Victoria - November 2019
2019 has been a busy year for your Committee. The Committee has been involved in a lot of internal and external advocacy work and overseeing several events for our members.
This edition’s Victorian Spotlight features an article on one of our Fellows, Professor Julian Wright, a consultant Nephrologist who works within the field of Rural Health.
Also included in this edition is Associate Professor Leeroy William’s article addressing the growing need for compassionate healthcare amidst increasing demands and expectations on a system under many stresses.
An event called The Ensuing Tsunami of Chronic Disease: How to Best Prepare was held at the Victorian Office in October in collaboration with the Australian Health Network. The event focused on increase in chronic diseases and multi-morbidities in our aging population and baby-boomer demographic challenges.
Our member events for 2019 will be capped off by the Victorian Trainee Research Awards and the MBA in a Day event, both of which will be held in November. I encourage all members to come along to one or both these events, or one of the many other events that the College conducts for members.
The next edition of our newsletter is due to be published in March 2020 and we are always keen to publish interesting content and support our Victorian members. If you have anything you would like to contribute, or a member you would like to nominate to be the feature for the Victorian spotlight section, please contact us.
I would like to wish you all a happy and enjoyable festive season from the RACP Victorian Regional Committee.
Professor Judy Savige FRCP FRACP FRCPA PhD MSc Dip Mgmt
Chair, Victorian Regional Committee
Many Government decisions on workforce are based on anecdotal data. As a response to this we are updating our records to assist our future decision making for physician education programs.
Did you know the hours you work, the professional activities you are engaged in and where you work impact the paediatrics and adult medicine workforce?
You’ll find My Work Profile on the payment confirmation page that will take you to your own work profile, or you can access it in MyRACP.
MyRACP supported internet browsers are Microsoft Edge, Chrome, Firefox and Safari.
How does My Work Profile benefit you?
Workforce data will be made available to you and will help:
- New Fellows decide which geographic area to work in Australia and New Zealand
- New Fellows choose between private or public practice
- you understand how your work hours compare with your peers
- the RACP and stakeholders including government policy-makers make better workforce decisions, based on current data
- Fellows understand activities they are undertaking; research, administration or clinical.
For more information, please read the My Work Profile FAQs. For details on what data will be collected and how it will be stored, please read the Privacy Statement.
Hear what others have to say about My Work Profile
Balancing medical science with humanity
We are excited to announce the keynote speaker for RACP Congress 2020, Professor Catherine Crock AM.
Professor Crock is not only a doctor at the Royal Children's Hospital; Melbourne, she is a music and theatrical producer, a humanitarian, a mother and a strong advocate for culture change in healthcare.
After identifying the direct correlation between organisational negativity and staff wellbeing and effectiveness Professor Crock founded the Hush Foundation and the Gathering of Kindness events. She is dedicated to building, nurturing and instilling a culture of kindness throughout the healthcare system.
Her two plays “Hear Me” and “Do You Know Me” have been performed in hospitals and aged care settings across Australia raising awareness of patient centred care, communication and patient safety issues and encouraging a shift in the culture and behaviour in healthcare.
Her keynote address Balancing science with humanity: how kindness restores the whole in medicine will be a not-to-be-missed highlight of RACP Congress 2020.
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.
Visit the Congress website to find out more about the program and to register.
Professor Julian Wright is a UK trained nephrologist who moved to Australia in 2012. Prior to his move he was a Consultant Nephrologist at Manchester Royal Infirmary from 2005. He was also Director of Postgraduate Medical Education at Central Manchester NHS Foundation Trust. Since his move to Australia, he is Head of the University of Melbourne’s Department of Rural Health, Director of Medical Student Education for the Rural Clinical School, and Professor of Medicine
The RACP VIC team caught up with Professor Wright to learn more about his work.
What is the most rewarding aspect of your role?
Fortunately, there are many rewarding aspects to my role. Observing medical students over their three years of clinical training move from novice clinicians to competent graduates is satisfying, working with the rural health team to achieve objectives together that as individuals we could never achieve is rewarding, and consulting in nephrology clinics and working directly with patients is stimulating.
What is it about your work that makes you want to get out of bed each morning?
My motivation is really about the next challenge. Most days there is some aspect to my role that will involve overcoming a hurdle. Providing excellent medical education in a regional setting across several campuses in diverse health service settings regularly throws up unanticipated issues that need to be resolved. Then there are ‘big picture’ challenges such as planning for an end-to-end rural stream of the Melbourne University MD degree with which it is exciting to be involved. It’s these challenges, big and small, that I look forward to the most.
What does a typical day at work look like for you?
My day is usually planned well as time is often tight, although this carefully put together schedule is often being revised by early morning. Non-clinic days involve a variety of teaching, planning meetings – usually clinical school related, supervisory meetings, representing the department at local functions and trying to fit in time for research. My wonderful EA schedules in a lunch break although that valuable time for catching up on emails is often double booked! My role involves fairly regular evening functions which whilst time consuming are most often enjoyable social events. Clinic days are different; once I’m consulting with patients it takes the time that is needed and that’s a privilege for me.
How do you manage work-life-balance?
Better as I’ve gotten older. I think I appreciate the need for balance much more now that I did 30 years ago. I now recognise the things I need to be doing to maintain balance and I’m a bit more deliberate in making time for non-work activities. I certainly admire the focus on work/life balance for younger health professionals that was lacking in the past. I’m sure we’ll have a much healthier and more effective health workforce because of this. Having said that, early in a medical career, it is still very difficult not to be consumed by work at times.
Are there any patient success stories that you can share?
Working in nephrology in a regional setting is very different than in a metropolitan setting where access to other specialists, and procedures, is considerably easier to arrange. I would site helping patients navigate the transition onto dialysis smoothly when they may have to make several trips to Melbourne in the process is a success.
The need for compassionate healthcare continues to grow amidst increasing demands and expectations on a system under many stresses. We can all imagine the challenges posed, but what would compassionate care look like to you? In 1994, Ken Schwartz was diagnosed with lung cancer at Massachusetts General Hospital, Boston. He was a 40-year-old healthcare lawyer with a wife and a two-year-old son. In an article for the Boston Globe Magazine entitled 'A Patient’s Story', he described the care he received succinctly: 'These acts of kindness – the simple human touch from my caregivers – have made the unbearable bearable'.1 He survived ten months, but before he died, he established the Schwartz Center for Compassionate Healthcare2 to ensure that all patients receive compassionate and humane care within an increasingly demanding healthcare system.
The Schwartz Rounds program has since been developed to provide an opportunity for people working in healthcare to address the emotional burden of the care we provide. Organisations in the USA, Canada, UK, Ireland, Australia and New Zealand are involved in the delivery of Schwartz Rounds to over 300,000 healthcare workers.2 In our region, the following organisations have partnered with the Schwartz Center to run these meetings: Alfred Health, Cabrini Health and Monash Health in Melbourne; Chris O’Brien Lifehouse in Sydney; and Auckland City Hospital in New Zealand.
My involvement with Schwartz Rounds began at Monash Health in 2017 as the Clinical Lead and facilitator for many of the Rounds. But what are these Schwartz Rounds? They are usually held at lunchtime and have a similar provision of food and drink for attendees as grand rounds. In contrast to grand rounds, they are open to clinical and non-clinical staff. This may seem unusual at first, but non-clinical staff often provide powerful insights into the care we provide. The Rounds are themed by a topic, e.g. 'the patient I will never forget' or 'dealing with anger in healthcare'. The theme is usually explored via the differing perspectives of three panelists who have volunteered to tell their story. A few days before the Round, the panelists are given the opportunity to tell their story in a rehearsal. The importance of this opportunity cannot be under-estimated, as it may be the first time that their stories are shared or even voiced. Panelists may be surprised by their response to telling their story, but this allows them to prepare for the Round emotionally.
The role of the trained facilitator starts at the rehearsal to build trust and confidence that the panelist will be safe. During the Round, the facilitator guides the audience, via the stories of the panelists, to reflect upon their own experiences and volunteer to share or discuss their insights. The Round is not about solving problems, but to connect the staff in their shared experiences within the healthcare system. The facilitation role is important in this regard, in conjunction with supporting the panelists and audience in what can be a highly emotional space. Subsequently, the facilitator and the team involved in organising the Round, need to help the group transition back to work via a process that ensures emotional safety and support. Follow-up contact, either face-to-face, via telephone or email enables the team to provide ongoing compassionate care to staff.
Interestingly, although the initial focus of Schwartz Rounds was on maintaining or improving compassionate patient and family care, there has also been an awareness of the support for healthcare staff in their work. Schwartz Rounds provide experiential learnings for staff about themselves, their colleagues and the systems they work in. Online videos are available3, but the emotion of the stories and the connections within in the room create links and understandings between staff that would never have existed. The international evidence regarding Schwartz Rounds show how they can support staff to work better together, be more compassionate to each other, and value the reflective space provided.4 Many organisations that have started these Rounds recognise that they can change the culture of organisations for the better, and hence continue to run them.
Our experience in Australia and New Zealand is growing and many organisations are exploring how they too can develop Schwartz Rounds. The overwhelmingly positive response from staff highlights the need for our workforce to share their experiences. Some healthcare professionals receive clinical supervision on a regular basis, but what about the rest of us? When was the last time you had personal clinical supervision for your work? This explains the value of Schwartz Rounds as a forum for support and compassion for each other. Healthcare staff can seek help via Employee Assistance Programs and each organisation should have a team of peer support workers to ensure staff are not left to deal with workplace trauma alone.
At a time when more demands on healthcare are being made, with higher expectations, the value of Schwartz Rounds cannot be denied. My personal view is that we should treat each other with the same respect we would show our patients and their families. If we undertake holistic care for the people we serve, then that same attention should be given to our colleagues. Our exposure to the human suffering of others has the capacity to expose our own suffering and vulnerability. As Dr Rachel Remen states: “The expectation that we can be immersed in suffering and loss daily and not be touched by it, is as unrealistic as expecting to be able to walk through water without getting wet”. In such circumstances, we often revert to task-based care in order to protect ourselves, rather than see this as a bridge to compassionate care. But compassion takes courage, whether with our patients or each other, to understand the waves of emotion and uncertainty in our human existence.
Associate Professor Leeroy William
President of The Australian & New Zealand Society of Palliative Medicine (ANZSPM)
Clinical Director of Supportive & Palliative Care service at Eastern Health
Adjunct Associate Professor at Monash University
The Australian Health Network, in association with the College hosted an evening discussion on ways to address the challenges of the ageing baby-boomer bubble and our increasing life expectancy. How will we ever manage the demand?
As clinicians and within our health system, we, collectively, are no longer simply dealing with individual ailments. We’re seeing a substantial increase in chronic diseases, multiple co-morbidities on top of increasing aged population. Many older patients seeking treatment now have two or more chronic illnesses. Our system can barely cope with the existing challenges and we now need to change gears dramatically and start preparing for the seismic shift in service demands. What solutions are necessary in order to cope?
Experts Professor Mike Roberts, Managing Director, UCLPartners Academic Health Science Networks (“AHSN”) and Associate Professor Nick Buckmaster, Chair, Consumer Advisory Group, RACP discussed practical changes being made in the various healthcare systems, what they’ve already done to start preparing for the shift and what successes they’ve encountered.
The event was chaired by Associate Professor Leeroy William, member of the Victorian Regional Committee and President of the Australian and New Zealand Society of Palliative Medicine, and succinctly summarised the discussions towards the end of the evening
- Need to integrate hospital services into the community. Can this concept be scaled up from successful smaller projects and would a public health approach provide a solution that would ensure universal coverage?
- We all have a responsibility to "activate" the population we encounter in our practice to supported self-management of their chronic illnesses, but also to "activating" our communities into action to support each other.
- Codesign of solutions has the potential for innovation, in conjunction with patients and their carers. This requires the necessary communication to facilitate true collaboration in service delivery.
- Holistic care plans that involve goals of care discussions and enable patients and carers to be guided by these plans, as well as healthcare professionals.
- Leadership to guide a population-based approach to healthcare and workforce development to meet future demands.
Host a SPDP face to face workshop
Contact your local Member Support Officer
or the Supervisor Learning Support
(SLS) unit for assistance in organising a workshop at your local site or upcoming specialty Annual Scientific Meeting.
Contact Supervisor Learning Support
if you are interested in hosting a SPDP workshop.
Become a SPDP online course / face-to-face 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
- Focussed on supervisor needs - ensure relevancy to supervisors from all training programs
- Accessible and flexible - flexible and adaptable workshop design which can be held at ASM and in local settings
Contact Supervisor Learning Support if you are interested in becoming a Facilitator.
MBA in a Day event – Saturday, 23 November
You are invited to MBA in a Day event on Saturday, 23 November. Held at the RACP Victorian Office, you will enjoy interesting and informative talks from members of various medical colleges.
- How our health system works
- How to be a more effective leader
- How your colleagues deal with work issues
This event is now fully booked. You may register to attend via video-conference only.
We would like to thank the Victorian Committee of Chairs of Medical Colleges who have organised this event.
When: Saturday, 30 November 2019
Time: 8.30am - 3.30pm
Where: Adelaide Convention Centre
Explore SA: Discover what you can do while in South Australia
Following on from the success of last year’s event, the 2019 ASM promises to be as engaging and stimulating as last year. Held under the theme 'Specialists. Together' at the Adelaide Convention Centre, the program has three parts, with something for everyone.
Session one is titled ‘Pain, addiction and death’ with three speakers who will discuss the opioid crisis, brain immune systems contributing to pain, addiction and death, and palliative care.
Session two is the judging of the Trainee Research Awards by our panel:
- Professor Paul Komesaroff FRACP, President of the RACP Adult Medicine Division
- Professor Paul Colditz FRACP, President of the RACP Paediatrics and Child Health Division
- Professor Steve Wesselingh FRACP, Executive Director of the South Australian Health and Medical Research Institute (SAHMRI).
Session three is titled ‘Diseases and therapies: old and new’. The four speakers will discuss the history and modern developments of the silicosis epidemic, and latest developments with rheumatoid arthritis, stroke and lymphoma.
Full-day registration is $75 for trainees and $95 for Fellows, with medical students and non-members also welcome. Due to popular demand, half-day registrations are also being offered for the first time this year.
Learn how to work more sensitively and effectively with migrant, refugee and asylum seeker patients in this new online course.
The course provides relevant facts and practical strategies for objectives such as good cross-cultural communication and facilitating easier navigation of the healthcare system. The course includes the perspectives and stories of a diverse range of individuals to help show the full picture.
Accessible anywhere and optimised for mobile on-the-go learning, RACP Online Learning Resources are free for members and counts towards Continuing Professional Development (CPD) requirements.
Fellows can claim CPD credits by listening to Pomegranate Health Podcasts
Ep53: Marrabinya — a hand outstretched
Marrabinya is a Wiradjuri word meaning 'hand outstretched.' It’s the name of a service in the Western New South Wales Primary Health Network which financially supports Indigenous Australians to attend specialist consultations. Aboriginal and Torres Strait Islander Peoples receive specialist medical care 40 per cent less often than non-Indigenous Australians. It’s easy to imagine communities out in the red desert and blame culture clash or the tyranny of distance, but most Indigenous Australians live in cities or regional communities. The Marrabinya staff explain how socioeconomic factors and institutional biases can accumulate to prevent Aboriginal patients from receiving the care they need.
Marrabinya is an exemplary model of principles that RACP has formalised in the Medical Specialist Access Framework. Indigenous leadership, cultural safety, person and family-centred approach and a context-specific approach can all contribute to great gains in the health of Aboriginal and Torres Strait Islander people.
Guests: Marrabinya Executive Manger Donna Jeffries and chronic care link staff Desley Mason, Kym Lees, Possum Swinton, Sandra Ritchie, Donna Jeffries, Melissa Flannery, Joanne Bugg, Jacob Bloomfield and Gaby Bugg.
Fellows of theRACP can claim CPD credits via MyCPD for listening to this episode and reading the resources below. Subscribe to Pomegranate Health in Apple iTunes, Spotify or any Android podcasting app