AFOEM eBulletin – 18 October 2019

National Return to Work Strategy 2020-2030

Safe Work Australia has announced the launch of the National Return to Work Strategy 2020-2030

The Strategy sets an ambitious 10-year action plan to improve return to work outcomes for workers across Australia.

It was developed in partnership with governments, business, industry and unions, and endorsed by work health and safety ministers. Consultation was also undertaken with academics, peak bodies, organisations and representatives from the insurance, legal and health sectors to help identify national policy issues and action areas to address them.

The return to work process can be complex and involves a range of stakeholders. The Strategy aims to better support workers through this process and help stakeholders to do the same. Improving national return to work outcomes can be achieved through the commitment and participation of all stakeholders who participate in the return to work process.

We encourage you to get involved and download a copy of the Strategy today.

A message from your President

Foreign Correspondent Report from the AFOEM President

3. HK Academy of Medicine (ASM venue)On 27 September I landed in Hong Kong airport at 4.30am. I was on my way to present the Professor SH Lee Keynote Lecture at the Annual Scientific Meeting of the Hong Kong College of Community Medicine (HKCCM), held at the Hong Kong Academy of Medicine. The theme for this year’s meeting was ‘Looking for Future Progress in Community Medicine’. 

Prior to leaving Australia I had reservations about the advisability of making the trip given the current disruptive events in Hong Kong. However, colleagues in Hong Kong were reassuring and went out of their way to warmly welcome my husband and me. They were very grateful that I came given the current circumstances and made us feel safe.  

The Faculty’s association with HKCCM extends back over 20 years, with visits from Professor Niki Ellis, Professor Malcolm Sim and Dr Robin Chase to mention but a few. This was a memorable visit as the HKCCM and our Faculty formalised our relationship.

The Hong Kong Academy of Medicine is located on the south side of the island of HK, well away from the CBD where the majority of the demonstrations occurred and were scheduled to occur over the next couple of days of my visit.

Dr Beata M Byok and Dr Joan FokThe HKCCM comprises three specialties: Public Health Medicine, Occupational Medicine and Medical Administrators, with Occupational Medicine being the smallest group. I was honoured to have been invited by Dr Thomas Tsang, President of the HKCCM and the organising committee, chaired by Dr Sammy Ng. It was also an opportunity to reconnect with Dr Mandy Ho, from the Hong Kong Department of Labour and Dr Joan Fok, who is an occupational physician in a government hospital. Both have attended AFOEM streams at past RACP Congresses and are known to several Faculty members.

The one-day program was broad and informative. Ranging from artificial intelligence, asking will it augment or disrupt healthcare, the current systems and processes for the management of occupational injuries in Hong Kong, to the challenge of delivering genomic medicine. There were eight free paper presentations, very similar to our Ramazzini presentations with an award being given for the best paper and several more papers presented as posters with a prize for the best poster.  

My keynote lecture was titled ‘Occupational Medicine: Past, Present and Future’, with an emphasis on return to work rehabilitation, which it turns out is more streamlined in Australia.  This was an opportunity to promulgate the benefits of positive certification for return to ‘good’ work, the Health Benefits of Good Work and that being at work is part of the recovery process.  The attendees were very interested in our systems and processes and are keen to learn more from us to help inform them as they develop their own systems and processes.

It was a valuable and collegiate meeting and I thank the HKCCM for the invitation and hosting my visit.

L-R Dr Derrick Au, Director Centre for Bioethics, The Chinese University of Hong Kong, Dr Thomas Tsang President of the HKCCM, Dr Beata Byok, Dr Sammy Ng, Chair ASM Organising Committee
L-R Dr Derrick Au, Director Centre for Bioethics, The Chinese University of Hong Kong, Dr Thomas Tsang President of the HKCCM, Dr Beata Byok, Dr Sammy Ng, Chair ASM Organising Committee

On another note, there are a few items that I would like to mention:

  • Congratulations to Dr Trish Batchelor from the Department of Foreign Affairs and Trade who commenced on Wednesday, 9 October 2019 as the Deputy Chief Health Officer. Her role is to assist the Chief Health Officer in providing expert clinical leadership and advice to the Department, the Commissions and the Minister on clinical and other health services and research issues related to the Department’s activities.  The Deputy Chief Health Officer will also assist the Chief Health Officer with the management of the Department’s contracted health advisors. 

  • The ANZSOM 2019 Annual Scientific Meeting will be held in Adelaide from 27 to 30 October. AFOEM has collaborated with ANZSOM as scientific program partner. Register online via the ANZSOM website

  • Nominations are open for the AFOEM President’s Awards until Friday, 15 November in the three categories below:
    • education, training and assessment
    • policy and advocacy
    • trainee commitment.

For more information, and to nominate, visit the RACP website

Dr Beata M Byok
President, AFOEM

RACP Congress 2020 – Early bird registration now open

Join your colleagues at RACP Congress 2020, from Monday, 4 to Wednesday, 6 May 2020 at the Melbourne Convention and Exhibition Centre in Melbourne, Australia. 

Listen to what Lead Fellow, Professor Don Campbell has to say about RACP Congress 2020: Balancing medical science with humanity.

In this rapidly changing world, RACP Congress 2020 will equip you to deliver healthcare, provide leadership and respond to need.

Congress 2020 Lead Fellow, Professor Don Campbell, encourages Fellows, trainees and stakeholders to attend Congress 2020. 

“Be a part of something bigger, contribute to the conversation. Congress 2020 will broaden your horizons, challenge your thinking and inform your practise.” 

With the theme of ‘Balancing medical science with humanity’, RACP Congress 2020 will look at a range of topics, exploring how the profession is transforming.

For more information on the program and to register visit racpcongress.com.au

Call for tenders – Mine dust lung disease prevalence study

The Department of Natural Resources, Mines and Energy (DNRME) is seeking tenders for a study into the prevalence of mine dust lung disease (MDLD) in Queensland.

As at 31 August 2019, 118 cases of MDLD had been reported to DNRME since 1984. This is a measure of the incidence of disease. Prevalence is the proportion of a population with disease at a point in time, or over a period of time.

DNRME is seeking to better understand the prevalence of MDLD in the context of the mining workforce population. It is intended that the study determine an annual prevalence rate and describe the trend based on available confirmed case and workforce population data. The scope is to include an analysis to give context to the results, including a comparison of prevalence in the Queensland mining workforce to other jurisdictions and industries.

Tenders can be submitted through the QTenders website with details as follows: 

  • Tender name: Prevalence study of coal mine dust lung disease
  • Tender number: OHHFY202
  • Closing date: 2pm, 22 October 2019

Email minershealth@dnrme.qld.gov.au for more information. 

RACP awards and medals

The AFOEM President’s Awards – it’s not too late to nominate

Recognise a Fellow or Advanced Trainee of the AFOEM for their outstanding contributions to the Faculty in any one of the following areas:

  • education, training and assessment
  • policy and advocacy
  • trainee commitment.

Closing date for nominations extended to Friday, 15 November 2019.

AFOEM Essay Prize

The AFOEM Essay Prize is open to medical students or interns in their first year after graduation. This prize is awarded for the best essay written, additional to curriculum requirements, or the best research project or assignment on any topic in the fields of occupational or environmental health. The recipient of this prize will receive $1,000. Applications close Thursday, 31 October 2019.

Details about all Faculty prizes are available on the RACP Foundation website.

RACP Indigenous Health Scholarships

The Australasian Faculty of Occupational and Environmental Medicine is proud to offer the 2020 Indigenous Australian and Māori Health Scholarship for Occupational and Environmental Medicine as part of the RACP Indigenous Health Scholarship Program.

The Program aims to support those medical graduates and current trainees of the RACP who identify as Aboriginal, Torres Strait islander or Māori on their chosen career path to becoming a Physician. The Scholarships provide a funded pathway through Basic, Advanced, Faculty or Chapter training in Australia and/or New Zealand.

Several scholarships are available for 2020, including:

  • College Indigenous Australian and Māori Health Scholarship
  • Indigenous Australian and Māori Health Scholarship for Paediatrics and Child Health
  • Aboriginal & Torres Strait Islander Health Scholarship
  • NZ Aotearoa Māori Health Scholarship

Applications close Saturday 30 November 2019.

Further details on these scholarships are available on the RACP Foundation website.

New Faculty exam email 

Faculty examinations have a new email address to better support Faculty candidates. 

Please make sure you update your email contacts to faculty.examinations@racp.edu.au and send any emails about Faculty exams to the new address. 

The old address (examinations@racp.edu.au) still exists but for Divisional Exam queries only.

Doctors say “Save Medevac”: Your opportunity to be part of the campaign

The Medevac Legislation, introduced in February 2019, has improved access to appropriate healthcare for refugees and asylum seekers being held offshore. It allows medical experts to make decisions about healthcare for seriously ill individuals and ensures they receive the medical treatment that they need in a clinically appropriate timeframe. Previous delays and failures to transfer ill asylum seekers resulted in preventable suffering. The RACP is proud to have been a key part of the campaign to establish Medevac, and we are now continuing this by leading medical college opposition to its repeal. 

Last weekend the RACP released an unprecedented statement with 10 other medical colleges calling on the Australian Parliament to maintain the Medevac legislation and the Independent Health Advice Panel (IHAP) process.

To continue keeping up pressure on the Parliament in the lead up to the Senate voting on this legislation in mid-November, we encourage all doctors to take part in our social media campaign to save Medevac. Show the Parliament that doctors say #SAVEMEDEVAC by retweeting with comment our kick-off campaign tweet featuring Professor Paul Colditz, RACP President, Paediatrics & Child Health Divisionwith your own selfie with the sign and #SAVEMEDEVAC.

You can also engage with our existing tweets (tweet #1tweet #2) and Facebook and LinkedIn posts to support momentum for this cause.

Download sign #SAVEMEDEVAC

AFOEM Regional Committee casual vacancies

There are various casual vacancies on AFOEM Regional Committees to be filled by way of expressions of interest.

New South Wales

  • one position open for Deputy Chair of AFOEM NSW Regional Committee

Queensland/Northern Territory

  • one position open for the Trainee Representative of AFOEM QLD/NT Regional Committee
  • one position open for Deputy Chair of AFOEM QLD/NT Regional Committee.

South Australia

  • one position open for Deputy Chair of AFOEM SA Regional Committee.

Western Australia

  • one position open for Trainee Representative of AFOEM WA Regional Committee.

Before nominating for the role, candidates must familiarise themselves with the following documents:

To nominate, submit a completed Expression of Interest Form and your resume by email to AFOEM@racp.edu.au.

RACP History of Medicine Library Opening

Registrations now open for IMS 2020

Registrations are now open for the Tri-nation Alliance International Medical Symposium (IMS), 20 March 2020, Amora Hotel Sydney, Australia.

Now in its ninth year, IMS is an annual event that reinforces the strong historical relationship between medical professions from Canada, New Zealand and Australia. Cementing these ties, a formal agreement between the Royal College of Physicians and Surgeons of Canada, The Royal Australasian College of Physicians, The Royal Australasian College of Surgeons, The Australian and New Zealand College of Anaesthetists and the Royal Australasian College of Psychiatrists created the Tri-Nations Alliance.  

The IMS 2020 theme, 'Providing care to underserved populations', is relevant to health professionals from all member countries. With a focus on higher medical education, delegates will explore how specialist training can support and enhance access to healthcare for critical populations experiencing difficulties in accessing healthcare, potentially due to location or isolation, social determinants or other specific issues.

Register now on the IMS website.  

AIDA Conference 2019 – Disruptive innovations in healthcare

The RACP were proud conference partners at this year’s Australian Indigenous Doctors’ Association (AIDA) Conference held in Darwin on 2 to 4 October. A number of RACP Fellows and trainees were present at the conference, including RACP President Associate Professor Mark Lane, Associate Professor Tamara Mackean, Dr Dennis Bonneyand and Dr Angie dos Santos. Staff included Director of Education Robyn Burley and Director of Policy and Advocacy Patrick Tobin.

The conference began with a Welcome to Country delivered by Dr Aleeta Fejo, the first locally-trained Northern Territory GP. Keynote speakers included AIDA President Dr Kristopher Rallah-Baker, Northern Land Council CEO Ms Marion Scrymgour, Danila Dilba Health Service CEO Ms Olga Havnen and Australian Medical Association Federal President Dr Anthony Bartone. In her address, Ms Scrymgour emphasised “let's not forget the importance of Aboriginal health practitioners who are the cultural brokers within our communities". Ms Scrymgour also drew attention to leadership and to the role of Treaty as vital to improving the health of Indigenous peoples.

The RACP held a workshop on ‘Community collaboration as a basis for specialist outreach services and innovative change’. Dr Josh Francis facilitated a powerful conversation with Indigenous patients, community leaders and doctors on the synergistic power of Indigenous community leadership and specialist physician care to tackle Rheumatic Heart Disease in Maningrida, a community of 2,400 people 500km from Darwin.

RACP President Mark Lane spoke at the ‘Growing our Fellows’ workshop, which was an opportunity for medical students and interns to interact with Indigenous members and leaders of Australia’s specialist medical colleges, ask questions and discuss career pathways through medicine.

A special congratulations to Dr Jaquelyne Hughes FRACP who was awarded Indigenous Doctor of the Year 2019. Dr Hughes is an inspirational leader in the field of kidney health, and advocate for Aboriginal and Torres Strait Islander doctors and patients.

RACP Curated Collections 

Your one-stop-shop to professional online resources

Curated Collections are learning guides based on the contributions and peer review of RACP Fellows and other industry experts. Each guide presents key readings, online courses, webcasts and other tools for physicians’ continuing professional development. 

Discover more today

$10,000 grants for doctors in training

Are you undertaking Advanced Training to further your career? Consider applying for a $10,000 grant through MIGA’s Doctors in Training Grants Program. There are many eligible training types including post graduate study, specialised fellowships, volunteer placements and more. Applications for the 2019 Program are open until Friday, 1 November 2019.

Find out more and apply

Physicians shaping Evolve

Evolve is a flagship initiative that aims to support physicians to safely and responsibly phase out low-value tests, treatments and procedures where appropriate, provide high-value care to patients based on evidence and expertise, and influence the best use of health resources, reducing wasted expenditure. RACP Fellows and trainees have recently shaped the next Evolve Strategy for 2019-21.

From 1 to 31 July 2019 the draft strategy was circulated through Divisions, Faculties and Chapters, Specialty Societies and through the Presidents eBulletins. We received 27 responses to the survey, one email response and also undertook a face-to-face consultation with the Paediatrics & Child Health Division. 

We received a lot of positive feedback and constructive criticisms. We value all feedback and have made changes to the strategy accordingly and are looking at how we can incorporate it in the implementation of the strategy to ensure Evolve is better meeting the needs of our members. We are pleased to share the updated Evolve Strategy 2019-21 and a summary of the consultation feedback.

Get involved in shaping and implementing Evolve by emailing evolve@racp.edu.au.

Read the September/October 2019 edition of RACP Quarterly 

RACP Quarterly is the RACP's member magazine.

Articles in the September/October 2019 edition include:

  • New discovery in the fight against Vitamin D deficiency
  • In-flight medical emergencies: Is there a doctor on board?
  • Obesity: Rising to the challenge
  • Medical needs of adolescent refugees resettling in Western Australia

Access previous editions of RACP Quarterly on the RACP website.

New Pomegranate podcast: Ep52 Opioids Part 2 – Regulation and marketing

In the previous episode we talked about the science of pain, opioid analgesia and dependence. Now we look at the influence of culture, regulation and marketing on opioid prescribing for chronic non-cancer pain. First, we ask which are the prescription opioids most commonly leading to dependence and why are they prescribed? Then we discuss the mixed messages that prescribers are getting from guidelines and pharmaceutical regulation. Ever-relaxing indications for pharmaceutical subsidies can nudge prescribing behaviour in the wrong direction.

Tasmania was for many years the worst performer on measures of opioid use and harm, but this all began to turn around from 2006. Addiction medicine specialist Associate Professor Adrian Reynolds explains how education, regulation and real-time prescription monitoring were brought together in that state.

Finally, an undeniable influencer of prescribing behaviour are the promotional campaigns organised by pharmaceutical companies. Pain medicine specialist Dr Chris Hayes explains that those within the medical profession should not be surprised by this, but should be wary so their professional judgement isn’t compromised. A couple of case studies provide context for the RACP’s Guidelines for ethical relationships between health professionals and industry.

Guests:

  • Dr Christopher Hayes FFPMANZCA (Director Hunter Integrated Pain Service)
  • Clinical Associate Professor Adrian Reynolds FAChAM (Clinical Director Alcohol and Drug Service, Tasmania)

Fellows of the RACP can claim CPD credits via MyCPD for listening to this episode.

Subscribe to Pomegranate Health in Apple iTunesSpotify or any Android podcasting app

SOMANZ evolving clinical practice

As evidence and clinical practice advances, Evolve and Choosing Wisely recommendations will reflect these changes. The previous iteration of the Society of Obstetric Medicine of Australia and New Zealand ‘Top-Five’ recommendations included: Do not perform a D-Dimer test for the exclusion of venous thromboembolism during any trimester of pregnancy. 

Recent studies have shown that using a D-Dimer along with a clinical algorithm can increase the reliability of D-Dimer testing in ruling out DVT and PE in pregnancy.

Furthermore, the alternative to D-Dimer tests for these purposes is the use of imaging tests, which have their own set of risks from radiation exposure. Where previous evidence which suggested D-Dimer testing was highly unreliable would have tipped the scales towards discouraging D-Dimer testing, the new evidence suggests the results of D-Dimer testing can be made more reliable. Thus, it is no longer apparent there would be strong benefits from discouraging the use of D-Dimer testing in these settings. Due to this change in evidence and physician support, this recommendation was officially removed in August 2019. A fifth recommendation has not been identified yet.

Australian Guidelines for the Prevention and Control of Infection in Healthcare

The National Health and Medical Research Council (NHMRC) is pleased to announce the release of the revised Australian Guidelines for the Prevention and Control of Infection in Healthcare (2019) (the guidelines). 

These have been produced by NHMRC in collaboration with the Australian Commission on Safety and Quality in Health Care, to ensure they reflect the latest national and international evidence on infection prevention and control. 

Effective infection prevention and control is central to providing high quality healthcare for patients and a safe working environment for those who work in healthcare settings. The guidelines provide evidence-based recommendations that outline the critical aspects of infection prevention and control, focusing on core principles and priority areas for action. 

The guidelines are for use by all working in healthcare – including healthcare workers, management and support staff. They provide a risk-management framework to ensure the basic principles of infection prevention and control can be applied to a wide range of healthcare settings. The level of risk may differ in different types of healthcare facilities; risk assessments are encouraged as part of the decision making and use of guideline recommendations. When implementing these recommendations all healthcare facilities need to consider the risk of transmission of infection and implement according to their specific setting and circumstances.

For further information on the review please visit the NHMRC Preventing Infection website.

Department of Health: Media release on the use of e-cigarettes

A media statement was recently released from Professor Brendan Murphy, Chief Medical Officer and jurisdictional Chief Health Officers’ relating to the use of e-cigarettes and reports of severe lung disease (including deaths) reported from the United States.

The media release can be found on the Department of Health's website. Please consider this information when assessing patients with unexplained respiratory symptoms.

PBAC outcome – changes to antibiotic listings on the PBS 

The Department of Health is undertaking a review of antibiotic listings on the Pharmaceutical Benefits Scheme (PBS).

In 2018-19, the Department commenced a review of antibiotic listings on the PBS that currently include a repeat when prescribed. The review is part of the Australian Government’s broader ongoing strategy to support best practice prescribing in Australia, as outlined in Australia’s First National Antimicrobial Resistance Strategy 2015-2019.

The review is being undertaken in stages with the first stage focusing on the top five antibiotics with repeats prescribed (by volume) on the PBS, being:

  • Amoxicillin
  • Amoxicillin + Clavulanic Acid
  • Cephalexin
  • Doxycycline
  • Roxithromycin.

The department’s review proposed changes to some of the PBS listings for antibiotics listed above.

The Pharmaceutical Benefits Advisory Committee (PBAC) considered the proposed changes to the listing of certain antibiotics to encourage antimicrobial stewardship at its August 2019 Intracycle Meeting.

The PBAC recommended the removal of repeat options for a range of listings where no repeats were deemed necessary as per the Therapeutic Guidelines. The PBAC also recommended aligning the listings for specific indications to the Therapeutic Guidelines where increased quantities are clinically indicated. The PBAC considered that the recommended changes, aligned as best possible with the current version of the Therapeutic Guidelines (version 16), would support antimicrobial stewardship and quality use of medicines as well as assist in the reduction of antimicrobial resistance.

An implementation date for the changes has not yet been established. More information on the specific PBS listings considered, changes recommended and implementation timeframes will be provided in the near future.

If you have any questions, please contact the Department at amr@health.gov.au.

An update from the Obesity Collective

Earlier in the year the College joined the Obesity Collective, a group of individuals and organisations from across Australia working to take on the obesity challenge together, with empathy and from a whole-of-society perspective.

Since then, the Collective has been active across a range of initiatives, including the launch of the Weight Issues Network (WIN). WIN is a growing organisation that represents the perspectives and needs of people living with overweight and obesity and those who care. The WIN hosted its first workshop at Westmead where over 40 new members discussed the need for a strong lived experience voice, advocacy priorities and the power of personal stories.

The challenge of obesity is widely discussed in the media, reports and strategic plans. The framing of the challenge influences the public’s perception and weight stigma. It is a goal of the Collective to have a more unified, consistent and balanced narrative around obesity. These key messages and concepts have been developed for Collective members to consider, use and adapt when referring to obesity, including in clinical settings and in discussions with patients. We invite you to review and comment on these messages by sending us an email at racpconsult@racp.edu.au. You might also be interested in the Collective’s Tiffany Petrie talking to the ABC about the dangers of fat shaming.

Finally, we invite you to fill in a survey from the National Association of Clinical Obesity Services (NACOS). NACOS represents organisations providing clinical obesity services in Australia. NACOS is committed to driving improvements to access to clinical obesity services and raising standards in clinical obesity care. The team are working with stakeholders to develop a framework for clinical obesity services and are asking for input from clinicians and people with lived experience of obesity.

To learn more about the Collective and participate in its work, visit the website or contact the organisation.

Expression of Interest  

Check the Expressions of Interest page at any time, to find out if there are any opportunities that are of benefit to you. 

Conferences and events

The Royal Australasian College of Physicians publishes notices of events and courses as a service to members. Such publication does not constitute endorsement or mandating of any such events or courses. 

Supervisor Professional Development Program (SPDP) workshops

General information webpage provides an overview of our three SPDP workshops.
Online workshops webpage provides dates and information on how to register for the online SPDP workshops.
Face to face workshops provides a list of dates and registering for the face to face workshops.

Go to the events list at any time to see what other events are coming up.

AFOEM contact details

Member enquiries
Phone: 
(AUS) 1300 69 7227
Phone: 
(NZ) 0508 69 7227
Email: 
memberservices@racp.edu.au 

AFOEM Faculty enquiries (including Council and committees):

Lucie Perrissel-Taggart, AFOEM Executive Officer
Phone: +61 2 8076 6351
Email: afoem@racp.edu.au

AFOEM Health Benefits of Good Work (HBGW) enquiries:
Email: HBGW@racp.edu.au

AFOEM Education and Training enquiries:
Email: occenvmed@racp.edu.au

AFOEM Examination enquiries:
Examination Coordinator, Assessment and Selection Unit
Email: examinations@racp.edu.au

AFOEM training site accreditation inquiries:
Site Accreditation Unit
Email: accreditation@racp.edu.au

AFOEM CPD enquiries:
Email: mycpd@racp.edu.au
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