Centre Shopping Centre
• Flexible Rent Structure
For more information please contact
Richard Cash on
9320 0000 or 0412 006 949
richard.cash@cbre.com.au
Mundaring
FT/PT VR GP
To join busy, friendly, modern, accredited,
fully computerised, well managed private
medical centre.
Excellently equipped treatment room with
fulltime RN support.
Fabulous career opportunity, attractive
remuneration and 6wks annual leave.
Pract Mgr - Michelle Alton.
Tel: 08 9295 1988
email: altonm@iinet.net.au
Applecross
Applecross Medical Group is a major medical facility in the southern suburbs.
Current tenants include GP clinic, pharmacy, dentist, physiotherapy, fertility clinic and pathology.
Both the GP clinic and pharmacy provide a 7 day service.
The high profile location (corner of Canning Hwy and Riseley Street Applecross), provides high visibility to
tenants in this facility.
A long term lease is available in this facility - the space available is 85m2, with the current layout including 4 consulting
rooms, procedure room and reception area. Would suit specialist group, radiology or
allied health group.
Contact John Dawson – 9284 2333 or 0408 872 633
May MEDICUS 71

CPR Training for
Practice Staff
2012
Wednesday
6:00pm – 9:00pm
20 June
12 September
14 November
Saturday
9:00am – 12:00pm
28 July
18 August
Does your staff need
CPR training?
The AMA is delivering three hour courses for
staff requiring CPR training to meet practice
accreditation requirements.
The learning outcomes of this unit provide the participant
with a nationally recognised unit of competency:
HLTCPR201B – Perform CPR.
The course will cover:
• Assessing the situation and responding to the signs of an
unconscious casualty
• Cardiopulmonary resuscitation following Australian
Resuscitation Council guidelines
• Defibrillation awareness
Location:
AMA House
14 Stirling Highway
NEDLANDS
Cost:
$70 per participant
72 MEDICUS May
To enrol, please contact AMA Training Services
email: training@amawa.com.au or phone: (08) 9273 3033

PostgraduateNews
Please forward submissions for Greensheet by 3 June 2012
for inclusion in July edition.
Contact Jennifer Hughes at: jennifer.hughes@amawa.com.au
WESTERN AUSTRALIA
WESTERN AUSTRALIA
Youth Friendly Doctor Training
2012 Program
The Youth Friendly Doctor Program (YFD) seeks to build the
capacity of doctors to communicate more effectively with
young people, address the barriers young people face in
accessing health care and promote adolescent friendly policies,
facilities and service delivery. This program is accredited with
the RACGP and attracts Category 1 and or Category 2 QI&CPD
Points.
MODULE 1
Establishing Connection and Conducting Assessments with
Young People
Workshop 1 – Ethics and the Law in Young People
2 October 2012
MODULE 2
Mental Health Disorders
Workshop 1 – Mental Health Disorders in Young People –
Assessment and Treatment
12 June 2012
Workshop 2 – The Psycho Social Wellbeing of Young People
10 July 2012
MODULE 3
Risk Taking Behaviours and Harm Reductions among
Young People
This module has completed for 2012 and will re-run in 2013
MODULE 4
Eating Disorders in Young People and Their Management
Workshop 1 – Overweight and Obesity in Young People
7 August 2012
Workshop 2 – Eating Disorders in Young People
11 September 2012
For enquires relating to the YFD program or to enrol in the
workshop visit:
www.amawa.com.au/IntheCommunity/YFDTrainingProgram.
aspx
Phone (08) 9273 3000 or email yfd@amawa.com.au
POSTGRADUATE EDUCATION & TRAINING
Date Postgraduate Education & Training Contact Information
7 June Bariatric Surgery: Contemporary Issues – Suitable for SET 3–5 Surgical Trainees,
Consultants, Bariatric Physicians, Dietitians, Psychologists and Nurses. Keynote
speakers, : Prof Jeffrey M Hamdorf and Prof James Toouli, discuss the role of surgery;
the role of multidisciplinary assessment; Novel Techniques; and Gastric Band versus
Sleeve Gastrectomy at 5 years. Venue: University of Western Australia
www.ctec.uwa.edu.au
9 June Western Trauma Course – Venue: TBA, Broome WATEC@health.wa.gov.au
1
11 June Eating Disorders: Advance Individual Therapy – Suitable for rural and remote
professionals and GPs. Through the use of case illustrations and participants’ own
experiences, this workshop includes specific therapeutic interventions for the
practicing clinician. 9am–4pm. Venue: Princess Margaret Hospital
19 June Endovascular Management of Aortic Aneurysms: An Update – Dr Peter Bray,
Consultant Vascular & Endovascular Surgeon at Sir Charles Gairdner Hospital and
Head of Department of Vascular Surgery at St John of God Subiaco, will provide an
update on the management of aortic aneurysms. Venue: AMA (WA) Nedlands
21 June Core Skills: Laparoscopic General Surgery – Suitable for RACS General Surgery
Trainees SET 1–3. This workshop aims to improve surgical safety, operative confidence
and operative efficiency in a way that cannot be provided by surgical supervision or by
other simulated environments. Venue: University of Western Australia
22 June Anatomy of Complications Workshop – Suitable for Obstetric and Gynaecology
Specialists. Venue: University of Western Australia
23 June Cardiac Core Skills Workshop – Suitable for RACS Surgical Trainees in Cardiothoracic
Surgery. Venue: University of Western Australia
27 June The Cutting Edge: Gynaecological Procedures – Suitable for GP Proceduralists and GP
Obstetricians. Venue: University of Western Australia
Blanca.PrietoHugot@
health.wa.gov.au
seminar@amawa.com.au
www.ctec.uwa.edu.au
www.ctec.uwa.edu.au
www.ctec.uwa.edu.au
www.ctec.uwa.edu.au
May MEDICUS 73

PostgraduateNews
Please forward submissions for Greensheet by 3 June 2012
for inclusion in July edition.
Contact Jennifer Hughes at: jennifer.hughes@amawa.com.au
POSTGRADUATE EDUCATION & TRAINING continued
Date
Postgraduate Education & Training
Contact Information
28 June The Cutting Edge: Advanced Procedures – Suitable for GPs who hold a VMP
appointment in GP Surgery. Venue: University of Western Australia
29 June The Cutting Edge: Advanced Skin Procedures – Suitable for GPs with surgery and
dermatology experience. Venue: University of Western Australia
29 June Emergency Procedures Practical Course: Part 1 – Suitable for GP Proceduralists.
Venue: University of Western Australia
30 June CTEC State Conference: Practical Management of Psychiatric Problems: Suitable for
consultants, trainees, registrars, GPs, nurses, allied health professionals, social workers
and medical students. Key speakers include: Dr Phillipa Brown, Dr Hemir Seble, Dr
Daniel De Klerk and Dr Helen McGowan. 8.30am–5.20pm.
Venue: Edith Cowan University, Bunbury
30 June Emergency Procedures Practical Course: Part 2 – Suitable for GP Proceduralists.
Venue: University of Western Australia
21 July WA Education Series 2: Musculoskeletal – to update the knowledge and skills of GPs
on musculoskeletal related issues presented in general practice.
Venue: RACGP WA Faculty
www.ctec.uwa.edu.au
www.ctec.uwa.edu.au
www.ctec.uwa.edu.au
www.ctec.uwa.edu.au
www.ctec.uwa.edu.au
Rachel.patterson@
racgp.org.au
26–27
July
Advanced Vascular Surgery: Anatomical Approaches – Suitable for consultants,
advanced and intermediate Vascular Trainees. Approved for College’s CPD program.
Venue: CTEC at University of Western Australia
www.ctec.uwa.edu.au
10 Aug Clinical Emergency Management Intermediate Workshop – Designed to build
participants knowledge, skills and confidence when responding to medical
emergencies. Includes CPR practice and assessment. Venue: Citigate Perth
www.racgp.org.au/cem/
dates
11–12
Aug
Clinical Emergency Management Advanced Workshop – Suitable for GP’s, GP
Registrars, International Medical Graduates. Designed to develop and/or reinforce
participants’ skills in managing emergency situations at an advanced level.
Venue: Citigate, Perth
www.racgp.org.au/cem/
dates
11 Aug Western Trauma Course – Venue: TBA, Carnarvon WATEC@health.wa.gov.au
14 Aug
–30 Oct
Vocational Graduate Diploma of Women’s Health - Non-procedural Obstetrics
- Suitable for GPs, registrars, junior medical staff from KEMH and other doctors.
6.20pm–8.30pm. Venue: Agnes Walsh Lounge, King Edward Memorial Hospital
kemhpostgrad@
health.wa.gov.au
21 Aug Core Skills – Neurosurgical Approaches– Suitable for Consultants, Registrars and
Trainees in Neurosurgery. Venue: University of Western Australia
25 Aug WA Education Series 3 – Mums and their Babies: to update the knowledge and skills of
GPs on medical issues concerning mothers and infants in the first years of life.
Venue: RACGP WA Faculty
3 Sept Eating Disorders: Supporting Parents and Carers with Information and Skills – Suitable
for rural and remote professionals and GPs. This workshop reviews key principles and
strategies for engaging and supporting parents through treatment, focusing on the
role of parent information and skills training. 9am–1pm.
Venue: Princess Margaret Hospital
13 Sept Core Skills: Foundation of Minimal Access Surgery – Suitable for Surgical Trainees,
Laparoscopic Assist in General Surgery, Vascular, Gynaecology, Urology &
Cardiothoracics – Metro and Rural GPs in the role of minimal access surgery.
Venue: University of Western Australia
14 Sept Core Skills: Intermediate Laparoscopic Skills Workshop – Suitable for Surgical Trainees
and Consultants in General Surgery, Vascular Surgery, Gynaecology, Urology,
Cardiothoracics. Venue: University of Western Australia
www.ctec.uwa.edu.au
Rachel.patterson@
racgp.org.au
Blanca.PrietoHugot@
health.wa.gov.au
www.ctec.uwa.edu.au
www.ctec.uwa.edu.au
74 MEDICUS May

WESTERN AUSTRALIA
WESTERN AUSTRALIA
POSTGRADUATE EDUCATION & TRAINING continued
Date
Postgraduate Education & Training
Contact Information
19 Sept Interventional Pulmonology – Suitable for Respiratory Physicians and Trainees.
Venue: University of Western Australia
Register your Interest – IUD and Implanon NXT workshops: FRWA Sexual Health
Services. Venue: 70 Roe Street, Northbridge
www.ctec.uwa.edu.au
www.fpwa.org.au
5 June
12 June
Open to all General Practitioners
St John of God – Subiaco Hosp. Ground Rounds
Prof Cameron Platell, Colorectal Surgeon
Mr Peter Woodland, Orthopaedic Surgeon
www.sjog.org.au/
hospitals/subiaco
Conferences and MeetingS
Date
Conferences and Meetings
9 June ACEM Scientific Meeting: Emergency Medicine: AnyTime, AnyPlace, AnyWhere –
Putting evidence into practice. Keynote speakers: Prof Anthony Brown with Dr Mel
Herbert and Dr Scott Weingart. Venue: UWA Club, Nedlands
30 June CTEC: Psychiatric Problems in General Practice
Venue: Edith Cowan University, Bunbury
peter.allely@
health.wa.gov.au
www.ctec.uwa.edu.au
26-28
July
26 – 28
July
26–28
July
21 – 25
Aug
30 Aug
– 2 Sep
Faculty of Radiation Oncology Annual Scientific Meeting
Venue: Shangri-La Hotel, Cairns, Queensland
Second World Health Care Networks Conference
Venue: Cairns Convention and Exhibition Centre
Faculty of Radiation Oncology Annual Scientific Meeting
Venue: Shangri-La Hotel, Cairns, Queensland
Annual Scientific Meeting – Australian and New Zealand Society of Occupational
Medicine (ANZSOM)
Venue: Abbey Beach Resort, Busselton
AOCR and RANZCR 2012 Annual Scientific Meeting
Venue: Sydney Convention and Exhibition Centre
www.FRO2012.com
www.whcnetworks.com
www.FRO2012.com
fiona@cfh.com.au
www.aocr2012.com
1
2012 JUNE
EVENT
FEATURE
Endovascular Management of Aortic Aneurysms – An Update
Tuesday 19 June 2012 – AMA Nedlands 6pm for a 6.30pm start
Dr Peter Bray, Consultant Vascular & Endovascular Surgeon at Sir Charles Gairdner Hospital
and Head of Department of Vascular Surgery at St John of God Subiaco, will provide an
update on the management of aortic aneurysms.
The seminar will include the benefits of screening programs; indications for aortic aneurysm repair; the requirements for
surveillance (pre and post intervention) and best medical management.
Dr Bray will also discuss endoluminal versus open repair of AAA, current management techniques for ruptured AAA, and
present two cases of advanced endovascular management of aortic aneurysms - Aortic Arch Aneurysm Repair and Off the
Shelf Fenestrated AAA Repair.
May MEDICUS 75

PostgraduateNews
Please forward submissions for Greensheet by 3 June 2012
for inclusion in July edition.
Contact Jennifer Hughes at: jennifer.hughes@amawa.com.au
GIVE IN TO YOUR DESIRE
WESTERN AUSTRALIA WESTERN AUSTRALIA
AT OUR END OF FINANCIAL YEAR EVENT.
2012 Events Calendar
The AMA (WA)’s events, seminars and workshops focus on topics of interest and relevance to medical
practitioners and practice managers.
Date Time Title Email
Code
Venue
June
2
Tue 12th 6:30pm YFD – Mental Health in Young People Y AMA (WA), Nedlands
Wed 13th 6:30pm Annual General Meeting E AMA (WA), Nedlands
Tue 19th 6:30pm Endovascular Management of Aortic Aneurysms S AMA (WA), Nedlands
Wed 20th 6:00pm CPR Training for Practice Staff T AMA (WA) Nedlands
Thu 21st 6:30pm Develop and Maintain a Sustainable
$
Practice
79,900DRIVE
- Module 1 S AMA (WA) Nedlands
AWAY
Thu 28th 6:30pm Develop and Maintain a Sustainable Practice - Module 2 S AMA (WA) Nedlands
Sat 30th 9:00am CPR Training for members T AMA (WA), Nedlands
IS 250 PRESTIGE WITH EMV
July Sat 7th 6:30pm 2012 Awards Night and Charity Gala Dinner E State Reception Centre,
$
57,900DRIVE AWAY
RX 350 PRESTIGE
Kings Park
Tue 10th 6:30pm YFD – The Psycho-Social Wellbeing of Young People Y AMA (WA), Nedlands
2 Wed 11th 6:30pm Develop and Maintain a Sustainable Practice - Module 3 S AMA (WA), Nedlands
Thu 26th 6:30pm Develop and Maintain a Sustainable Practice - Module 4 S AMA (WA), Nedlands
Sat 28th 9:00am CPR for Practice Staff T AMA (WA) Nedlands
Aug
2
Tue 7th 6:30pm YFD – Overweight and Obesity in Young People Y AMA (WA), Nedlands
Wed 8th 6:30pm Develop and Maintain a Sustainable Practice - Module 4 S AMA (WA), Nedlands
Tue 21st 6:00pm Diabetes Workshop S AMA (WA), Nedlands
Sept
Tue 4th 6:30pm CV Writing and Interview Skills workshop S AMA (WA), Nedlands
Tue 11th 6:30pm YFD – Eating Disorders in Young People Y AMA (WA) Nedlands
Sat 22nd 9:00am CPR Training for members T AMA (WA), Nedlands
Oct
Nov
For more information on 2012 events please visit www.amawa.com.au/membership/events.aspx
Email Code:
2
Tue 2nd 6:30pm YFD – Ethics and the Law in Young People Y AMA (WA), Nedlands
Fri 12th All day 2012 Charity Golf Day E Royal Perth Golf Club
76 MEDICUS May
Sat 10th 9:00am CPR Training for members T AMA (WA), Nedlands
Develop and
Maintain a
Sustainable
Practice
Now is the time to begin an affair. Because from May 1 to June 30 Lexus is
offering great drive away deals on its spirited IS 250 and superb RX 350.
So end the nancial year and begin an obsession. Visit Lexus of Perth in Osborne Park today.
S – seminar@amawa.com.au
T – traning@amawa.com.au
E – event@amawa.com.au
Y – yfd@amawa.com.au
O – mail@amawa.com.au
Visit Lexus.com.au/offer to arrange your test drive as this offer must end June 30.
If you have ever wondered how to develop your own private practice and ensure that it is a
sustainable practice, then this set of seminars is for you.
Seminars will include information on your legal and statutory requirements, financial
options, and the essentials of Medicare and employers obligations to staff. You can either
attend all modules or choose those modules relevant to your particular circumstances.
Module 1: Thu 21 June – Legal Structures and Real Life Examples Phone 9340 9000
Module 2: Thu 28 June – Financial Management 359 Scarborough and Your Beach Practice Road, Osborne Park WA 6017
enquiries@ lexusofperth.com.au www.lexusofperth.com.au
Module 3: Wed 11 July – Medicare
DL18807
After Hours: Morgan Haase 0419 959 658
Module 4: Thu 26 July – Risk Management and Medico –Legal Obligations
Price shown is the recommended drive away price for a private buyer and includes Module 12 months registration, 5: Wed 12 months 8 Aug compulsory – Employer third party insurance Obligations (CTP), a recommended dealer delivery charge and stamp duty. Please note that
your actual drive away price may differ depending on your individual circumstances. Accordingly, please talk to your local Lexus Dealer to con rm the price that is speci c to you. Pricing applicable from 1 May 2012 to 30 June 2012 at
participating dealers. Lexus reserves the right to extend any offer. VALID L2777 LEX00235/FP 050812-164

Help your patients keep their
New Year’s Resolution
New study shows Chest CT for lung cancer
reduces mortality by 20% amongst high risk
individuals.
Ultra-low dose CT – every
patient – every time
Sub-Specialist read scans
Leading edge technology
Visit www.envisionmi.com.au for full
information about case finding for lung
cancer
178 Cambridge Street Wembley
tel: 6382 3888
fax: 6382 3800
email: info@envisionmi.com.au
May MEDICUS 77
CT • MRI • X-RAY • ULTRASOUND • NUCMED • DENTAL

Who else...
has medical equipment finance specialists?
WESTERN AU
Equipment, fit-out and practice assets are
critical to the way in which you run your
practice and care for your patients. Investec
has a range of finance structures where
you can select repayment options to suit
your cashflow, enabling you to update your
equipment now and be best placed to treat
your patients’ needs.
Be at the forefront of your profession.
Western Australian finance specialists
L-R: Adrian Raath, Alison Butler, Debbie Kiely, Richard Curia, Ryan Hunt,
Nina Innes, Ricky Wong, Amanda Abbott, Steven Van Der Walt
Your finance.Our specialisation.
On call: 1300 131 141 or www.investec.com.au/medicalfinance
Commercial Property Finance • Equipment, Fit-out and Car Finance • Goodwill and Practice Purchase Loans • Professional Overdrafts
• Home Loans • Savings Accounts • Income Protection and Life Insurance • Medical Indemnity
Investec Professional Finance Pty Ltd ABN 94 110 704 464 (Investec Professional Finance) is a subsidiary of Investec Bank (Australia) Limited ABN 55 071 292 594 (Investec Bank) AFSL/ACL 234975. All finance
is subject to our credit assessment criteria. Terms and conditions, fees and charges apply. Deposit products are issued by Investec Bank. Before making any decision to invest in these products, please contact
Investec Professional Finance, a division of Investec Bank, for a copy of the Product Disclosure Statement and consider whether these products suit your personal financial and investment objectives and
circumstances. 78 MEDICUS We reserve the May right to cease offering these products at any time without notice. Income Protection/Life Insurance is distributed by Experien Insurance Services Pty Ltd (Experien Insurance Services)
which is an authorised representative of Financial Wisdom Limited. AFSL 231138 (AR No.320626). Experien Insurance Services is part owned by Investec Professional Finance Pty Ltd.