October 2014 - Sunshine Coast Local Medical Association

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