Tasmania - August 2019
I am delighted to announce the 2019 Tasmanian Physicians Conference will be on Friday, 8 November at the Launceston General Hospital. Physicians and trainees are invited to come together for an update on the latest research in Tasmania. This year’s theme is physician vulnerability: are you at risk? The conference explores online communications and medico-legal risk. With constant changes in these areas, it is challenging for physicians to remain informed, confident and protected in their practice. Register today to join us for one of the educational and social highlights on the Tasmanian medical calendar.
This year, the Tasmanian Trainee Research Awards will be held in conjunction with the 2019 Tasmanian Physicians Conference. I encourage all trainees to submit an abstract for the awards. It is a great experience and the winner will receive the opportunity to present their research at RACP Congress 2020. Applications are open now.
I would like to invite all members to consider the Butler and Stevens Prize. The Tasmanian Regional Committee is offering the T.C Butler and F.R.T Stevens Prize for the best written submission received on work completed in Tasmania affecting the health of a vulnerable group in society. The award is open to all RACP trainees and New Fellows (within three years of admission to Fellowship).
This edition’s ‘Fellow in Focus' article features an article on one of our Committee members Associate Professor Heinrich Weber, Clinical Director of Paediatrics at Tasmanian Health Service – Northwest, based in Burnie.
Finally, if you have a service or member you would like to nominate to be the feature for the Tasmanian spotlight section for the next eBulletin, please let us know. As usual we are always on the lookout for interesting content and how we can better support the Tasmanian members through local activities. Please send us your feedback and suggestions.
Dr Rajesh Raj
Chair, Tasmanian Regional Committee
Associate Professor Heinrich Weber joined the Tasmanian Health Service - North West in October 2010 as a Paediatrician. He qualified as a Paediatrician in South Africa and subsequently obtained his registration in Paediatric Pulmonology, as well as further education in allergology and public health/epidemiology. Apart from extensive clinical exposure, he has also been a principal investigator in a number of multinational clinical trials, predominantly asthma related clinical trials.
The RACP team caught up with Associate Professor Weber to learn more about his work.
What is the most rewarding aspect of your role?
The privilege to serve the most vulnerable population in our society and hopefully contribute to improving their quality of life.
What is it about your work that makes you want to get out of bed each morning?
It is teamwork and the ability to work collaboratively with a number of colleagues, including nursing, allied health and administrative staff. My work place is a very supportive environment where people are eager to assist with any new ventures or projects. The other rewarding aspect of the job is that it is multi-faceted and includes clinical duties, administrative duties, teaching and a research element.
What does a typical day at work look like for you?
My on-call week starts with an early morning ward round, followed by other clinical duties, as well as outpatient clinics. During the on-call week we remain on-call for 24 hours a day for a full week. The acuity of cases can vary tremendously and includes the odd resuscitation. There are regular general outpatient duties, which includes a multidisciplinary asthma/allergy clinic.
We have a multidisciplinary cystic fibrosis clinic which is managed in collaboration with Professor Phil Robinson and the CF centre team of the Royal Children’s Hospital in Melbourne. We manage the outpatient clinics at two neighbouring hospitals about 50 kilometres apart.
In addition, I provide outreach clinics to King Island which is a 35 minute flight across the Bass Strait where I am also able to enjoy good cheese and reportedly the best beef in the world.
Apart from the clinical duties, I attend numerous meetings as part of my administrative role. Another element of the job involves teaching, i.e. students, junior doctors and registrars. Besides all the clinical and administrative duties, I engage in research activities which largely spills into after hours activities.
How do you manage work/life balance?
Managing work/life balance has been my new year’s resolution for the past few years and still remains a work-in-progress. I have recently started playing tennis again and I’m also a huge fan of Roger Federer. I enjoy watching sports, such as soccer, rugby, cricket and Formula One racing. I have a keen interest in photography and hope to hone my photographic skills in the near future. I’m an avid music lover and love to listen to a range of music from classical to jazz. The advantage of living on a coastal city is that I can put my feet up and soak up the sights and sounds of the ocean.
Are there any patient success stories that you can share?
There are numerous individual patient success stories, which varies from successes with individual patients. Example are: a recent clinical diagnosis of coarctation of the aorta which required immediate cardiac surgery and a child born with aberrant left coronary artery who presented with failure to thrive only and required emergency cardiac surgery. These are among the most recent cases that come to mind.
Other success stories in my role include establishing outreach clinics in rural Tasmania and the Aboriginal healthcare facilities. I mentored a nurse practitioner who has now attained her certification and is able to run independent outpatient clinics. I was further instrumental in establishing a multidisciplinary paediatric asthma/allergy clinic. As part of the quality improvement initiative we introduced allergy skin prick testing, routine lung function testing and developed an electronic asthma database.
I try to select my annual conference so I can go to a place I haven't been before, so I can see more of the world. I have just been to Japan for the first time to attend the 18th International Paediatric Pulmonology Conference (CIPP) in Chiba. Other than taking the wrong bus from the airport to Tokyo instead of to Chiba, then having to take a train back to where I was meant to be, arriving two hours late to the hotel, the trip was uneventful. The Japanese people are tidy and organised; the hotel/resort was impressive next to the conference centre and only $100 per night.
But I had a very different experience when I attended the 16th CIPP meeting in Lisbon. My hotel for $100 per night was called the KEEP and was next to the castle on top of the hill in the middle of the city. Portugal experienced a heat wave in June 2017 and a fire destroyed 520,000 hectares and killed 46 people a few weeks earlier near Lisbon.
I was looking forward to a good night's sleep and kept the window open to cool the room, sleeping on top of the sheets. In the early hours of the morning, I woke up scratching my arms and hands furiously. Thinking I was being bitten by mosquitoes, I dived under the sheets. I got even more itchy and felt something crawling over my legs. I jumped out and put the light on (and glasses on) and saw hundreds of bugs of various sizes swarming over the wall and in the bed.
I spent the rest of the night sitting on the edge of the bed looking at the internet for another hotel. At first light I went down to the reception to speak about the problem. Her response was "what do you want me to do about it, change the linen? That won't help" I said "there's hundreds of them on the wall!" She gave me a bigger room with its own toilet downstairs. I sat on the bed exhausted and saw a bed bug on the sheet - I had carried one with me from the previous room. Squish!
I attended the conference covered in huge welts. There were at least eighty on my face and neck when I counted (not a pretty sight). I suspect there were a few hundred on the rest of my body. They were incredibly itchy, painful and burning, despite taking antihistamines. I had them for a week.
I couldn't understand why previous guests hadn't been bitten but apparently 30 per cent of people bitten don't react and some react days later. From a web search I learnt that Lisbon is notorious for its hotels having bed bugs. There is even a list of infested hotels and the KEEP is now on that list.
Did you know that bed bugs (cimex lectularius) can live for over a year without having a meal? After a feed they rest for five to seven days to digest the blood. They are difficult to eradicate being resistant to most pesticides and hiding in cracks. Pyrethroids, dichlorvos and malathion can be effective. Exposure to heat above 50 degrees celsius for twenty minutes (such as in a tumble drier) or temperatures below 17 degrees will kill adults and eggs. A female lays one to five eggs a day and can lay up to 500 eggs during her life. The eggs hatch within two weeks and the nymphs go through five moults reaching maturity in five weeks. The adult is about 50mm long and lives on average four to six months. They inject an anaesthetic and anticoagulant when they bite so the victim doesn't feel it at the time. They are not known to transmit diseases (I hope!).
To my horror, when I got home I found I had brought some Portuguese bedbugs with me in my luggage.
Do you have a conference experience that you would like share with us? Please email us.
I am proud to be the Chair of the Victorian and Tasmanian Trainees’ Committee (VTTC), a position I have been entrusted with over the past 18 months. When I first joined this committee over two years ago, I was in the throes of basic training and facing the prospect of the hardest exams of my career.
I remember distinctly receiving the email with an expression of interest to join the VTTC. I reflected that this would be a productive way to explore and address issues facing trainees and provide a means of communication with our College to foster better relationships and facilitate positive changes to enhance the trainee experience.
I considered whether I would manage the commitments required in addition to my clinical work. However, I have found the meetings to be a great time away from my clinical work to network with like-minded people. They have also allowed me to explore the evolving landscape of the trainee journey and provide feedback to the College regarding our experiences.
I am inspired by my fellow committee members, who come from a range of specialties and backgrounds, with a common ambition to advocate for trainee wellbeing and explore innovative ways in which to improve learning, education and training.
During my time on the VTTC, we have run an inaugural trainee wellbeing event, participated in trainees’ days, the AMA careers expo and contributed to the delivery of the trainee orientation day. We are continuing to explore ways in which we can promote trainee wellbeing through community initiatives such as fundraising events.
Our recent focus has been on advocating for greater transparency and communication from the College executive. We highlighted the issues with the Advanced Training Selection and Matching (ATSM) process which resulted in the College exploring its responsibilities and releasing aggregate data relating to application and recruitment statistics to ensure that gender disparities and unconscious bias are minimised.
We are determined to continue to address issues of gender inequities in some of the medical specialties and the role we and the College can play in facilitating meaningful change. We are exploring both barriers and solutions to achieving gender parity within advanced training.
The changes within our College, having welcomed a new President and Executive Board last year, herald new opportunities to revolutionise our College. The vast improvements in communication, transparency, compassion and accountability have been well recognised. We feel the contemporary approach of the new board will further strengthen its credibility and rebuild trust and relationships with trainees.
We welcome trainees to provide feedback on what matters most to you and how we can best represent you. If you are interested in joining the VTTC, please let us know. You can get in touch with us via email or via the RACP trainees’ Facebook page.
If you wish to share interesting content via our trainees’ newsletter, please contact us via email.
Dr Louise Segan
Supervisors Professional Development Program (SPDP) workshops
SPDP workshops are aimed at up-skilling Advanced Trainees and preparing them for a supervisory role following completion of their training. The workshops are an excellent opportunity for trainees to learn from and exchange experiences with other trainees.
The Supervisors Professional Development Program is a three-part program either face-to-face or online designed and developed specifically for Supervisors and is free of charge to all members of RACP.
- practical skills for supervisors
- teaching and learning in healthcare settings
- work-based learning and assessment
For more information or to register for an upcoming workshop visit the events page
Host a SPDP face-to-face workshop
Contact your local Member Support Officer
or the Supervisor Learning Support Unit
for assistance in organising a workshop at your local site or upcoming specialty Annual Scientific Meeting.
Become a SPDP workshop facilitator
SPDP workshop facilitators are RACP Fellows who are interested in medical education and facilitating skill-based workshops with their peers. They plan, manage and provide guidance for SPDP workshops to ensure each workshop is:
- credible - physicians are best placed to facilitate training for their peers
- focused on supervisor needs - ensure relevancy to supervisors from all training programs
- accessible and flexible - adaptable workshop design which can be held at ASM and in local settings.
I have been pleased to be a Fellow of the Australasian Faculty of Public Health Medicine since 1991. I came to Tasmania seven years ago to do a job for one year, but never found a (good) reason to leave.
I now live with my wife Penelope in Launceston and thoroughly enjoy all that Tasmania has to offer; challenging yet enjoyable work, a relaxed lifestyle, loads of new friends and a simply wonderful place to be.
My early career was in Primary Health in Victoria after graduating from the University of Melbourne, and RMO at the Alfred Hospital and Royal Children’s Hospital, but by the mid 1980s I felt that I could do better by working with groups of people to prevent ill health, than just talking to individuals one-on-one.
So I went back to University and completed the Masters of Public Health degree at Monash University in 1989, then became a FAFPHM. At that time the MPH had two streams, one public health and the other occupational medicine. I chose the latter and have never regretted it.
My work ever since has been a really interesting blend of clinical medicine, including rural and remote medicine, medical projects to improve the health of populations in Africa, infectious diseases consulting, occupational and preventive medicine. But unusually I have also used my public health experience to improve the health of occupational populations.
From 2007 to 2011 I worked on a number of projects in rural and remote medicine, which actually led to me doing a short clinical stint in Northern Tasmania, and then of course remaining here.
Today I am an active member of the Tasmanian Regional Committee and involve myself in public and occupational medicine consulting.
Since living here I have observed that Tasmania, like the rest of Australia has excellent acute health services when you really need them, but also like the rest of Australia, the health ‘system’ itself suffers from truly significant shortcomings and system failures, particularly in relation to the timely sharing of patient information.
But perhaps worst of all the health of some populations remain potentially compromised due to the lack of coordinated services, lack of physical rehabilitation and paucity of services for the management of chronic pain, as a glaring example. I often think that rather than just prescribing drugs for people with chronic disease, wouldn’t it be better to prevent that disease by keeping people informed and active.
Perhaps a hydrotherapy pool in each town would do more good in preventing chronic disease progression in the community than expanding hospital beds, employing more doctors and nurses, and the inevitable administrators.
One of the most exciting public health projects I am involved with in Tasmania is the establishment of an expert group called ‘My Connected Health’. This not for profit group is a diverse range of Launceston healthcare providers under the umbrella of Connected Launceston. The purpose is to see what people on the ground consider necessary to modernise the Tasmanian Healthcare System.
We have undertaken dozens of interviews with providers in all aspects of health and identified three major challenges - regional silos, disconnect between clinical and executive managers, and operational disconnects within hospitals, and when hospitals exchange information with the community.
We are committed to push on with this project to convince leaders that we need to align clinicians with the executive, break down silos, improve clinical efficiency, connect easily with community providers, improve clinician recruitment, and not just focus on recurrent system failures with band aid solutions.
Real-time examples of systems already exist in Australia that reduce costs, lower burden on staff, increase revenues, reduce hospital stays, reduce unexpected readmissions and reduce prescribing errors and medication costs. We identified a case study interstate that has been running now for three years with the potential to reduce system costs by as much as 15 per cent.
Therefore, the considerable challenges remain, but I remain optimistic and consider it a privilege to be a public health physician in Tasmania.
Dr Barry Gilbert
MB, BS, MPH, FAFPHM, FSIA, FAIM, CF
Specialist Public Health Physician, Occupational Medicine Consultant
Applications for this year’s Trainee Research Awards are open until Saturday, 31 August 2019.
The Trainee Research Awards provide a wonderful opportunity for trainees to present their research at a regional event. Trainees selected at each regional event will have the opportunity to present at RACP Congress 2020 in Melbourne.
For more information please visit the Foundation webpage.
Submissions close Saturday, 31 August at 5pm AEST.
Ethics lies at the very heart of what it is to be a physician and is as relevant now as it was when first discussed two and a half thousand years ago. The ethics online learning resource focuses on the sorts of ethical issues that are a constant feature of health care, and it also addresses some of the ideas that underpin ethics, such as the relationship between ethics and the law and the difference between ethics and rights.
The aims of this course are to:
- encourage discussion and broaden thinking about the main ethical issues facing physicians
- encourage reflection on appropriate courses of action in situations that may be ethically challenging
- challenge participants’ understanding of, and attitudes towards, ethics
- model ethical practice
- help participants reflect on their own and their profession’s ethical commitments.
The Australasian Faculty of Public Health Medicine (AFPHM) is celebrating the 10th year of the John Snow scholarships. Applications are open until Monday, 30 September
These Scholarships provide opportunities for medical students to increase their appreciation of public health medicine as a medical speciality and potential career path.
Nine Scholarships are available each year, representing each State/Territory of Australia and New Zealand. All medical students currently enrolled in Australian or New Zealand medical schools are encouraged to apply.
The selected representatives are invited to present at RACP Congress 2020 in Melbourne. Trainee registration and travel assistance of up to $400 are included. An overall winner will be presented with a certificate in recognition of their achievement.
Full details about this scholarship are available on the website. Please contact RACP Foundation if you have any questions.
The new 2019 MyCPD Framework came into effect in January 2019. It changes the CPD activities you need to record to meet CPD requirements.
The framework is designed to help you prepare for future regulatory requirements to be introduced with the Medical Board of Australia’s Professional Performance Framework (PPF). The Medical Board launched the PPF in response to the final report from the Expert Advisory Group on re-validation.
The RACP’s simplified framework strengthens CPD by engaging Fellows in a range of CPD activities from three categories. CPD activities are required in at least two of the following categories:
- educational activities
- reviewing performance
- measuring outcomes.
Activities in the educational activities category are worth one credit per hour. Activities under the reviewing performance and measuring outcomes categories are worth three credits per hour.
Your annual CPD requirement is still a minimum of 100 credits. Each category is capped at 60 credits. You do not need to record credits in all three categories.
You can continue to choose which CPD activities to complete as long as you can record a minimum of 14 hours of activities that review performance and/or measure outcomes.
Further details are available on the CPD webpage.
Resources are available to assist you with meeting the new requirements including:
The CPD Team are happy to answer your questions. If you need further information or advice, please contact them on 1300 697 227 or via email.
Pomegranate Health is RACP’s award-winning podcast that explores compelling questions about the culture of medicine. Listen to the interesting discussions between clinicians, researchers and advocates on pertinent and thought-provoking topics. Each episode is developed with the guidance of RACP members, to inspire excellence in practice.
One of our newest episodes Training in the bush sees the podcast team visiting physicians at the Dubbo Base Hospital. The hospital services a catchment of 130,000 people spread across an area the size of Great Britain. Whilst the need in the area is high, Dubbo presents an example of strong clinical leadership and training across numerous specialties.
Past podcasts include:
Subscribe today to be among the first to find out about new episodes. Podcasts are available on Spotify, Apple Podcasts and any Android podcasting app.
Do you have an idea you want to discuss, or just want to give some feedback? Email us.
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