The people behind the policies... - Australian Medical Association ...

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medico-legalGuardianship Tribunal proceedings – <strong>the</strong> role of <strong>the</strong> medicalpractitioner by Melanie Shea<strong>The</strong> Guardianship Tribunal (Tribunal) exercises protective jurisdictionfor <strong>people</strong> over <strong>the</strong> age of 16 living with a decision making disability.<strong>The</strong> Tribunal determines applications for <strong>the</strong> appointment ofguardians and financial managers and can provide substitutedconsent to medical or dental treatments. Fur<strong>the</strong>r, <strong>the</strong> Tribunaloversees procedures for appointing enduring guardians.In most cases medical practitioners maybecome involved in Tribunal proceedingswhere:n <strong>The</strong>y have a patient who is <strong>the</strong> subjectof an application in <strong>the</strong> Tribunal and<strong>the</strong> doctor has been asked to reporton <strong>the</strong> decision making ability of <strong>the</strong>patient; orn <strong>The</strong>y have been asked, ei<strong>the</strong>r by afamily member or by <strong>the</strong> subject of aTribunal order, to conduct a medicaltreatment and <strong>the</strong>re are concernsabout consent to <strong>the</strong> treatment; orn <strong>The</strong>y have concerns about <strong>the</strong> abilityof a patient to manage <strong>the</strong>ir ownaffairs.Applications in <strong>the</strong> TribunalIn applications for guardianship <strong>the</strong>Tribunal may decide to appoint a privateguardian (a family member or willingfriend) or <strong>the</strong> Public Guardian. Guardiansare appointed for adults who areincapable of making <strong>the</strong>ir own decisionsabout <strong>the</strong>ir lifestyle. <strong>Medical</strong> treatmentdecisions are included in applications forguardianship.In applications for a financial manager,<strong>the</strong> Tribunal may decide to appoint aprivate financial manager (family orwilling friend) or <strong>the</strong> NSW Trustee where<strong>the</strong>y decide a person is incapable ofmaking <strong>the</strong>ir own decisions about <strong>the</strong>irfinances.Pursuant to ei<strong>the</strong>r of <strong>the</strong>seapplications, <strong>the</strong> Tribunal may contacta doctor requesting a report attestingto <strong>the</strong> decision making ability of apatient. While this is not a subpoena,4 I THE NSW DOCTOR I MARCH 2011<strong>the</strong> report should be completed in areasonable time and certainly before <strong>the</strong>commencement of <strong>the</strong> hearing. Doctorsmay not be able to charge for preparinga report so be mindful of <strong>the</strong> amountof time spent. In <strong>the</strong> first instance <strong>the</strong>doctor should contact <strong>the</strong>ir patientand advise that <strong>the</strong>y have been askedto make a report. While consent is notnecessary for <strong>the</strong> report to be provided,and may be difficult to get if <strong>the</strong>re arecapacity concerns, it is prudent to have adocumented discussion with <strong>the</strong> patientabout <strong>the</strong> report. <strong>The</strong> Tribunal requiresthat <strong>the</strong> person making <strong>the</strong> applicationserve a copy of <strong>the</strong> application on <strong>the</strong>subject person and <strong>the</strong> subject of <strong>the</strong>requested report must be aware of <strong>the</strong>application.In circumstances where doctors treatseveral members of <strong>the</strong> same family<strong>the</strong>y may have concerns where ano<strong>the</strong>rfamily member is making an applicationfor guardianship. Doctors must make aclinical judgment as to <strong>the</strong> contents of<strong>the</strong> report and not become embroiled infamily disputes. Any conflict of interestmust be clearly outlined in <strong>the</strong> reportto <strong>the</strong> Tribunal. Importantly, regardlessof which family members are patients,<strong>the</strong> doctor must ensure to maintainconfidentiality of <strong>the</strong> subject of <strong>the</strong> reportand must communicate directly with<strong>the</strong> Tribunal ra<strong>the</strong>r than o<strong>the</strong>r familymembers.<strong>The</strong> Tribunal may also hearapplications for enduring guardianship.Enduring guardianship will becomeactive for decision making once a personloses capacity and <strong>the</strong> treating medicalpractitioner may be asked to report on<strong>the</strong> ability of a patient to manage living athome independently when that occurs.<strong>Medical</strong> practitioners are not entitled towitness <strong>the</strong> signature and execution ofan enduring guardianship however <strong>the</strong>yare allowed to approach <strong>the</strong> Tribunal toseek a review if <strong>the</strong>y have concerns aboutwhe<strong>the</strong>r <strong>the</strong>ir patient had capacity toconsent to <strong>the</strong> enduring guardianship.Consent to medical treatment<strong>Medical</strong> practitioners will be aware<strong>the</strong>y have a legal duty to obtain consentto treatment before treating anypatient. It is <strong>the</strong> medical practitioner’sresponsibility to determine whe<strong>the</strong>ra patient is capable of understanding<strong>the</strong> general nature and effect of <strong>the</strong>treatment and whe<strong>the</strong>r <strong>the</strong>y are ableto give a valid consent. If a practitionerbelieves that a patient is not capableof informed consent <strong>the</strong>y must seekconsent from an appropriate substitutedecision maker including <strong>the</strong> ‘personresponsible’ or <strong>the</strong> Tribunal. <strong>The</strong>Guardianship Act 1987 (<strong>the</strong> Act) statesthat a person responsible may be alegally appointed guardian of <strong>the</strong> person,or <strong>the</strong> spouse or de facto spouse, orrelative with a close relationship, or anunpaid carer. <strong>The</strong> Tribunal can makeorders for substituted consent, where<strong>the</strong>re is no person responsible or where<strong>the</strong> person responsibly will not consentto <strong>the</strong> proposed treatment.Cont. page 18

From <strong>the</strong> CEOLooking forward – looking backFiona DaviesCEO, AMA (NSW)Elections (particularly in NSW when <strong>the</strong>y onlyhappen every four years) are a good time forreflection. This election is resulting in lotsof interest in <strong>the</strong> past 16 years of <strong>the</strong> LaborGovernment and particularly why doctorsworking in <strong>the</strong> NSW public hospital system areso concerned about what has happened to <strong>the</strong>irhospitals.<strong>The</strong> issues in NSW hospitals are very similar to<strong>the</strong> issues in o<strong>the</strong>r states and, in fact, hospitalsaround <strong>the</strong> world. <strong>The</strong> demand for healthcarecontinues to grow, as do <strong>the</strong> costs of providingthat care, and money to spend on hospitals isfinite. However <strong>the</strong>re is a clear depth of feelingamong doctors about our hospitals. For evidenceof this you don’t have to look much fur<strong>the</strong>r thanDr Andrew Pesce who left a quiet life as anobstetrician at Westmead Hospital two years agoto stand for <strong>the</strong> Presidency of <strong>the</strong> AMA based on<strong>the</strong> depth of his concern.I date <strong>the</strong> difficulties in our hospitals to <strong>the</strong>event surrounding Campbelltown and CamdenHospital in 2003-2004. I particularly recall beingat Governor Macquarie Tower in December 2003,looking over <strong>the</strong> views of <strong>the</strong> Harbour to see <strong>the</strong>nHealth Minister, Morris Iemma announce hewas going to go after <strong>the</strong> individual doctors andnurses he felt were to blame for <strong>the</strong> events atCampbelltown and Camden Hospital.As we have written over and again in <strong>The</strong> NSWDoctor, subsequent reviews cleared <strong>the</strong> doctorsand nurses of Campbelltown Hospital. Thanks to<strong>the</strong> advocacy of <strong>the</strong> AMA and passionate doctors,Campbelltown and Camden is now “shorthand”for what happens when doctors are forced towork in a compromised, under resourced system,ra<strong>the</strong>r than any implications of poor medicalpractice.Despite this most doctors talk about feelinga significant loss of trust in a Government thatwas so willing to seek individuals out to make<strong>the</strong>m personally responsible for a poor system.Campbelltown and Camden was also importantbecause of <strong>the</strong> extent to which good clinicianbasedadvice was ignored for political expediency.<strong>The</strong> Greater Metropolitan Clinical Taskforce hadadvised that Camden maternity service shouldnot be opened because it was unsafe and wouldcompromise care. Despite this a political decisionwas taken to open <strong>the</strong> service and doctors had tolive with <strong>the</strong> consequences.<strong>The</strong> AMA’s advocacy in this state election hasalso been informed by <strong>the</strong> lessons learnt duringCampbelltown/Camden. We are pushing fora long-term vision for health not short-termpolitical fixes and promises. We want a planto ensure well trained doctors working where<strong>the</strong>ir community needs <strong>the</strong>m. We want generalpractice to be genuinely engaged in our hospitals,not through large bureaucracies but by beingseen as intrinsic to <strong>the</strong> care of <strong>the</strong> patients. Wewant to build on <strong>the</strong> work already achieved withhealth reform in returning doctors and nurses tofrontline decision making in our hospitals.Stop Press... AMA (NSW) Health ForumNSW HEALTH MINISTER, CARMEL TEBBUTTAND SHADOW HEALTH MINISTER, JILLIAN SKINNERWestmead Hospital Education CentreThursday, 10 March 201112.00 noon – 2.00 pmAllAMAmemberswelcomeLight refreshments available from 12.00 noon, program begins at 12.30pmRSVP to Janene Wardrop at AMA (NSW)via email at Janene@amansw.com.auor phone 02 9439 8822 www.amansw.com.au I 5

featureDeputy Premier and MinistCarmel Tebbutt MP by Narelle SchuhWell known in <strong>the</strong> political arena, ourcurrent Deputy Premier and Ministerfor Health, <strong>The</strong> Hon. Carmel Tebbuttran for Marrickville Council in 1993 andhas been involved in <strong>the</strong> left wing of <strong>the</strong>Labor Party since <strong>the</strong> mid 1980s.“What inspired me into politics wasto make a difference to <strong>the</strong> communityI lived in. I particularly wanted to have<strong>the</strong> opportunity to make a differencefor <strong>people</strong> who struggled, experienceddisadvantage. I was very muchattracted to <strong>the</strong> social justice principlesof <strong>the</strong> Labor Party and that’s why Ijoined <strong>the</strong>m in 1985. To me it offered<strong>the</strong> best program and philosophiesabout supporting <strong>people</strong> who aredisadvantaged, supporting working<strong>people</strong> and making a difference in <strong>the</strong>irlives.”On juggling parenthood,responsibilities to her local electorateand holding <strong>the</strong> role of Health Ministerand Deputy Premier, Carmel says “Youhave to be disciplined. You have to beorganised and recognise you can’t doeverything.” Often her day starts at6.00am with <strong>the</strong> morning radio andan early walk helps “get <strong>the</strong> day offto a good start”. It’s a day that canbe completely varied. “Sometimesit can be in <strong>the</strong> office, meeting withvarious different health stakeholders.Sometimes it can be in <strong>the</strong> electorate,meeting with constituents or doingthings out and about in my electorate.I spend a lot of <strong>the</strong> time on <strong>the</strong> roadvisiting hospitals and health services soit really is mixed and I love that.”Most comfortable in <strong>the</strong> occupationof politics Carmel says it’s all about“making a difference” to local and stateresponsibilities. “It is definitely worthit. You have to work hard but so youshould because you’re representing <strong>the</strong><strong>people</strong> and <strong>people</strong> expect you to put youreverything into it.”For Carmel, <strong>the</strong> essential qualitiesof a politician include liking and beinginterested in <strong>people</strong>. Representing<strong>people</strong>, understanding <strong>the</strong>ir needs andaspirations and how to help meet thoseis also crucial. An interest in issues, aninner strength to withstand pressuresand <strong>the</strong> ability to still be clear about whoyou are and what you believe in are keycriteria. “Good politicians need to becompassionate, <strong>the</strong>y need to understandnot everyone has <strong>the</strong> opportunities sometake for granted.”Inner strength and a thick skin arealso essential in politics, “You can’t betoo thin skinned because <strong>people</strong> arecritical, <strong>people</strong> do criticise you and youhave to be able to withstand that and stillcontinue on doing what you believe in.”Wearing many different hats makesprioritising an essential politicalingredient for Carmel. In her electorateshe attempts to address all issues ofconcern equally, admitting some issuesare more readily resolved at a stateGovernment level. In <strong>the</strong> health portfolioCarmel relies on <strong>the</strong> clinical advice of <strong>the</strong><strong>people</strong> who work in <strong>the</strong> health system.“I’m not a clinician so I can’t make thosejudgements about what is more pressingor urgent but I do try to be very receptiveto what I hear. I find <strong>the</strong> best thing isto talk to frontline doctors, nurses ando<strong>the</strong>r health professionals because itgives you a really good understandingof what <strong>the</strong> needs of <strong>the</strong> system are andhow best to respond.”National health reform tops Carmel’slist of achievements and she washeavily involved in <strong>the</strong> lead-up to <strong>the</strong>negotiation of <strong>the</strong> COAG Agreementlast year which she says will continueto provide significant benefits for NSWwith <strong>the</strong> establishment of <strong>the</strong> LocalHealth Networks and Governing Councilscreating opportunities for greatercommunity and clinician involvement.Bedding-down <strong>the</strong> establishment of <strong>the</strong>LHNs to provide opportunities for greaterclinician engagement will be an ongoingchallenge. “We are <strong>the</strong> first state tomove ahead with <strong>the</strong> implementation of<strong>the</strong> Local Health Networks (LHNs). Weappointed <strong>the</strong> Governing Councils andthat was all ready to go on 1 January2011. <strong>The</strong>re was a lot to do in <strong>the</strong> lastsix months of last year but we workedvery closely with all <strong>the</strong> key stakeholdersand while it’s going to be a challenge toactually transition to <strong>the</strong> new structure Ithink <strong>the</strong>re’s a lot of positive support andoptimism about what can be achievedthrough <strong>the</strong> LHNs.”Continuing <strong>the</strong> implementation ofnational health reform is a key priority.Carmel says <strong>the</strong>re is a great need tobe able to develop better incentives for6 I THE NSW DOCTOR I MARCH 2011

er for Health, <strong>the</strong> Hon.more coordinated care and getting <strong>the</strong>right health professionals in <strong>the</strong> rightplaces is a challenge, especially in ruraland regional NSW. “Making sure that <strong>the</strong>Agency for Clinical Innovation can playa key role in supporting evidence-basedbest practice models of care is part ofhow we plan to manage <strong>the</strong> challengesof <strong>the</strong> future and make our healthsystem more sustainable. That has to beled by doctors, nurses and allied healthprofessionals.”Carmel is a big believer in <strong>the</strong> factGovernments have a role to play inbeing able to support <strong>people</strong> to leadhealthier lives, providing information andurban planning to increase recreationopportunities. Obesity, Type 2 diabetesand cardiovascular disease front <strong>the</strong> listof Labor’s health concerns.<strong>The</strong>re is agreement with <strong>the</strong> premiseof <strong>the</strong> AMA’s Last Drinks campaign,that <strong>people</strong> have a right to have anight out without being threatened byalcohol-fuelled violence and anti-socialbehaviour. <strong>The</strong> favoured approach fromLabor however is not a “one size fits all”but one that is tailored to each particularcommunity. She says “<strong>The</strong> List” –a listing for <strong>the</strong> top 50 most violentpremises which must adhere to onerousrestrictions regarding alcohol service –and <strong>the</strong> “hassle free nights” policy havemade positive inroads into reducingalcohol-related violence across <strong>the</strong> state.On <strong>the</strong> topic of polls and focus groups,Carmel believes while <strong>the</strong>y cannotreplace policy and evidence that isgrounded in good practice, “Politicsis a democratic system so you haveto be able to effectively represent <strong>the</strong>community and take to <strong>the</strong> community<strong>policies</strong> that are going to meet with<strong>the</strong>ir approval. So, it’s not surprisingpoliticians use focus groups and o<strong>the</strong>rways to gauge community views. I don’tthink it ever replaces a commitment toyour own set of values though and todoing what is in <strong>the</strong> best interest of <strong>the</strong><strong>people</strong> you are representing, guided byevidence and best practice.”Carmel is proud of <strong>the</strong>ir achievementplacing all medical graduates in 2011but says it’s going to take time and <strong>the</strong>reis no doubt that in future years placinggraduates will be a challenge. “It isvery good that we are seeing medicalgraduates coming through as <strong>the</strong>re’sbeen a shortage of doctors and we’readdressing that now but it’s going to taketime until those doctors are trainedupin specialties and fill shortages,particularly in region and rural areas.”She cites <strong>the</strong> Clinical Education andTraining Institute (CETI) as one way ofmeeting <strong>the</strong> needs of workforce traininginto <strong>the</strong> future, toge<strong>the</strong>r with makingbetter use of electronic resources tosupport training.“We have guaranteed we will placeall NSW domestic graduates into <strong>the</strong>future. <strong>The</strong>n <strong>the</strong>re is <strong>the</strong> challenge thatonce <strong>the</strong>y’ve done a couple of yearsand want to specialise, that we canprovide speciality training as well. Weare committed to continuing to expandspecialty training but it’s got to be in-linewith workforce needs. I think as we seemore students come through <strong>the</strong> system<strong>the</strong>y won’t necessarily be able to chooseonly <strong>the</strong> areas that are most attractiveto <strong>the</strong>m, <strong>the</strong>y’ll be encouraged to go intoo<strong>the</strong>r areas as well.”It’s going to be a busy campaign trailfor Carmel with, at <strong>the</strong> time of goingto print, Labor set to roll-out more of<strong>the</strong>ir health policy in <strong>the</strong> lead-up to <strong>the</strong>election. “It’s ultimately up to <strong>the</strong> <strong>people</strong>of Marrickville to decide whe<strong>the</strong>r <strong>the</strong>ywant to give me ano<strong>the</strong>r opportunityto represent <strong>the</strong>m in <strong>the</strong> Parliament. Ihope <strong>the</strong>y do and I’ll be working as hardas I can up until <strong>the</strong> 26th of March toconvince <strong>the</strong>m <strong>the</strong>y should but it’s <strong>the</strong>irdecision in <strong>the</strong> end.” www.amansw.com.au I 7

featureDeputy Leader of <strong>the</strong> OppoHealth, Jillian Skinner MPActive in politics within <strong>the</strong> Liberal Partyfor more than 20 years, Jillian SkinnerMP was elected to <strong>the</strong> NSW LegislativeAssembly in 1994, gaining re-election torepresent <strong>the</strong> <strong>people</strong> of <strong>the</strong> North Shorein 1995, 1999, 2003 and 2007.“Every day of <strong>the</strong> year, nothing issacred,” Jillian’s alarm sounds at5.59am, just in time to catch <strong>the</strong> 6.00amradio news followed by <strong>the</strong> newspaperdelivery to prepare for a day that couldinvolve commenting to <strong>the</strong> media,heading to Parliament, attendingelectorate activities or talking to <strong>people</strong>around <strong>the</strong> state.A thinker and a writer, Jillian is“passionate about contributing to‘local community’ – which for me is <strong>the</strong><strong>people</strong>, groups and character of <strong>the</strong>electorate of North Shore. Everyonehas a responsibility to participate in <strong>the</strong>local communities <strong>the</strong>y are part of andsince living in Sydney I have been activelyinvolved with community organisationsin <strong>the</strong> North Shore electorate. When <strong>the</strong>local Liberal Party branches wanted alocal member who was already active,passionate and not afraid to have a pointof-viewon local issues and stand-up forlocal community groups, I said ‘Yes’!”Jillian has never been afraid to standup for things she is passionate aboutincluding championing <strong>the</strong> cause ofdoctors, nurses and o<strong>the</strong>rs working inour health system to improve patientoutcomes. “Working in health isrewarding and challenging. I have beenprivileged to be <strong>the</strong> Shadow HealthMinister for more than a decade and<strong>the</strong>re is nothing more I want in politicsthan to be <strong>the</strong> Minister for Health in anO’Farrell Government.”Over <strong>the</strong>se years Jillian has met someamazing individuals and seen some of<strong>the</strong> best clinicians in <strong>the</strong> country performnothing short of miracles. <strong>The</strong>re’s nota moment she looks back and regrets.“<strong>The</strong> long hours only serve to excite meand highlight <strong>the</strong> potential that lies at<strong>the</strong> core of <strong>the</strong> NSW health system. Wehave <strong>the</strong> best medical workforce in <strong>the</strong>country. I know what our clinicians arecapable of doing and I’m eager to startworking with <strong>the</strong>m to solve <strong>the</strong> problemsso <strong>the</strong>y can perform to <strong>the</strong>ir potential.”For Jillian, <strong>the</strong> essential qualitiesof a politician include being able tolisten. She strives to ensure initiativesdeveloped truly respond to issues raisedby <strong>the</strong> community and clinicians. “For16 years I’ve been getting out <strong>the</strong>re,visiting hospitals, speaking to doctors,nurses and allied health professionals.I understand <strong>the</strong>ir issues but moreimportantly I am committed to fixing<strong>the</strong>m, not just making announcementsthat are never delivered.”Ano<strong>the</strong>r important quality is beingable to take on <strong>people</strong>’s concerns andtranslating that into policy and action.“Everyone can identify <strong>the</strong> problems butnot everyone can help <strong>people</strong> work-up<strong>the</strong> solutions and I think that’s a reallyimportant skill in a politician, as isengaging o<strong>the</strong>rs in being able to workout <strong>the</strong> solution as well.” A thick skin isalso an essential trait and somethingJillian says you have to learn on <strong>the</strong> job.Health is an area where you hear alot of tragic stories from patients andhealth professionals. <strong>The</strong> health systemisn’t perfect and can let <strong>people</strong> downand <strong>the</strong>se failures also affect our healthworkforce. Most horrifying, Jilliansays, are <strong>the</strong> stories of bullying andharassment in our health system thatshe hears so often and pledges to dealwith as a top priority if elected. “I’m anempa<strong>the</strong>tic person and feel for grievingfamilies and hurting employees. I want<strong>the</strong> health system that I lead to echo mysympa<strong>the</strong>tic approach. So often what<strong>people</strong> want is acknowledgement andsupport when things go wrong and aquick but fair mechanism to deal withquestions and complaints.”<strong>The</strong> ability to get a better deal forpatients and being able to fix a problemfor an individual patient or <strong>the</strong>ir familyJillian cites as a wonderful achievement.When I speak to her she is in <strong>the</strong>Hunter Valley and has just come from<strong>the</strong> Wansey dialysis unit where sheannounced a small amount of extrafunding. “<strong>The</strong>y’re over <strong>the</strong> moon as itwill make such a difference in <strong>the</strong> livesof <strong>people</strong> on dialysis in that community,”she says. “Meeting <strong>the</strong> requirements of<strong>the</strong> number of <strong>people</strong> who are going tobe on dialysis in <strong>the</strong> future is a massiveissue.”8 I THE NSW DOCTOR I MARCH 2011

sition and Shadow Minister forJillian is excited about <strong>the</strong> health<strong>policies</strong> to be announced in <strong>the</strong> comingweeks such as <strong>the</strong>ir policy to reformgovernance of <strong>the</strong> health system. Thisfocuses on much greater involvement ofcommunities and clinicians in running<strong>the</strong> system, extended clinical referralnetworks and greater accountabilityand transparency. Passionate aboutsupporting researchers, be <strong>the</strong>y inhospitals, institutes, universities orworking independently, Jillian is proudof <strong>the</strong>ir policy to bring medical researchback into <strong>the</strong> health portfolio, increasefunding and develop a 10-year medicalresearch strategic plan for NSW.If elected to govern Jillian says shewill work with health professionals ando<strong>the</strong>rs in <strong>the</strong> community to “put <strong>the</strong>patient back at <strong>the</strong> heart of <strong>the</strong> healthsystem, firstly by improving <strong>the</strong> moraleof those working within it <strong>the</strong>n movingonto priorities preventing ill-health,better managing chronic illness, keeping<strong>people</strong> from unnecessary hospitalisationand fixing hospitals – includingupgrading buildings and equipment.”On <strong>the</strong> AMA’s Last Drinks campaign,Jillian cites Barry O’Farrell’s electionpromise to use whatever measuresbest suited to deal with alcohol-fuelledviolence and o<strong>the</strong>r anti-social behaviourat licensed premises.“ I want <strong>the</strong> healthportfolio to also contribute to lesseningproblem drinking in our communitywhich is why we’ve committed to arange of preventative health measuresincluding a $10million fund to increasedrug and alcohol treatment programs.”Regarding polls and focus groupsJillian is adamant “<strong>The</strong>y don’t delivergood government. A NSW Liberals &Nationals Government will deliver realchange and put <strong>the</strong> public back at <strong>the</strong>centre of decision making, basing bigpolicy decisions on sound research andlistening to <strong>people</strong> at <strong>the</strong> coalface ra<strong>the</strong>rthan <strong>the</strong> polls.”On our health workforce issues Jilliansays we need to be smarter about<strong>the</strong> different places we can train ourmedical workforce and <strong>the</strong>re shouldbe a “smorgasboard” of experiencesfor graduates not only in city hospitalsbut in smaller rural ones and evenpartnerships with overseas hospitals forstudent exchanges. “A student doctorI spoke to recently said a lot of hercolleagues were choosing specialtieswhere <strong>the</strong>y thought <strong>the</strong>y’d most likelygain employment, not <strong>the</strong> ones <strong>the</strong>yreally were passionate about. I thinkthat’s very sad. I think you are muchbetter at <strong>the</strong> things you are passionateabout doing. It might mean <strong>the</strong>y all can’tbe in <strong>the</strong> city, <strong>the</strong>y might need to do astint in <strong>the</strong> country and <strong>the</strong>se are <strong>the</strong>kind of incentives we need to work on.”In her many discussions with <strong>the</strong> AMA,specialist doctors, colleges and o<strong>the</strong>rprofessional bodies Jillian is aware of<strong>the</strong> critical importance of providing ahospital environment where doctors andnurses can do <strong>the</strong> right thing by patients.“<strong>The</strong>se discussions have also focused on<strong>the</strong> need to provide adequate numbersof staff and safe working hours for <strong>the</strong>medical workforce that we all need torun our health system now and into <strong>the</strong>future.”In <strong>the</strong> lead-up to <strong>the</strong> election Jillianwill spend time with many candidatesall over <strong>the</strong> state. As for after <strong>the</strong> 26th ofMarch… “I’ll spend some time with myfamily, friends and supporters – and ifwe win, have a glass of champagne butan early night because <strong>the</strong> next day iswhen <strong>the</strong> most important work begins.” www.amansw.com.au I 9

feature<strong>The</strong> social glue of LMAs by Elyse CainLocal <strong>Medical</strong> <strong>Association</strong>s (LMAs)may well be <strong>the</strong> social glue sticking<strong>the</strong> medical profession toge<strong>the</strong>r.For decades <strong>the</strong>y have providedopportunities for doctors to socialiseand discuss areas of commoninterest. This is certainly <strong>the</strong> casewith LMAs such as <strong>the</strong> Kuring-gaiDistrict <strong>Medical</strong> <strong>Association</strong> (KDMA),<strong>the</strong> Warringah District <strong>Medical</strong><strong>Association</strong> (WDMA), <strong>the</strong> Mt Druitt<strong>Medical</strong> Practitioners’ <strong>Association</strong>(MDMPA) and <strong>the</strong> Nepean <strong>Medical</strong><strong>Association</strong> (NMA).Dr Robyn Napier, <strong>Medical</strong>Secretary and <strong>Medical</strong> Directorat <strong>the</strong> AMA (NSW) stresses thatLMAs are an extremely importantpart of <strong>the</strong> medical profession.LMAs facilitate communicationbetween medical practitioners of allspecialties, something she considersabsolutely vital for <strong>the</strong> unity of <strong>the</strong>profession. “Doctors are extremelybusy and LMAs encourage <strong>the</strong>mto take a break and mix with <strong>the</strong>ircolleagues. This reduces isolationand encourages <strong>the</strong> growth of<strong>the</strong> profession,” Dr Napier said.“Particularly with Medicare Localsreplacing many of <strong>the</strong> Divisionsof General Practice throughoutNSW, it will become increasinglyimportant for LMAs to be <strong>the</strong>local representative bodies for <strong>the</strong>medical profession.”It may be too early to tell whe<strong>the</strong>rLMAs will experience renewedinterest from <strong>the</strong> profession in <strong>the</strong>iractivities as a direct result of <strong>the</strong>new Division structure, leading toa heightened representative rolein local health issues that extendbeyond social and educationalevents. Dr Harry Lorang, Vice-President of <strong>the</strong> WDMA said timewill tell whe<strong>the</strong>r <strong>the</strong> Medicare Localswill play a role in triggering renewedinterest in LMAs as representativebodies. “I would certainly hope thatLMAs will experience an increasedrole in local health issues of <strong>the</strong>clinical or medico-legal sort but for<strong>the</strong> moment <strong>the</strong>y are predominantly<strong>the</strong> source of most educational andsocial events for doctors,” Dr Lorangsaid.Dr Hani Bittar of <strong>the</strong> MDMPA saysthat <strong>the</strong> effects of <strong>the</strong> new Divisionstructure have not yet been noticedby general practitioners in <strong>the</strong> MtDruitt region. In spite of this DrBittar does see <strong>the</strong> potential forLMAs to become more vocal inpublic health matters at a local level.“LMAs could be major stakeholdersand team players for planning anddelivering public healthcare to localcommunity and hospital servicesdue to <strong>the</strong>ir connection with localcommunity, local GPs, local AHPsand, in our case, with communityhealth at <strong>the</strong> HealthOne NSW level,”Dr Bittar said.NMA President Dr MichelleCrockett hopes to see increasedinteraction between different LMAsin <strong>the</strong> future to share ideas onacquiring new membership andstreng<strong>the</strong>ning <strong>the</strong> associations.“Many of our doctors do not livein <strong>the</strong> area which can sometimesbe a problem for membershipand running events,” Dr Crockettsaid. “In addition, everyone is verybusy and many already belong to anumber of different organisations,some of which are exclusively forGPs.”This is where LMAs fit into <strong>the</strong>equation; <strong>the</strong>ir major benefits liein <strong>the</strong> ability to bring doctors fromall specialties toge<strong>the</strong>r, be it foreducational, social or representativepurposes.Mrs Jo Dowe of <strong>the</strong> KDMA saysit is about creating events fordoctors with busy schedules thatwould o<strong>the</strong>rwise not occur, whereall practitioners can be amongstcolleagues in a relaxed atmosphere.“<strong>The</strong> KDMA is RACGP accreditedand each year hosts bi-monthlyeducational dinners, an annualinternational conference, a sociallong weekend and a golf day,” MrsDowe said. “This year we haveintroduced a social afternoon at <strong>the</strong>races into <strong>the</strong> mix.”12 I THE NSW DOCTOR I MARCH 2011

featureHealth needs and outcomes for children in out-ofbyMelinda Clarke and Kylie Gwynne | Life Without BarriersMost <strong>Australian</strong> children have <strong>the</strong>chance to grow up safe and well infamilies where <strong>the</strong>y are cared for,supported and enabled to growinto contributing members of <strong>the</strong>community. Some children, however,grow up in out-of-home care. For <strong>the</strong>sechildren growing up safe and well is afar less certain outcome.Out-of-home care is provided acrossAustralia for children and young<strong>people</strong> who are unable to live with<strong>the</strong>ir families. Out-of-home care cantake <strong>the</strong> form of foster care (living witha family), residential care (living in astaffed house with o<strong>the</strong>r children), orkinship care (living with a relative).Children enter out-of-home carefollowing an assessment by <strong>the</strong> statebasedcommunity services governmentdepartment, usually because achild abuse or neglect matter issubstantiated, or <strong>the</strong>ir family is unableto care for <strong>the</strong>m. In NSW this is <strong>the</strong>responsibility of Community Services,part of <strong>the</strong> Department of HumanServices. Children may be placed intemporary or short term out-of-homecare by <strong>the</strong> Department and <strong>the</strong>n <strong>the</strong>Children’s Court can determine if achild will be placed in <strong>the</strong> care of <strong>the</strong>Minister and in out-of-home care in <strong>the</strong>longer term.Health is one of <strong>the</strong> most basicindicators of wellbeing in children andyoung <strong>people</strong>, including social andemotional wellbeing, which in turnis related to quality of life. Childrenand young <strong>people</strong> in out-of-homecare are a particularly vulnerablepopulation and are more likely to havephysical and mental health problemscompared to <strong>the</strong> general population ofchildren. <strong>The</strong>re is a myriad of researchdemonstrating that children in out-ofhomecare have higher rates of health,dental, developmental, behavioural andemotional problems and a significantnumber also have a physical and/orintellectual disability. For example,Nathanson and Tzioumi 1 (2007)found that, compared to <strong>the</strong> generalpopulation, children seen at <strong>the</strong> SydneyChildren’s Hospital out-of-home clinicwere:n Four times more likely to haveproblems with vision;n Eight times more likely to haveproblems with hearing;n Two to three times more likelyto have speech and languagedifficulties; andn Much less likely to be fullyimmunised.<strong>The</strong>re are a range of risk factors in<strong>the</strong> early life of children and young<strong>people</strong> who enter care that increase<strong>the</strong>ir risk for developing healthproblems including:n Poor diet;n Inadequate healthcare;n Increased risk of accidental injuryassociated with poor parentalsupervision;n Physical and emotional traumaassociated with various forms ofmaltreatment;n Exposure to parental drug abuse(pre- and post-birth);n Exposure to high levels of conflictand family violence; andn Attachment disruption.Some children and young <strong>people</strong>are fur<strong>the</strong>r disadvantaged by multipleplacement changes, leading to pooremotional and social adjustment.Placement changes can sometimestranslate into poor communicationabout health history leading to delaysin accessing <strong>the</strong> right healthcare andsupport services. Although <strong>the</strong>re isa large body of research evidencepointing to <strong>the</strong> poor state of healthof children in out-of-home care, andthis evidence has been accepted bygovernments across Australia, fur<strong>the</strong>rwork is required in order to alter <strong>the</strong>course of <strong>the</strong> trend.<strong>The</strong> National Standards for Outof-HomeCare 2 will be implementedthis year and were developed viaan extensive national consultation.<strong>The</strong> KPMG Final Report – NationalStandards for Out-of-Home Care 3 –identifies physical and mental health asone of <strong>the</strong> six key areas of overall childwellbeing. Standard 5 requires thatchildren and young <strong>people</strong> have <strong>the</strong>irphysical, developmental, psychosocialand mental health needs assessed andattended to in a timely way.<strong>The</strong> standard goes on to state that:Children and young <strong>people</strong> enteringcare are to have <strong>the</strong>ir health needsassessed and receive specialisedservices to respond to <strong>the</strong>ir healthchallenges so that <strong>the</strong>ir chances foroptimum health are maximised. <strong>The</strong>16 I THE NSW DOCTOR I march 2011

home care in Australiachild or young person’s physical,developmental and psychosocialand mental health needs are to beidentified in a preliminary healthcheck. This will provide advice on <strong>the</strong>specialist services required and <strong>the</strong>timing of a comprehensive health anddevelopmental assessment. Childrenand young <strong>people</strong> are to have <strong>the</strong>ir ownwritten health record which moves with<strong>the</strong>m if <strong>the</strong>y change placements.Effective implementation of thisnew National Standard will go someconsiderable way to ensuring that <strong>the</strong>health needs of children in out-of-homecare are met in a more consistent way,leading to more positive outcomes.This will require substantial effortand commitment on <strong>the</strong> part of stategovernments – both communityservices and health portfolios and <strong>the</strong>many non-government organisationsthat provide out-of-home care services.Children in out-of-home care are partof our community and experience pooroutcomes through no fault of <strong>the</strong>ir own.It is incumbent on all of us to work toensure that <strong>the</strong>y have a better chanceto grow up safe and well.Life Without Barriers is <strong>the</strong> largest nongovernmentprovider of out-of-home careacross Australia1 Nathanson, D., & Tzioumi, D. (2007). Health needs of<strong>Australian</strong> children living in out-of-home care. Journal ofPaediatrics and Child Health, 43, 695-699.2 http://www.fahcsia.gov.au/sa/families/pubs/nat_std_4_outofhomecare/Pages/default.aspx3 http://www.fahcsia.gov.au/sa/families/pubs/kpmg_final_report_nsfohc/Pages/default.aspx4 Report on Government Services 2010 http://www.pc.gov.au/__data/assets/pdf_file/0006/93966/61-chapter15.pdfp 15.125 Report on Government Services 2010 http://www.pc.gov.au/__data/assets/pdf_file/0006/93966/61-chapter15.pdfTable 15A.166 http://www.community.nsw.gov.au/docswr/_assets/main/documents/bcg_report.pdf p A. 60.7 Harden, B. (2004) Safety and Stability for Foster Children:A Developmental Perspective in Children, Families andFoster Care Vol.14, No.1, p 39.8 Nor<strong>the</strong>rn California Training Academy (2008) PlacementStability in Child Welfare Services: Issues, Concerns,Outcomes and Future Directions Literature Review. p 4.9 http://www.lboro.ac.uk/research/ccfr/Publications/placementstabilitylitreview.pdf p.2.10 Report on Government Services 2010 http://www.pc.gov.au/__data/assets/pdf_file/0006/93966/61-chapter15.pdfTable 15A.2411 Life Without Barriers 2008/09 data for NSW OOHCservices12 http://www.create.org.au/news-and-events/kids-in-carewithout-a-road-mapOut-of-home in Australia<strong>The</strong>re are about 34 000 children in out-of-home care in Australia, including15,211 in NSW 4 . <strong>The</strong> rate of children in out-of-home care Australia-wide is6.7 per 1,000 children. This rate is 44.8 per 1,000 for indigenous children, and4.9 per 1,000 for non-indigenous children.<strong>The</strong> rate for children in out-of-home care in NSW is 9.4 per 1,000 children(71.3 indigenous; 6.6 non-indigenous). Victoria is 4.3 per 1,000 children (48.7indigenous; 3.8 non-indigenous), Queensland 6.7 per 1,000 children (36.0indigenous; 4.6 non-indigenous) and Western Australia 5.1 per 1,000 children(38.8 indigenous; 3 non-indigenous). 5In NSW, Community Services directly provides out-of-home care forapproximately 85 per cent of children in out-of-home care with <strong>the</strong> remaindercared for by non-government agencies. Non-government agencies haveresponsibility for 84 per cent of high needs children. 6Placement stability for children in out-of-home care is often used as aproxy indicator of quality. 7,8,9 In NSW, 43.5 per cent of children in out-of-homecare have moved three or more times per year. 10 Australia-wide this statisticis 50.3 per cent. For non-government agency Life Without Barriers in NSW,<strong>the</strong> proportion of children moved three or more times per year is 2.3 percent 11 ). <strong>The</strong> higher <strong>the</strong> number of moves <strong>the</strong> greater <strong>the</strong> impact on schooling,healthcare and social networks.Outcomes for children in out-of-home care are very poor. A survey by <strong>the</strong>CREATE Foundation found that:“<strong>The</strong>y are at higher risk of developing recognised characteristics ofyouth who have left care such as being more likely to be undereducated,unemployed, to earn less, become a parent at a younger age, be involvedin <strong>the</strong> juvenile justice system, become homeless, be dependent on socialassistance, have mental health issues, attempt suicide and be at a higher riskof substance abuse”.<strong>The</strong> CREATE report noted that:n 64 per cent of young <strong>people</strong> do not have a leaving care plan (a strategy forlife after being in <strong>the</strong> care system).n 35 per cent of young <strong>people</strong> in out-of-home care are homeless in <strong>the</strong> firstyear after leaving care.n 46 per cent of boys in out-of-home care are involved in <strong>the</strong> juvenile justicesystem.n 35 per cent of young <strong>people</strong> in out-of-home care completed Year 12.n 29 per cent are unemployed (compared to <strong>the</strong> national average of9.7 per cent).n 28 per cent were already parents <strong>the</strong>mselves. 12 www.amansw.com.au I 17

medico-legalGuardianship Tribunal proceedings –<strong>the</strong> role of <strong>the</strong> medical practitioner Cont. from page 4Defined in <strong>the</strong> GuardianshipRegulation 2010 (<strong>the</strong> Regulations)are four types of medical treatment –special, major, minor and urgent.A medical practitioner must approach<strong>the</strong> Tribunal for consent if:n <strong>the</strong> proposed treatment is special;n <strong>the</strong> person responsible is not availableand <strong>the</strong> proposed treatment is major;n <strong>the</strong> patient is objecting to <strong>the</strong>proposed treatment (major or minor)and <strong>the</strong>re is no appointed guardian tooverride objections.An application for consent to medicalor dental treatment is available on <strong>the</strong>Tribunal’s website.Only <strong>the</strong> Tribunal can consent tospecial medical treatment (whichincludes a pregnancy termination,vasectomy or tubular occlusion).<strong>The</strong> 2010 Regulation removed <strong>the</strong>prescription of drugs of addictionfrom <strong>the</strong> special medical treatmentcategory and it is now consideredmajor medical treatment for which <strong>the</strong>Tribunal or a person responsible canconsent. Major medical treatment alsoincludes procedures for which a generalanaes<strong>the</strong>tic is required.For minor medical treatments (asdefined in <strong>the</strong> Regulation), where <strong>the</strong>person responsible is not available,medical practitioners may chose to treat<strong>the</strong> patient, without consent, providedthat <strong>the</strong> doctor notes in <strong>the</strong> patient’sfile that <strong>the</strong> patient is not objectingto <strong>the</strong> treatment, that <strong>the</strong> treatmentis necessary and that <strong>the</strong> treatmentwill promote <strong>the</strong> patient’s health andwellbeing.In any of <strong>the</strong> categories of treatment, if<strong>the</strong> practitioner considers <strong>the</strong> treatmentis urgent and necessary <strong>the</strong>y may treatwithout consent.All consents and requests for consentmust generally be provided in writingexcept where this is not practicable.<strong>The</strong> Regulations require that <strong>the</strong> medicalpractitioner keep a record of <strong>the</strong> name18 I THE NSW DOCTOR I MARCH 2011and address of <strong>the</strong> person providingconsent as well as any conditionsattached to <strong>the</strong> consent and <strong>the</strong> nature of<strong>the</strong> treatment for which consentwas given.It is important that practitioners areaware of <strong>the</strong> safeguards containedwithin <strong>the</strong> Act and <strong>the</strong> Regulations whichensure that treatment is only given to<strong>people</strong> who lack <strong>the</strong> capacity to consentto medical treatment where it is clearly in<strong>the</strong> best interest of <strong>the</strong> patient.Concerns about a patientIf a doctor has concerns about a patient’sdecision making ability in respect of <strong>the</strong>patient’s lifestyle, financial management,or <strong>the</strong>ir ability to consent to medical ordental treatment, <strong>the</strong> practitioner shouldspeak to <strong>the</strong> patient and <strong>the</strong> family(being conscious of confidentiality) aboutwhe<strong>the</strong>r <strong>the</strong>re is an enduring guardianor power of attorney already in place for<strong>the</strong> patient. If not, provide details of <strong>the</strong>Guardianship Tribunal for <strong>the</strong> family toapproach and discuss <strong>the</strong>ir options.In respect of medical treatment if<strong>the</strong>re is a ‘person responsible’ to makedecisions about consent, <strong>the</strong> proposedmedical treatment can be discussedwith <strong>the</strong>m in order to obtain substitutedconsent. If possible a request forconsent should be made in writingwith information about <strong>the</strong> particularcondition that requires treatment, <strong>the</strong>nature of <strong>the</strong> proposed treatment andits effects, <strong>the</strong> risks associated and anyalternative treatments.If you treat a patient with anintellectual or physical disability or familymembers of such a person and you haveconcerns about <strong>the</strong> family coping withcaring for that person, <strong>the</strong> Departmentof Aging, Disability and Homecare shouldbe contacted to arrange respite care.For moreinformation<strong>The</strong> Medico-Legal and IndustrialDivision at <strong>the</strong> AMA (NSW) are happyto answer any questions you haveabout <strong>the</strong> Guardianship Tribunal,phone 02 9439 8822.Alternatively <strong>the</strong> Tribunal has avery helpful website at http://www.gt.nsw.gov.au/

<strong>Australian</strong> <strong>Medical</strong> <strong>Association</strong> (NSW) LimitedELECTION NOTICE2011 ELECTION OF COUNCILRichard Kidd, Principal of <strong>Australian</strong> Election Company will be <strong>the</strong> Returning Officer for <strong>the</strong> 2011 election of <strong>the</strong>Council of <strong>the</strong> <strong>Australian</strong> <strong>Medical</strong> <strong>Association</strong> (NSW) Limited pursuant to <strong>the</strong> Industrial Relations Act, 1996 and<strong>the</strong> Regulations <strong>the</strong>reunder.NOMINATIONSN.B. No member or Nominated Representative shallnominate for more than one class (position) on Council.Nominations in writing are hereby invited for <strong>the</strong>following positions on Council:SPECIAL INTEREST GROUPONE (1) to be elected from each of <strong>the</strong> followingclasses:Physician ClassSurgeon ClassOphthalmologist ClassPsychiatrist ClassPathologist ClassGeneral Practitioner ClassRadiologist ClassAnaes<strong>the</strong>tist ClassObstetrician/Gynaecologist ClassSalaried Doctor ClassRural Doctor ClassDoctor in Training ClassStudent Member ClassZONESONE (1) to be elected from each of <strong>the</strong> followingclasses:Nor<strong>the</strong>rn Metropolitan Zone ClassSou<strong>the</strong>rn Metropolitan Zone ClassCentral Metropolitan Zone ClassWestern Metropolitan Zone ClassNorth Western Metropolitan Zone ClassSouth Western Metropolitan Zone ClassNew England and North Coast Zone ClassIllawarra and South Coast Zone ClassNorth West Zone ClassSouth Zone ClassHunter and Central Coast Zone ClassUNRESTRICTED GENERAL MEMBERCATEGORYIn <strong>the</strong> “Unrestricted General Member Class”, afur<strong>the</strong>r SIX (6) to be elected from any of <strong>the</strong> aboveclasses (with <strong>the</strong> exception of <strong>the</strong> Student MemberClass) provided that at least three (3) of those six (6)shall be general practitioners.With <strong>the</strong> exception of <strong>the</strong> Student Member Class, candidates and <strong>the</strong>irnominators must be Ordinary Members, or in <strong>the</strong> case of a company,<strong>the</strong> Nominated Representative of an Ordinary Member. Candidatesmust be members of <strong>the</strong> relevant class of <strong>the</strong> <strong>Association</strong> and must befinancial members of <strong>the</strong> <strong>Association</strong> as at <strong>the</strong> date of <strong>the</strong> closing ofnominations, i.e. 5:00pm, Wednesday, 6 April 2011. Candidates mustbe nominated by not less than two (2) o<strong>the</strong>r members of <strong>the</strong> relevantclass who must be financial members of <strong>the</strong> <strong>Association</strong>. No personmay nominate more candidates than <strong>the</strong> number to be elected in eachclass.In respect of <strong>the</strong> Student Member Class, candidates must be StudentMembers of <strong>the</strong> <strong>Association</strong> and must be nominated by not lessthan two (2) o<strong>the</strong>r Student Members of <strong>the</strong> <strong>Association</strong>. No StudentMember may nominate more than one (1) candidate.A candidate may complete a Statutory Declaration in Support ofCandidature, <strong>the</strong> contents of which will be included in a CandidateInformation Sheet which will accompany voting material when it isposted. A Nomination Form and Statutory Declaration in Support ofCandidature are included in this issue of <strong>The</strong> NSW Doctor. Additionalcopies are available from <strong>Australian</strong> Election Company, telephone1800 224 420.CLOSE OF NOMINATIONSNOMINATION FORMS AND STATUTORY DECLARATIONS IN SUPPORTOF CANDIDATURE MUST BE RECEIVED BY THE RETURNINGOFFICER, AUSTRALIAN ELECTION COMPANY, NOT LATER THAN5:00PM, WEDNESDAY, 6 APRIL 2011. THEY MAY BE POSTED TOTHE RETURNING OFFICER, PO BOX 3016, CABOOLTURE BC QLD4510 OR PREFERABLY FAXED TO (07) 3408 8722, (07) 3289 1096,(07) 3351 2537 OR HAND DELIVERED TO AUSTRALIAN ELECTIONCOMPANY, 43 MARINA BLVD, BANKSIA BEACH QLD 4507.Any defect in a Nomination or Statutory Declaration in Support ofCandidature must be rectified by <strong>the</strong> candidate prior to <strong>the</strong> close ofnominations. A candidate may only withdraw his/her nomination inwriting prior to <strong>the</strong> close of nominations.Should more than <strong>the</strong> required number of nominations be received, adraw will be conducted to determine <strong>the</strong> order of candidates’ nameson <strong>the</strong> ballot paper at <strong>the</strong> <strong>Australian</strong> Election Company office at11:00am, Thursday, 7 April 2011. Candidates or <strong>the</strong>ir representativesare invited to witness <strong>the</strong> draw.VOTINGIf <strong>the</strong> election is contested, a postal ballot will be conducted and closingat 12 Noon, Tuesday, 10 May 2011. Members of <strong>the</strong> <strong>Australian</strong> <strong>Medical</strong><strong>Association</strong> (NSW) Limited, financial as at 5:00pm, Wednesday, 6 April2011 (and Student Members of <strong>the</strong> <strong>Association</strong>) entitled to vote inthat class or classes that are contested will be sent a ballot paper onWednesday, 20 April 2011.<strong>The</strong> method of voting to be observed for this election will be “First Past<strong>the</strong> Post”. Any enquiries concerning this election should be directed to<strong>Australian</strong> Election Company, telephone 1800 224 420.Richard Kidd, Returning Officerfor <strong>the</strong> 2011 <strong>Australian</strong> <strong>Medical</strong> <strong>Association</strong> (NSW) Limited Election.

COUNTRY ZONES7. One (1) member of Council shall bea member who carries on his or herprofession in <strong>the</strong> Hunter and CentralCoast Zone (Hunter and Central CoastZone Class), which comprises <strong>the</strong> localGovernment areas of:Muswellbrook WyongGosford NewcastleLake Macquarie CessnockPort Stephens GloucesterMaitland Great LakesDungog Upper HunterSingletonBroken Hill8. One (1) member of Council shall bea member who carries on his or herprofession in <strong>the</strong> Illawarra and SouthCoast Zone (Illawarra and South CoastZone Class), which comprises <strong>the</strong> LocalGovernment areas of:Bega Valley Wollongong EurobodallaShellharbour Wollondilly ShoalhavenWingecarribee Kiama9. One (1) member of Council shall be a member whocarries on his or her profession in <strong>the</strong> New England andNorth Coast Zone (New England and North Coast ZoneClass),which comprises <strong>the</strong> Local Government areas of:Moree Plains Tamworth Port Macquarie –Armidale – Coffs Harbour HastingsDumaresq Narrabri Richmond ValleyBellingen Lismore BallinaKempsey Inverell KyogleTenterfield Gunnedah Liverpool PlainsNambucca Guyra GwydirByron Greater Taree UrallaGlen Innes Walcha Clarence ValleyTweed10. One (1) member of Council shall be a memberwho carries on his or her profession in <strong>the</strong> SouthZone (South Zone Class), which comprises <strong>the</strong> LocalGovernment areas of:Wentworth Leeton NarranderaBombala Berrigan AlburyCarrathool Wagga Wagga Goulburn-Coolamon Greater Hume MulwareeNORTH WESTSOUTHMoreeNEW ENGLAND &NORTH COASTArmidaleHUNTER &CENTRAL COASTDubboMudgeeNewcastleOrangeBathurstCowra(Metropolitan)AlburyGoulburnWagga WaggaILLAWARRA &SOUTH COASTBatemans BayEdenWollongongCoffsHarbourPortMacquarieGundagai Urana TumbarumbaSnowy River Murray JuneeQueanbeyan Tumut YassDeniliquin Boorowa PalerangYoung Harden ConargoJerilderie Upper Lachlan BalranaldWakool Lockhart CootamundraHay Griffith MurrumbidgeeTemora Cooma-Monaro Corowa11. One (1) member of Council shall be a member whocarries on his or her profession in <strong>the</strong> North West Zone(North West Zone Class), which comprises <strong>the</strong> LocalGovernment areas of:Broken Hill Mid-Western BourkeParkes Regional CabonneOberon Bland ForbesWellington Lithgow City LachlanCoonamble Weddin DubboBathurst Bogan WalgettCowra Gilgandra WarrumbungleBrewarrina Warren Central DarlingBlayney Cobar NarromineOrangeINTERPRETATIONd) “Doctor in Training” means an employed member who is undertaking a course of post graduate training and who does not o<strong>the</strong>rwise fall within any of<strong>the</strong> classes referred to in paragraphs (a) to (i) of Rule 36.1.e) “Rural Doctor” means a member or Nominated Representative who is engaged in a private medical practice in one of <strong>the</strong> Zones referred to inparagraphs (l) to (p) inclusive of Rule 35.2 where <strong>the</strong> practice at which that member or Nominated Representative is primarily engaged in carrying onhis or her profession is not in a Town or City which has a Base Hospital.f) “Student Member” must be an undergraduate of <strong>the</strong> faculty of medicine from a university in New South Wales & Student Member. All ipso factocases to be a Student Member of <strong>the</strong> <strong>Association</strong> and when he/she is qualified to be an Ordinary Member of <strong>the</strong> <strong>Association</strong> of if he/she ceases tobe a medical student.

<strong>The</strong> AMA (NSW) Clinical ConferenceNEWYORK8-14 May 2011ENQUIRIES – MEDICAL TOURS AUSTRALIA PTY LTDEmail: info@medicaltoursaustralia.com.au • Web: www.medicaltoursaustralia.com.auPO Box 4109, Winmalee NSW 2777 • Ph: 02 4754 5000 • Fax: 02 4754 47398948 4000

AMA (NSW) / NSW HEALTHMEDICAL CAREERSEXHIBITIONIf you’re a medical student, intern or registrar who hasn’t yet picked a training programor are looking to change specialties, this is an event that you cannot miss. Have yourquestions answered by expert exhibitors. Pre-registration is highly recommended.DATE AND TIME Saturday 19 March 201110:00am – 4:00pmREGISTRATION FROMVENUEADMISSION9:30amAJC Convention CentreRandwick RacecourseFREELASTCHANCETOREGISTER!Proudly sponsored byNSW HealthCare FlightQualityOccupationalHealthRANZCPLast MinuteLocumsAustralasian College of Sport PhysiciansFaculty of Medicine Sydney UniversityMDA NationalMedic OnCallNSW GP training providers<strong>The</strong> Royal <strong>Australian</strong> and New Zealand College of RadiologistsAvantRoyal Australasian College of PhysiciansRoyal <strong>Australian</strong> and New Zealand College of OphthalmologistsRoyal <strong>Australian</strong> and New Zealand College ofObstetricians and Gynaecologists<strong>The</strong> Royal College of Pathologists of Australasia<strong>Medical</strong> Indemnity Protection Society Ltd<strong>Australian</strong> and New Zealand College of Anaes<strong>the</strong>tistsREGISTER ONLINE AT: events@amansw.com.au www.amansw.com.au I 21

AMA (NSW), toge<strong>the</strong>r withpartners Investec Experien,Cutcher & Neale and<strong>The</strong> Prosper Groupinvite you to a:TAX, PROPERTY ANDFINANCE STRUCTURINGMASTERCLASSKey steps to wealthgeneration and preservationDate & LocationWednesday, 30 March 2011, 6.00-8.00pmAMA (NSW) Conference CentreGrd Flr, 69 Christie StreetSt Leonards NSWEvent details6.00pm Drinks and Canapes6.30pm Welcome6.40pm PresentationsCostAMA (NSW) Members – $45Non Members – $75AMA (NSW) Member bring a non member friend -$20 discount for member ($25 for member, $75for non member)Attendees will receive $100 towards <strong>the</strong>ir 2012AMA (NSW) membershipThis unique, interactive workshop takes <strong>the</strong> formof a panel discussion with AMA (NSW) PreferredPartner experts. Using a number of scenariosunique to medical practitioners our panel will showyou how to make <strong>the</strong> most of your earning power.<strong>The</strong> panel consists of:Stafford HamiltonInvestec ExperienJarrod BrambleCutcher & Neale Accounting and Taxation ServicesChris White<strong>The</strong> Prosper GroupRSVPFor more information and bookings emailAMA (NSW) at events@amansw.com.auAMA (NSW) GOLF SOCIETYCALENDAR OF EVENTS 2011Interstate Weekend - Coolum | Friday, 4 - Monday, 7 MarchAMA Charity Golf Classic(PRO-AM) - Terrey Hills Golf Club, Thursday, 17 MarchThis is an AMA (NSW) Charitable Foundation Event<strong>The</strong> President’s CupMonash Country Club, 2 MayCountry Weekend & Spring Cup Bonville Golf ResortAccommodation: Bonville Golf ResortThursday, 8 - Sunday, 11 September<strong>The</strong> AMA International ShieldMauna Lani, Big Island, Hawaii | Sunday, 9 - Tuesday, 18 OctoberBMA CupElanora Country Club, 15 DecemberCHARITY CLASSIC, TERREY HILLS GOLF CLUBPRO/AM | 17 MARCH 2011RSVP to Kathy Thornton by 7 March 2011 on 02 9902 8144 oremail amagolf@amansw.com.auAs a key component of <strong>the</strong> AMA (NSW) Charitable Foundation’sfundraising efforts <strong>the</strong> 2011 Charity Classic golf tournament willbe held at <strong>the</strong> prestigious Terrey Hills Golf Club. More than100 amateur and senior Pros will test <strong>the</strong>ir skill on thischallenging course.A senior PGA professional will join each team of three andprovide personalised attention and expert instruction throughout<strong>the</strong> day. Free coaching clinics will also be conducted by seniorPGA professionals prior to <strong>the</strong> event which will be a stablefordcompetition (individual and team) over 18 holes, with nearest <strong>the</strong>pin and longest drive.Schedulen 11.30am – registration, lunch and free golf clinicn 1.00pm sharp – hit-off with shotgun start (players ready to moveout at 12.40pm)n 6.30pm – tournament dinner and presentation of trophiesand prizesTHE PRESIDENT’S CUP, MONASHCOUNTRY CLUB | 2 MAY 2011Monash is situated in a unique and naturalbushland setting offering a magnificent golfcourse and ocean views. Situated high in <strong>the</strong>hills above Narrabeen on Sydney’s beautiful nor<strong>the</strong>rn beaches,Monash has an acclaimed par 72 par layout with superb,challenging greens. Registration from 10.00am. Golf Societymembers will receive registration forms in March.<strong>The</strong> President’s Cup is a stableford event and all golfers arewelcome. For more information contact Kathy Thornton on02 9902 8144 or email amagolf@amansw.com.au www.amansw.com.au I 25

classifiedsPROFESSIONAL MEDICAL WEBSITE DESIGNBy doctors, for doctors. Patients search your name online!Ensure your website reflects you as a clinician.Discount for AMA members.Visit our showcase: http://www.webinjection.com.au.EQUIPMENT FOR SALEExamination bunks, waiting room chairs, desks with drawersand overhead bookshelves, wall mounted lights, optiplanfiling cabinets, Panasonic multi-system phones, baby changetable and more. Phone 02 9736 1682 or 0407 203 899.CONSULT ROOM AVAILABLEModern consult. room avail. for any medical specialist incl.dermatologist or paramedical at practices in Windsor, Ryde,Hornsby, Parramatta and Orange. Secretarial/billing supportavail. Very res. rates. Phone Dr Shaun Segal 0416 000 585,email shaun.segal@sou<strong>the</strong>rnsun.com.au.IMMEDIATE START, FT/PT/GPR MENTORSHIPHigh remuneration. Friendly well established, computerisedAGPAL-accredited, allied health dietitian, physio, audiology.Pathology centre within. Phone 0424 547 949.MEDICAL CENTRE FOR LEASE, MACQUARIE ST, SYDNEYRare offering. 191sqm vacant Grd floor suite opp. SydneyHospital. Superb fit-out. Ideal location for all types ofpractice in premier medical precinct. Very res. rates.Phone 0414 819 836.CONSULTING ROOMS FOR LEASENew consulting rooms opposite Prince of Wales Hospital,Randwick. Would suit paediatrics. Phone 02 9310 0606.THE NSW DOCTORADVERTISING RATESRATES x1 X3 X6 X11Full pg $2700 $2500 $2300 $2100Half pg $1700 $1600 $1500 $1400Third pg $1100 $1050 $1000 $950Quarter pg $900 $850 $800 $7502 pg insert $2900 $2700 $2500 $23004 pg insert $3300 $3100 $2900 $2700Not including GSTNB. AMA members receive up to five free classified advertisementsper annum.<strong>Medical</strong>debtscollectedprofessionallyDon’t give up on your bad debts!Guardian Collection Agency has been servicing <strong>the</strong> medicalprofession for over 20 years, with an exceptional success rate,a simple, commission-only fee structure and a reputation forintegrity, efficiency and 100% personal service.We differ from <strong>the</strong> large, impersonal run-of-<strong>the</strong>-millagencies in <strong>the</strong> following ways:● No cost to you unless we collect – our income dependson our success rate● We devote 100% of our time to debt collection● Unique ‘counselling’ approach to debtors – we addresspatients’ problems● Stable, professional, family owned and operatedContact us:Phone: (02) 9488 8597 ● Fax: (02) 9988 4207Email: guardian@sydney.net

Just some of <strong>the</strong> services that are available include awards advice and updates, court representation,mediation and human resource consulting. A comprehensive range of legal packages and draft contractsare available for members for a nominal fee. In addition, below are a list of our member service partnersto assist you whatever <strong>the</strong> need.membershipAMA (NSW) Member Service PartnersAMA Auto Buying ServiceA free service specialising in <strong>the</strong>acquisition, funding and disposal of allTressCox LawyersExpert legal advice for <strong>the</strong> medicalprofession. Members are entitled to aunique duty solicitor scheme offeringone free consultation (referral required).makes and models of motor vehicles.Make your membership more rewarding every dayMembership has its rewardsAssign <strong>Medical</strong>Accountants/Tax Advisers PanelAMA Platinum Assists members Edge to source Credit competent,Experienced accounting firms whofriendly and committed staff for your Cardcan assist you with your personal andAMA (NSW)Reward yourself with business has <strong>the</strong>everyday or most practice. comprehensive Medico-Legal and Employment Relations advice in Australia.Membership professional accounting and taxationMembership Just some of <strong>the</strong> services that are has available its includetravel and benefits. has awards rewardsadvice its and rewardsneeds.updates,Selectcourt<strong>the</strong>representation,firm most suitable forAMA (NSW) has AMA <strong>the</strong> mediation most (NSW) comprehensive and human resourceCommonwealth has <strong>the</strong> most Medico-Legal consulting.comprehensive Bank and AMedico-Legal Employment comprehensiveand Relations rangeEmployment advice of legal your Relations in packages Australia. requirements. and draft contractsadvice in Australia.A Just sophisticated some of <strong>the</strong> Just services reflection are availablesome that of Offering of <strong>the</strong> arefor your membersservices available a special professional forthat merchant includea nominalare available awards facility success, fee.at adviceIna <strong>the</strong> addition,include and AMA awards updates,below has partnered areadvice courta listand representation,of with our member American service Express partners to give youMembership to assist you whatever <strong>the</strong> need. has its rewards updates, court representation,complimentary mediation and human AMA (NSW) Member Reward Cardmediation benefits resource and with low consulting. human fee <strong>the</strong> of exclusive 0.68% resource A for comprehensive most consulting. new credit AMA cards. 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New rates Zealand for AMA locations. members.and negotiate your home, and AMA negotiate investmentcards participating and merchant restaurants, facilities. hotels andand Investec Property overdraft Experien advisor facilities. or buyer’s Auto agent your Buying able home, Service to investment Discounted Save up rates to $365 for AMA on membership.members.and Save TressCox up to $365 Lawyers on membership.properties O<strong>the</strong>r negotiate benefits:or commercial your home, investmenttourist attractions.properties premises,A free service or commercial specialising premises, Save up25to $365 on membership.in <strong>the</strong>Fees Expert TressCox as follows: legal advice Lawyers Joining for <strong>the</strong> $200;propertiesSpecialist source, performorfinancecommercialto due meet diligencepremises,<strong>the</strong> personal and negotiateFees as follows: Joining $200;medicalsaving Receive you automatic time and subscriptions money.To take advantage of saving acquisition, your tobenefits time <strong>the</strong>funding and following money. publications:Fees One as Auscellardoor follows: year $265; Joining Two $200;and disposal call AMA of all (NSW) Member One profession. Services Expert year $265; legal Members Two advice on years are (02) and $465. entitled duty 9439 to solicitor a 8822 schemen n AMA List of <strong>Medical</strong> makes Services and and models Fees of Book motor vehicles.unique with one duty free solicitor consultation scheme offering (referral required).or 1800 O<strong>the</strong>r 813 423 benefits: (outside Metropolitan areas) 4www.nswama.com.au%AMA (NSW)years $465.REBATEWineGow-Gatessaving and propertiesyou practice ortime and needs Group commercialmoney. of members. premises. FinanceOne year Society American $265; Two Express years $465.Complete solutions for insurance practice and requirements, financial services motorBoutique Offering corporate wines specially affinity programs negotiated andO<strong>the</strong>r benefits:25one free consultation (referral required).O<strong>the</strong>r benefits: withn vehicles, specialn <strong>The</strong> NSW commercial/residential packages for AMA members.Doctorproperty25Receive automatic subscriptions Receive automatic <strong>the</strong> following subscriptions Assign publications: to <strong>Medical</strong>Introduce a new<strong>the</strong> following publications:% member CaltexAccountants/Tax REBATEto StarCard AMA (NSW) and receiveReceive automatic subscriptions n n <strong>The</strong> <strong>Medical</strong> <strong>the</strong> following Journal publications: of Australia% prices special REBATEfor discounts members to every members month. for creditServices include: Wealth Creation, Riskcards and merchant facilities.and overdraft facilities.Advisers Paneln n AMA List of <strong>Medical</strong> ServicesAssists membersand FeestoBooksource competent,a cheque equal to 25% of <strong>the</strong> new member’sn n AMA List of <strong>Medical</strong> Management, Services and Fees Doctors’ Book Practice InsuranceCaltex StarCardExperiencedConsolidateaccountingfuel expensesfirms whointo one monthlyn n AMA List of <strong>Medical</strong> n Services n <strong>Australian</strong> and Fees Medicine Bookand Superannuation.subscription Consolidate Auscellardoor your via AMA vehicle our Member (NSW) Get Memberfriendly and committed staff for yourcan statement. fuel expenses WineGow-Gates Groupassist you with Fuel your discounts: personal 2.5 and cpl off Unleaded,n n n <strong>The</strong><strong>The</strong>NSWNSWDoctorDoctorn n <strong>The</strong> O<strong>the</strong>r NSW member Doctor services includeprogram. <strong>The</strong>re are no limits.n n AMA Action (e-newsletter) business or practice.Introduce a new member professional Vortexto AMA95, accounting Diesel(NSW)and and 1.5 taxation receivecpl off Vortex 98Introduce Introduce a new a new member memberonto Society oneto AMA to AMAeasy-to-read(NSW) (NSW) and receive andmonthlyreceivestatementComplete insurance and financial servicesn n n <strong>The</strong> <strong>The</strong> <strong>Medical</strong> <strong>Medical</strong> Journal n n of Medprac of <strong>The</strong> Australia Australiawith Boutique access wines to <strong>the</strong> at specially following negotiated fuelwith subscriptions special <strong>Medical</strong> Super packages Journal Fund of to for Australia <strong>the</strong> AMA AMA members. Lista chequeof a cheque Servicesequal equal to 25% to a 25% of cheque <strong>the</strong> of new <strong>the</strong> equal new member’s to member’s 25% needs. of Select <strong>the</strong> new <strong>the</strong> member’sfirm most suitable fordiscounts: prices for members 2.5cpl off every unleaded, month. Vortex 95nn n <strong>Australian</strong> Medicine Commonwealth Banksubscription via our your Member Virgin requirements.n n <strong>Australian</strong> Medicine<strong>The</strong> Services and perfect Fees include: super book, Wealth fund for <strong>The</strong> Creation, doctors, NSW Risk Doctor, subscription subscription via via our our Member Member Get Get Member Member Blue Get – Member <strong>The</strong> LoungeMEDPRAC To take advantageOfferingofayourspecialbenefitsmerchant program. program. facilitycall <strong>The</strong>re at <strong>The</strong>re AMAa are are no (NSW)and DieselMemberand 1.5cplServicesoff Vortex 98.on (02) 9439 8822program. limits. no limits. <strong>The</strong>re are no Significantly limits. reduced rates with no joining fee andn n SUPERANNUATIONn AMA Action (e-newsletter) with no entry fees. Have <strong>the</strong> option ofManagement, <strong>The</strong> <strong>Medical</strong> Doctors’ Journal Practice of Insurance Australia,Caltex StarCardn n AMA Action (e-newsletter)AMA (NSW) Member Reward Cardor managing and <strong>Australian</strong> 1800 Superannuation. your 813 fund Medicine 423 using low (outside fee a range of and 0.68% of Metropolitan Health for most in credit <strong>the</strong> cards. areas) Hertz Consolidate 4www.nswama.com.auyour vehicle savings fuel expenses of $100 per year.Significant savings every year withinvestment managers.As onto <strong>the</strong> one official easy-to-read car rental monthlyparticipating partner statementSpotlight e-newsletter.for restaurants, AMA, hotels andTo take advantage To take Medprac of your advantage Super benefits Fund Investec of call your Experien AMA benefits (NSW) call Member AMA (NSW) Services Hertz with accessMember offers on (02) on discounted to <strong>the</strong> (02) 9439 followingServices tourist 9439 rates 8822 fuelattractions. and 8822a range (02) 9439 8822Specialist finance to meet <strong>the</strong> personalFitness Firstor or 1800 813 423 or 1800 (outsideProsper <strong>The</strong> perfect Groupof discounts: member 2.5cpl benefits off all unleaded, year round. Vortex 95Call AMA (NSW) member 813 services super Metropolitan fund for doctors,423 (outside onareas)and practice Metropolitan 4www.nswama.com.auMEDPRACneeds of members. Finance areas) 4www.nswama.com.auand Diesel and 1.5cpl American Special off Vortex reduced Express 98. rates on standard gym02 9439 SUPERANNUATION 8822 or emailA with property no services@amansw.com.auentry advisory fees. Have (buyer’s <strong>the</strong> agent) option ofQantas Clubsolutions for practice requirements, motorOffering memberships corporate and affinity no programs joining fee. and Administration feewho managing can source, your fund perform using due a range diligence ofDiscounted Hertz rates forvehicles, commercial/residential propertyspecial AMA applies. members. discounts to members for creditand investment negotiate managers. your home, investmentSave As <strong>the</strong> up official to $365 car on rentalcards membership. partnerand merchantfor AMA,Visit our websites | www.amansw.com.au facilities.properties or commercial and premises, overdraft|facilities.www.ama.com.auFees Hertz as offers follows: discounted Joining rates $200; and a rangesaving Prosper you Group time and money.One of member year $265; benefits Two Auscellardoor all years Foxtel year $465. round. Business AMA (NSW) WineGow-Gates GroupA property advisory (buyer’s agent)Society Free standard installation of our business valueDislclaimer: AMA (NSW) may financially benefit fromCompleteits relationshipinsurancewithandPreferredfinancialPartnersservices Qantas ClubO<strong>the</strong>r benefits: who can source, perform due diligenceBoutique package, wines plus at specially two months negotiated free on a 12-month25with special packages for AMA members.prices contract. for members every month.Receive automatic subscriptions and negotiate to <strong>the</strong> your following home,Servicespublications: investmentinclude: Wealth Creation, Risk % Discounted REBATErates for AMA members.Save up to $365 on membership.properties or commercial premises,Fees as follows: Joiningn n AMA List of <strong>Medical</strong> Services and Fees Book Management, Doctors’ Practice InsuranceCaltex $200; StarCard www.amansw.com.au I 27saving you time and money.One year $265; Twoand Superannuation.Consolidate years $465. your vehicle fuel expensesn n <strong>The</strong> NSW DoctorIntroduce a new member to AMA (NSW) onto one and easy-to-read receive monthly statementn O<strong>the</strong>r n <strong>The</strong> <strong>Medical</strong> benefits: Journal of Australiawith access to <strong>the</strong> following fuelO<strong>the</strong>r benefits:Membership has its rewardsAMA (NSW) has <strong>the</strong> most comprehensive Medico-Legal and Employment Relations advice in Australia.Just some of <strong>the</strong> services that are available include awards advice and updates, court representation,mediation and human resource consulting. A comprehensive range of legal packages and draft contractsare available for members for a nominal fee. In addition, below are a list of our member service partnersto assist you whatever <strong>the</strong> need.MEDPRACSUPERANNUATIONAMA Auto Buying ServiceA free service specialising in <strong>the</strong>acquisition, funding and disposal of allmakes and models of motor vehicles.Assign <strong>Medical</strong>Assists members to source competent,friendly and committed staff for yourbusiness or practice.Commonwealth BankOffering a special merchant facility at alow fee of 0.68% for most credit cards.Investec ExperienSpecialist finance to meet <strong>the</strong> personaland practice needs of members. Financesolutions for practice requirements, motorvehicles, commercial/residential propertyand overdraft facilities.Gow-Gates GroupComplete insurance and financial serviceswith special packages for AMA members.Services include: Wealth Creation, RiskManagement, Doctors’ Practice Insuranceand Superannuation.Medprac Super Fund<strong>The</strong> perfect super fund for doctors,with no entry fees. Have <strong>the</strong> option ofmanaging your fund using a range ofinvestment managers.Prosper GroupA property advisory (buyer’s agent)who can source, perform due diligenceand negotiate your home, investmentproperties or commercial premises,saving you time and money.Receive automatic subscriptions to <strong>the</strong> following publications:n n AMA List of <strong>Medical</strong> Services and Fees Bookn n <strong>The</strong> NSW Doctorn n <strong>The</strong> <strong>Medical</strong> Journal of <strong>Australian</strong> n <strong>Australian</strong> Medicinen n AMA Action (e-newsletter)AMA (NSW) Member Service PartnersTressCox LawyersExpert legal advice for <strong>the</strong> medicalprofession. Members are entitled to aunique duty solicitor scheme offeringone free consultation (referral required).Accountants/Tax Advisers PanelExperienced accounting firms whocan assist you with your personal andprofessional accounting and taxationneeds. Select <strong>the</strong> firm most suitable foryour requirements.AMA (NSW) Member Reward CardSignificant savings every year withparticipating restaurants, hotels andtourist attractions.American ExpressOffering corporate affinity programs andspecial discounts to members for creditcards and merchant facilities.Auscellardoor AMA (NSW) WineSocietyBoutique wines at specially negotiatedprices for members every month.Caltex StarCardConsolidate your vehicle fuel expensesonto one easy-to-read monthly statementwith access to <strong>the</strong> following fueldiscounts: 2.5cpl off unleaded, Vortex 95and Diesel and 1.5cpl off Vortex 98.HertzAs <strong>the</strong> official car rental partner for AMA,Hertz offers discounted rates and a rangeof member benefits all year round.Qantas ClubDiscounted rates for AMA members.Save up to $365 on membership.Fees as follows: Joining $200;One year $265; Two years $465.25 % REBATEIntroduce a new member to AMA (NSW) and receivea cheque equal to 25% of <strong>the</strong> new member’ssubscription via our Member Get Memberprogram. <strong>The</strong>re are no limits.To take advantage of your benefits call AMA (NSW) Member Services on (02) 9439 8822or 1800 813 423 (outside Metropolitan areas) 4www.nswama.com.au

membership<strong>The</strong> AMA is leading <strong>the</strong> discussion in <strong>the</strong> proposed healthsystem reform. You can help support your professionalorganisation by encouraging your colleagues to join.<strong>The</strong>re has never been a better time to refer a colleague.2011 Subscription RatesFrom 1 MarchCATEGORY Total (incl GST) Monthly amount25%rebatemember-getmemberprogramIntroduce a new member toAMA (NSW) and receive a chequeequal to 25 per cent of <strong>the</strong> newmember’s subscription.No limits apply!Refer today!Specialist Member 1099.17 109.92General Practice Member 978.33 97.83Members first year after graduation (Intern) 161.66 16.17Members second year after graduation 283.33 28.33Members third year after graduation 283.33 28.33Members fourth year after graduation 522.50 52.25Members fifth year after graduationand subsequent years as RMO/Registrar 640.17 60.42Non-Specialist salaried <strong>Medical</strong> Officer 894.16 89.42Joint subscription member & spouse or partner ** **Members in academic position not in active practice 769.17 76.92Members in part time positions engaged 11-25 hours pwk 580.84 58.08Members in part time positions engaged up to 10 hours pwk 247.17 27.42Members in full-time post graduate study 428.33 42.83Members over 70 still in active practice 446.66 44.67Members absent from Australia for full calender year 449.17 44.92Members permanently retired 218.33 21.83Fifty year members and Gold Medal Recipients NIL NILMaternity Leave* NIL NILStudent Members NIL NIL* 1 year maximum. Please contact AMA (NSW) to arrange.** 30% discount applies to each individual subscription.Yes join me up!I wish to become a member of <strong>the</strong> <strong>Australian</strong> <strong>Medical</strong> <strong>Association</strong> and <strong>the</strong> <strong>Australian</strong> <strong>Medical</strong> <strong>Association</strong> (NSW).I agree to observe <strong>the</strong> principles stated in <strong>the</strong> Declaration of Geneva and <strong>the</strong> Rules of <strong>the</strong> AMA.NAME AND TITLEgender MALE FEMALE DOBADDRESSPOSTCODE business homeTelephoneMOBILEemailCategory/DisciplineAMOUNT $I was referred by my colleague (optional)AMEX MASTERCARD VISA CHEQUECARD NOEXPIRY DATE ____ /____NAME ON CARDCARDHOLDER’S SIGNATUREmail to AMA (NSW), PO Box 121, St Leonards NSW 1590, or fax 02 9438 3760enquiries@amansw.com.auwww.amansw.com.au

While you builda career, we’ll helpbuild your wealth.You don’t need us to tell you how much dedication and commitment is requiredto build a successful career in medicine.But we can tell you how to build your fi nancial success and security.As specialists in accounting services for medical practitioners, we understandboth your unique circumstances and <strong>the</strong> opportunities available to you. By putting<strong>the</strong> right structure in place now, you can be confi dent of reaping <strong>the</strong> appropriaterewards in <strong>the</strong> future.And if you’re already well into a career, we can review your current structureto ensure you’re maximising <strong>the</strong> available opportunities.To start <strong>the</strong> conversation, simply contact Jarrod Bramble on freecall 1800 988 522.<strong>The</strong>re’s no obligation and no charge for <strong>the</strong> initial discussion for AMA members.■ Freecall 1800 988 522cnmail@cutcher.com.au

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