201911 November


Chair report


Message from Dr Bruce Willett, RACGP Queensland Chair

Recently, a lovely middle-aged lady sat in front of me. We dealt with her difficult skin lesions and a chronic cough, but it turns out the real reason she was there was to share a story with me – that she had recently discovered her next-door neighbour, and best friend of the last 40 years, was actually her sister. That was a very interesting story and there was quite a bit involved in this consultation.

With such consultations, we are rightly expected to keep comprehensive records. When I graduated, not so long ago, a few lines on a 4 x 6-inch card represented most consultations. Now, we are all expected to:

  • take part in shared decision-making
  • meet minimum referral criteria for public hospitals (which are sometimes a little arbitrary)
  • deal with complex chronic diseases (seems we are the new general physicians)
  • deal with multiple comorbidities as our patients are getting older and sicker
  • meet ever-increasing legislative and other compliance standards, and
  • be aware of and consult with ever more clinical guidelines.

While most of these things are improvements in the way we do things, GPs are constantly being expected to do more and more with less. Medicare freezes are stark, but the real threat has been from decades of no indexation.

The argument from the government is clear: if the majority of GPs are willing to accept the bulk-bill rebate, then clearly it is adequate. The truth is that most GPs feel for their patients and want them to have the best healthcare regardless of their ability to pay.

Ten years ago, there was quite a marked GP shortage yet bulk-billing rates remained persistently high, mostly because GPs care about patients who cannot afford it. GPs cannot be expected to continue to underwrite the system.

General practice must value what it does to have others value what we do. Asking those who are in a position to contribute to their healthcare to do so is becoming essential for the continuation of quality primary care in this country; however, there are those who are not in a position to contribute and for them, it is clear we need to be thinking of other ways of funding their healthcare.

Many of us have long resisted blended payments with some form of voluntary registration; however, it is becoming increasingly apparent as countries across the world struggle with paying for their healthcare that new forms of funding for the whole community now need to be considered.

The patient I mentioned above had difficult problems and she expected that I could help her in a general practice setting, close to home and community, and with someone she knew and trusted with this delicate information. We need to be properly resourced to continue to help these kinds of patients in our communities.


Dr Bruce Willett

Chair, RACGP Queensland

Calendar of events


Upcoming Queensland events

Event Date Location
New Fellows Committee presents 'GPs got talent' Friday 22 November 2019 Brisbane
ALM: Managing older patients in general practice Saturday 30 November 2019 Brisbane - FULL
CPR workshop Tuesday 3 December 2019 Brisbane - FULL
2020.1 Applied Knowledge Test (AKT) and Key Feature Problem (KFP) pre-exam workshop Saturday 7 December 2019 Brisbane
2020.1 AKT and KFP pre-exam workshop Sunday 8 December 2019 Brisbane
CPR workshop Thursday 23 January 2020 Brisbane
2020.1 KFP Friday 7 February 2020 Brisbane, Bundaberg, Cairns and Townsville
2020.1 AKT Saturday 8 February 2020 Brisbane, Bundaberg, Cairns and Townsville
CPR workshop Saturday 22 February 2020 Eatons Hill
CPR workshop Tuesday 3 March 2020 Brisbane
New Fellows Hot Topics Saturday 7 March 2020 Brisbane

Events in the spotlight


GPs got talent

The RACGP Queensland New Fellows Committee is celebrating GPs’ talents and passions (beyond medicine) with a showcase on Friday 22 November 2019.

The event is a celebration of those creative pursuits that promote relaxation and wellbeing, regenerate the spirit and renew the joy in our lives and work, such as dance, drama, music, paint, photography, sculpture, drawing, poetry and prose.

Show your work, strut your stuff or simply come along to experience what others have created. It will provide an opportunity to connect and network with other GPs and to share experiences and ideas.

Submissions are still open. To exhibit your work, email qld.events@racgp.org.au with details of the piece (photo and measurements of work to be exhibited, file/s for pre-recorded performance or digital art, or description of live performance).

We look forward to seeing you there!

Register to attend.


Newsletters 2023 news


GP19 through the eyes of a medical student

RACGP Queensland provided one lucky Queensland medical student with a free trip to GP19.
Here is what Stevan Borchardt had to say about the experience.

Steven-Borchardt-medical-student-at-GP19-1.jpg

So what was GP19 like for a final-year medical student? Well, as someone who is still on the path to becoming a GP, I can tell you it was truly stimulating! The presenters were great; highly engaging, very encouraging, and so motivated to convey their knowledge to others. I spoke with many of the conference attendees, and we all agreed that the hardest thing about the conference was choosing which sessions to go to.

The venue and catering were fantastic. I’m pretty sure I wasn’t the only one who over-indulged. The conference stalls were fun and informative too and I loved the giveaway items, though I’m not sure when all the prize draws will be … perhaps my winning bottle of Moët is in the mail.

What struck me most about the conference though, was all the wonderful people I had the pleasure to meet. Everyone was ready to chat, and when they heard I was a student, they were eager to advise me and help me think about my future. A career in GP, through the RACGP, is looking like a brighter and more exciting future than ever.

I want to thank RACGP Queensland for the bursary I received to travel to and attend the conference. I look forward to my next GP conference and to hopefully joining the ranks of general practice in the future.

By Stevan Borchardt, University of Queensland 4th year medical student and excited future GP.

Members, tell us what you want from your faculty

RACGP Queensland has employed two new membership engagement officers who are keen to understand what our members would like from their faculty when it comes to communications, education and collegial events.

Drop the team a line via qld.events@racgp.org.au and let us know what we should be including in the 2020 calendar.

Upcoming examination dates

2020.1 KFP Friday 7 February 2020
2020.1 AKT Wednesday 18 March 2020
2020.1 OSCE Saturday 23 May 2020


If you are interested in becoming an examiner for the 2020.1 Objective Structured Clinical Examination (OSCE) in May next year, email the RACGP Queensland Examinations team on qld.exam@racgp.org.au or call 07 3456 8944.

Alternatively, download and submit the application form.

Acute rheumatic fever and rheumatic heart disease in Australia

Rheumatic heart disease (RHD) is 100% preventable. It results when permanent damage to the heart valves develop after usually repeated episodes of acute rheumatic fever (ARF), an autoimmune reaction to an untreated group A streptococcus (GAS) infection – either skin or throat. Common complications of RHD are heart failure, atrial fibrillation and stroke; they are associated with significant premature morbidity and mortality. Like human immunodeficiency viruses / AIDS, the GAS / ARF / RHD cascade is another example of infection becoming a chronic condition.

In Australia, these diseases primarily affect Aboriginal and Torres Strait Islander peoples in the north of the country with some of the highest documented rates in the world. The rates may be even higher as there is likely to be under-diagnosis of ARF (notoriously difficult requiring complex clinical criteria to be fulfilled) and under-reporting, regardless of it being classified as a clinically notifiable disease in Queensland since 1999; however, an audit of hospital records by the Queensland RHD Register and Control Program in 2015–16 showed that areas outside northern Queensland still have cases. While the issue occurs in Aboriginal and Torres Strait Islander peoples due to health and social disparities, healthcare providers should remember that these diseases also occur in other socially disadvantaged populations notably Pacific Islanders, Maoris, refugees and migrants.

ARF / RHD are a quintessential marker of the poverty and inequity present in this country. Environmental settings with a high incidence of GAS exposure are associated with socioeconomic deprivation, such as overcrowding and poorly functioning health hardware to allow good hygiene in combination with poor carer health literacy (ARF mainly affects children aged 5–15 years) and a lack of access to appropriate healthcare for the treatment of sore throats and skin sores can set the stage for ARF. This would require long-acting benzathine penicillin injections every 21–28 days (not monthly) for many years to prevent RHD. If these injections are not given at the appropriate intervals, then cases are put at risk of another GAS infection, episode of ARF and an increasing likelihood of RHD.

As a primary health care provider, treat sore throats and skin sores with appropriate antibiotics; this may vary according to geography and social circumstances. Remember the patterns of symptoms and signs that can be ARF and if there is a possibility of the disease (use the app to help), do appropriate testing and refer to the hospital for admission. If diagnosed with ARF, organise chronic disease care plans for patients and streamline your practice’s processes to facilitate regular intramuscular penicillin injections to prevent RHD.

View The Australian guideline for prevention, diagnosis and management of acute rheumatic fever and rheumatic heart disease: Quick reference guides (2nd edition). A new edition is expected in December this year. If you have any questions or need assistance, email the Queensland Register and Control Program via ArfRhdRegister@health.qld.gov.au or call 1300 135 854.

This article has been provided by Dr Vicki Slinko, Public Health Physician, Rheumatic Heart Register and Control Program Queensland.


External news


Preventing mental health issues for infants and children

‘Preventing mental health issues for infants and children’ (recorded) webinar explores how to engage in conversations with parents about their children’s social and emotional wellbeing, apply ‘micro-skills’ that support these conversations, and identify and mitigate risks to infants and children when working with children and parents. Download and read the transcript or view the webinar.

Featuring Psychiatrist and Emerging Minds Deputy Chair Dr Nick Kowalenko, GP Dr James Best and Family Partners Stuart and Ann Weston.

Brought to you by the RACGP and the Emerging Minds National Workforce Centre for Child Mental Health.

GP research participation opportunities

Mental health in the primary care setting

Calling all GPs in the  Brisbane North region! How do you feel about the support available to manage mental health concerns in your primary care setting?

Beacon Strategies is looking to speak with GPs who practise within the Brisbane North Primary Health Network region regarding the support available to help you manage mental health concerns in the primary care setting. Choose to participate via phone, video, online webinar and focus group, request a visit to your practice, or you can complete a survey in your own time.

Register your interest.

Dermoscopy in general practice

The University of Queensland is researching the training and use of dermoscopy in general practice. Please follow the link below to a short survey that should take 1–2 minutes to complete. If you have any queries regarding this study, please email Miranda.coleman@uqconnect.edu.au

Complete the survey.
 

Complex mental health conditions

GPs are invited to participate in an Australia-wide study investigating clinician attitudes, beliefs, and confidence in treatment towards complex mental health conditions. The online survey will take approximately 15–20 minutes to complete. If you have any queries regarding this study, please email katrina.chapman@cqumail.com

Complete the survey.


Visit recruitGP – the RACGP’s trusted, single source for general practice employment opportunities across urban, remote and rural Australia.

It’s free for RACGP members.

The RACGP does not accept any responsibility for any loss or damage that may result from reliance on, or the use of, any information contained in this newsletter.

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