A quietly successful advocacy
This year, the Queensland Government introduced the extremely useful resource ‘The Viewer’ allowing GPs to view several Queensland Health record items, including pathology and radiology results, and emergency department attendances. If you haven’t signed up to use it, I strongly recommend you do.
Recently, some of the Hospital and Health Services (HHS) around the state have decided that The Viewer could be used to replace discharge summaries from the emergency department. After some quietly effective advocacy from Dr Michael Clements (while he was Acting Chair RACGP Queensland), it appears that in some regions this decision has now been reversed. A decision we all applaud.
The important principle here is that information access systems like The Viewer and the My Health Record are not designed to replace other forms of clinical handover. They are information sources, not communication tools. It is the medical IT version of using a hammer to replace a screwdriver – you can do it sometimes, but it usually doesn’t end well.
We thank Queensland Health and the HHS concerned for their understanding and cooperation. RACGP Queensland is keen to continue to represent the interests of GPs and our patients by championing good clinical handover.
Expanding pharmacy powers?
The Queensland Government has established a Parliamentary Inquiry to investigate the establishment of a pharmacy council. The primary function of the council will be to oversee the pharmacy ownership legislation. As part of the Inquiry, the Parliamentary Committee will be looking into the legislation, which currently restricts pharmacy ownership to pharmacists in Queensland.
The more concerning aspect of the terms of reference are the discussion in the briefing papers to extend the right to prescribe several medications to pharmacists. Essentially, the Pharmacy Guild is seeking the ability to write repeat prescriptions for most chronic disease medications. Additionally, they are seeking a more defined scope of practice for pharmacists and pharmacy assistants to take over more traditional GP roles.
RACGP Queensland has strongly opposed these moves. As such, we have made a strong submission to the Inquiry and I expect to be addressing the committee in the near future. This move will no doubt contribute to further fragmentation of patient care and hamper the GPs’ ability to properly monitor and follow up on patients. We are working with the Australian Medical Association Queensland to strongly oppose these proposed changes. Further information about the Inquiry is available.
RACGP presidential elections
The RACGP Presidential elections recently concluded. I was an unsuccessful candidate in the election. I would very much like to thank everyone around the state for the fabulous support and encouragement I received, and to wish RACGP President-elect Dr Harry Nespolon all the best and my full support.
Dr Bruce WillettRACGP Queensland Chair
PLAN ahead – PLAN support session
Thursday 2 August
Tuesday 7 August
Tuesday 14 August
Wednesday 5 September
Annual Member Meeting
Friday 7 September
National Fellowship and Awards Ceremony
Wednesday 10 October
Thursday to Saturday 11–13 October
Save the date – Paediatrics ALM
Saturday 17 November
Hello, Queensland New Fellows.
Almost 40 New Fellows converged over two days at the Novotel Twin Waters Resort last Saturday and Sunday 7–8 July for the 2nd Annual Queensland New Fellows Hot Topics, and Careers and Business Conference.
Among the highlights: On Day 1, topics available were about learning how to perform driver’s medical assessments, first trimester screening tests, transgender health and back examinations. On Day 2, how to engage with staff in an empowering way, tips for building or buying into a practice, financial management and how to live your dream career. We also enjoyed some fun team-building games on the Saturday evening before an intimate buffet BBQ dinner under a teepee.
Thank you to all the committee members and faculty staff who put in the hard yards leading up to the conference. We are all looking forward to planning the 2019 event and will keep you posted!
This August, we will be walking 5 km as a team in the Bridge to Brisbane to help raise funds for the Doctors' Health Advisory Service Queensland, a service that supports the mental wellbeing of medical students and junior doctors. Come and socialise with your colleagues and support this important service.
On Saturday 17 November 2018, we will be hosting a paediatrics workshop in Cairns. Although the New Fellows Committee is hosting this event, it is open to all RACGP members (experienced GPs, New Fellows, registrars, intern and resident medical officers and medical students). Save the date now, muster your mates, and come along for a quality education event in the tourist capital of Australia.
2018.2 OSCE pre-exam workshop (Cairns)
Saturday 15 September 2018
2018.2 OSCE pre-exam workshop (Brisbane)
Saturday 22 September 2018
Sunday 11 November 2018
If you are interested in becoming an examiner, the RACGP Queensland Examination team is interested in hearing from you, particularly if you are practicing in North Queensland or the Gold Coast. Examining at the OSCE allows you to earn Quality Improvement and Continuing Professional Development (QI&CPD) points while making a valuable contribution to the future of your own profession.
New examiners will need to apply by mid-August in order to complete training in time for the 2018.2 OSCE.
For more information, download an application form, email email@example.com or call 07 3456 8944.
A Joint Select Committee on Constitutional Recognition Relating to Aboriginal and Torres Strait Islander Peoples 2018 (the Committee) has been established to inquire into and report on matters relating to constitutional change.
The RACGP has supported constitutional change for Aboriginal and Torres Strait Islander people for many years. During NAIDOC Week (8–15 July 2018), the RACGP took the opportunity to further demonstrate its support for the constitutional recognition of Aboriginal and Torres Strait Islander peoples in Australia.
In its submission to the Committee, the RACGP endorsed the recommendations of the Uluru statement from the heart (the Uluru Statement). The Uluru Statement was the result of a constitutional convention held in 2017 at the foot of Uluru that brought together over 250 leaders from Aboriginal and Torres Strait Islander communities.
The RACGP support for the Uluru Statement is consistent with the RACGP’s commitment to Close the Gap in health inequality, our membership of the Close the Gap Steering Committee, our support for the Redfern Statement and reflects our ongoing support for Aboriginal and Torres Strait Islander leadership and health.
The RACGP has also shown its support by adding its name to the ACOSS petition to the Australian Parliament. We join over 10,000 other signatories calling for support for the Uluru Statement.
Read more on the RACGP submission to support the Uluru statement.
RACGP Rural is now taking registrations for the September intake of the Focussed Psychological Strategies Skills Training (FPS ST). This modular training will address a demonstrated need for GPs to extend their mental health skills in an accessible and flexible manner. The program blends online and peer-group learning in four modules and will take approximately 14 weeks to complete.
A past participant offered the following feedback on the FPS ST:
‘This has been an invaluable activity and it has already helped in my everyday practice substantially. Living rurally, I don't think I would have had any other opportunity to learn these skills otherwise.’
The FPS ST is accredited for 120 category 1 QI&CPD points and two Category 2 QI&CPD points. It has also been accredited by the General Practice Mental Health Standards Collaboration (GPMHSC) as an FPS skills training. Participants who successfully complete the program can apply for FPS provider status with Medicare and gain access to additional Medicare Benefits Schedule items for FPS services provided in their general practice.
Visit the RACGP website for more information.
The RACGP has launched a new education program to support non-vocationally (non-VR) doctors on their pathway to Fellowship. The Practice Experience Program (PEP) will provide targeted educational support for non-VR doctors, primarily international medical graduates, to help them prepare for RACGP Fellowship and to deliver quality general practice care to their patients.
The PEP will commence as a pilot for 400 doctors in January 2019 and will be delivered in partnership with the Regional Training Organisations (RTOs). The pilot is Commonwealth Government supported resulting in a reduced cost to participants.
For more information, visit the PEP pilot website.
Free webinar: 8.00–9.00 pm AEST, Thursday 9 August 2018
Are you looking for a sea or tree change? Are you looking for a new experience or a bit of an adventure?
This ‘locuming’ webinar aims to provide you with insights into the work and the tools required to successfully locum in rural and remote communities. Listen to experienced GP locums discuss the challenges and rewards, and have your questions answered.
View more information. If you have any questions, call RACGP Rural call on 1800 636 764 or email firstname.lastname@example.org
For the past 10 years, members have enjoyed the benefits of accessing DynaMed, the evidence-based clinical reference tool that provides clinically-organised evidence summaries for more than 3400 topics created by doctors and other healthcare professionals for use primarily at the point of care.
Members now have access to DynaMed Plus, which is available via the RACGP John Murtagh Library's web pages. An app is available for iPhones, iPads, Android phones and Android devices. Find the ‘Get the DynaMed Plus Mobile App’ link in the ‘Spotlight’ section on the DynaMed Plus website and follow the instructions.
A number of user guides are provided that introduce DynaMed Plus features, functionality and some videos, which use clinical scenarios to describe patient presentations, search strategies and results.
DynaMed Plus is a member-only resource (your RACGP website login is required).
*This article was submitted by Dr Alexandra Hofer from Thursday Island Hospital.
The clinic nurse was setting up for an incision and drainage (I&D) of an abscess. After opening the dressing pack and laying out the necessary equipment, she inquired about my glove size.
I replied, ‘Small.’ She said, ‘Oh no, Doc. What size sterile gloves?’
This made me question a very routine practice of mine. Clinical question: Does the use of non-sterile gloves for the I&D of a simple abscess increase the risk of infection?
Interestingly, when I asked a couple of colleagues about this question, I received a mixed response. Some had a similar practice to my own and others preferred sterile gloves, but not always for the reason of reducing infection. Of those who preferred sterile gloves, some cited convention as their main driver, while others had a personal preference for the better fit and dexterity afforded by sterile gloves. Most agreed that they would wear sterile gloves if there was any anticipation of deloculating the abscess with a gloved finger.
So what is the evidence? Well, this appears to be an evidence-free zone and the best studies that I could find to answer my question relate to minor outpatient skin procedures, rather than putting a knife into a collection of pus.
Findings 1: Systematic review & Meta-analysis, 2016
This review included 13 studies with over 11,000 patients who had cutaneous or mucosal outpatient procedures, including Moh’s surgery, laceration repair and standard excision (Please note, the authors recommended against generalising this evidence to more advanced/complex procedures).
Rates of surgical site infection were very similar in both groups (sterile gloves: 2.0% versus non-sterile gloves: 2.1%) with a relative risk of 1.06 (95% CI 0.81–1.39), which essentially means there was no difference!
Can this be generalised to our population in far North Queensland?
Findings 2: Prospective RCT, North Queensland, 2015
This trial included 493 patients presenting to a private general practice in Mackay for a minor skin excision. Rates of infection were a lot higher than that of other similar cohorts (approximately 8% versus 2%). The reason for this is unclear, but the authors suggest the humid, tropical environment or patient behaviour in a rural setting may have something to do with it. Nonetheless, they found that non-sterile gloves were not inferior to sterile gloves for minor skin procedures in general practice (rates of infection with non-sterile gloves: 8.7% versus non-sterile gloves: 9.3%). Strengths of this study included a standardised excision protocol, a uniform definition for a surgical site infection and intention-to-treat analysis.
So what are the practical implications?
Non-sterile gloves do not increase the risk of surgical site infection in the setting of minor skin procedures and there is evidence to generalise these findings to our tropical North Queensland location. It seems both reasonable and rational to apply these findings to the I&D of a simple abscess; therefore, next time I’m asked for my glove size, I’ll be able to support my choice with a little more academic rigour.
The RACGP Queensland Research Support Committee coordinates the ‘Article pick’ segment. We are looking for contributors for 2018. Please submit your article pick or send any queries about contributing to Queensland Research Support.
*Please note the opinions expressed by 'Article pick' authors may not reflect the opinions of the RACGP.
Saturday 25 August – Brisbane
This free seminar will attract 40 Category 1 QI&CPD points. Learn about the practical steps of setting up your own practice from health industry experts, everything from securing premises, legal requirements, council approval, design and fit-out, finance, IT and phone solutions, complex Medicare registrations, recruitment and much more. You will be provided with an outline of the steps involved in setting up a practice and an approximate cost for your practice go-live date. Medical practitioners present their personal experience, hurdles and quick wins that they experienced on the same journey.
Register now for this free seminar today.
7.15 pm AEST, Tuesday 14 August
This webinar will feature a facilitated discussion of a vignette by an interdisciplinary panel of subject matter experts. The panel comprises:
This is the eighth webinar in the 'Mental health and the military experience' series produced by the Mental Health Professionals’ Network on behalf of the Department of Veterans’ Affairs.
This webinar aims to help doctors better understand the complex relationship between chronic pain and mental health.
This activity is accredited for two Category 2 QI&CPD points.
Australia’s National Diabetes Services Scheme (NDSS) supports people living with all types of diabetes. While most in the diabetes community are aware of the NDSS and its wide range of unique subsidized products and services, there are people with diabetes who are not registered with the NDSS and may be unaware of the support it provides. Those living with diabetes, but without access to the NDSS, are placed at a tremendous disadvantage.
The NDSS also offers a vast range of information, support and education for people with diabetes via face-to-face, online and telephone programs delivered by Diabetes Queensland. As a health practitioner, you can help your clients by making sure they are registered with the NDSS and that they understand how best to access its services.
Register people with diabetes now at www.ndss.com.au or call the NDSS Helpline on 1300 136 588.
For further information visit Diabetes Queensland’s NDSS feature.
Children’s Health Queensland Hospital and Health Service (CHQHHS) and The Lady Cilento Children’s Hospital have advised that their specialist referral forms have changed. GPs should use the customised practice management software templates or the following form for all referrals to the Lady Cilento Children’s Hospital:
Specialist referral form
Lady Cilento Children's Hospital Heads of Clinic list
Specialist Children’s Health services are delivered subject to individual catchment restrictions. Please check the catchment area for the service your patient requires via the Find a service page before submitting your referral.
Children who live within the Lady Cilento Children’s Hospital catchment should be referred to the hospital for specialist treatment as required.
Children who live outside the Lady Cilento Children’s Hospital catchment should be referred to their local hospital and health service if they require treatment for general paediatric conditions.
Patients should be referred directly to the Lady Cilento Children’s Hospital if:
Further referral informal and details are available on the CHQHHS website.
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It's free for RACGP members.