The President's Message – 20 March 2020
To say that times have been challenging recently is an understatement. Many of us have been swept up in the huge response to the COVID-19 pandemic. From working right on the frontlines with patients in healthcare settings across Australia and Aotearoa New Zealand, through to our members who are providing clinical, epidemiological and policy advice at the highest levels of Government in both countries.
Many of us have been pulled away from any kind of normal routine to deal with this unprecedented situation. For frontline medical staff, the effects of this crisis are similar to coping with a significant disaster and may continue to be for some time. Remember this - your College is with you. We’re aware of many of the difficulties you are facing and we are working to support you.
The Australian Red Cross evidence based first principles for coping in these circumstances are:
- Safety: clear risk messages. Monitor for rumours/disinformation, address safety concerns, support family reunification
- Be calm: act in a calm way to reduce others distress. Identify coping strategies to help.
- Stay connected: help people connect with their loved ones
- Self and community: help people identify their strengths and apply new strategies to cope. Take breaks, get good nutrition and sleep, talk to others, avoid drugs and alcohol, exercise. (See suggested coping strategies from Beyond Blue below)
- Hope: promote positive expectations even if you feel overwhelmed
Beyond Blue also offers the following advice about maintaining positive mental health during the outbreak:
- Try to maintain your usual regime
- Get enough rest during work hours and between shifts
- Eat healthy foods and engage in physical activity
- Stay connected with colleagues, family and friends by phone or online
- Be aware of where you can access mental health support at work
Information is also available on the RACP Physician Health and Wellbeing webpage.
Here is some of the advocacy we have underway right now to ensure you get the support you need:
- We have contacted all Australian state and federal Department of Health contacts and Ministry of Health contacts in Aotearoa New Zealand emphasising the importance of government support for our Fellows and trainees at the frontline of this crisis, specifically in relation to Personal Protective Equipment (PPE) and health and safety considerations.
- We have received concerning reports that community-based specialists have had difficulties at times accessing PPE.
- Through the media, we’re calling on governments to ensure all specialist physicians, as well as GPs, have access to PPE. We have also raised the issue with the Australian Federal Health Minister’s office and the Department of Health and are also talking with New Zealand authorities.
- In Australia, expanded access to telehealth is a top priority - we are collecting a range of examples from members of circumstances requiring expanded access, which we are pursuing.
- We are working with an expert clinical reference group including specialists in infectious diseases, public health, occupational and environmental medicine, geriatrics and respiratory medicine.
We’ve also set up a special webpage for those of you in private practice or healthcare settings who may not have access to COVID-19 clinical protocols or guidelines and will be shortly updating it with advice for employers from our AFOEM colleagues.
All of this is against a sobering background of international border closures, office and community lock-downs, business closures and global concern about the long-term social and economic consequences.
In these very difficult times, many members of the community are looking to us for advice and for leadership. Whether you’re in private practice, or working in a large hospital network, keep talking to your College – communicating the issues you are facing, and how we may be able to help.
We don’t have warehouses of essential medical supplies – but we do have influence and can convey your concerns and messages to decision makers.
The Australian Government and Department of Health and the New Zealand Ministry of Health continue to regularly send us updates. We will keep you updated through our website of any new information they have asked us to share with you. You will also find the latest news from the College regarding events, exams, CPD and how we can support you.
You will likely already be aware of the difficult decision we have made to postpone the following examinations until at least October 2020:
- Divisional Clinical Examination for Paediatrics & Child Health and Adult Medicine in Australia and New Zealand
- AFRM Fellowship Written Examination (General) – Modified Essay Question and MCQ Papers
- AFRM Fellowship Written Examination (Paediatrics) – Short Answer Question and MCQ Papers
- AFRM Module 1 Written Assessment
- AFRM Module 2 Clinical Assessment.
We are mindful of the considerable disruption caused to trainees, supervisors and DPEs. The Exams team in conjunction with the College Education Committee and the COVID-19 Examinations Advisory Group made up of chairs of the Examinations Committees and the two Basic Training Committees are working on a plan to deliver exams later in the year.
The bans on large-scale gatherings have also affirmed our decision to postpone Congress 2020 and the associated convocation ceremony in May. All new Fellows who have been invited or registered to attend convocation will be contacted with further information. We understand this news may be difficult for some, but your safety and wellbeing are of the utmost important to us. Those who have registered will receive a full refund, and you can read more about it on our webpage.
Separately, our recent investment in updating College IT systems has proved fortuitous in light of the crisis. A large proportion of RACP staff are now working remotely with only minor disruption to our operations and services. I recognise and thank the staff for the flexibility and speed at which they’ve responded and the innovative ways they are using the new technology to continue providing service to our members.
We hope that the only significant change for you in experience in our service is a transition to online committee meetings rather than face-to-face gatherings, and we will likely have to change the format of the AGM and EGM. We will still be running the meetings as scheduled, but are investigating our ability to hold these electronically, and will advise you as soon as we are able to.
We appreciate and acknowledge the tremendous work our members are doing to help protect the community from this pandemic. Many of us are working longer hours and under extremely stressful conditions. If you need support, the RACP Support Program is available 24 hours a day, seven days a week. This free, fully confidential and independent helpline is available to all Fellows and trainees and is managed by Converge International.
I send best wishes to you and your loved ones during this unprecedented global crisis.
Associate Professor Mark Lane
We have developed a COVID-19 webpage to help equip you with the most up-to-date information surrounding the coronavirus pandemic. It provides you with the latest advice and recommendations from the Australian Government, Department of Health and the New Zealand Ministry of Health. It is also a reference point for any changes to College exams, events, conferences and meetings as a result of COVID-19.
Extension for 2019 MyCPD
We acknowledge the enormous impact of COVID-19 on our Fellows and we understand many of you require an extension, as well as additional support this year. To support you with your CPD requirements, Fellows with an incomplete 2019 CPD record will have an automatic extension until midnight (AWST) Friday, 31 July 2020. There are no fees associated with this extension and we will continue to monitor the situation closely to review whether further extensions are necessary.
We have received several enquiries from members concerned about the impact of COVID-19 on their 2020 CPD activities. We are in contact with both the Medical Board of Australia and the Medical Council of New Zealand to discuss the ongoing impact and the implications for your 2020 CPD activities.
Our College is calling upon members to submit expressions of interest to our new Gender Equity in Medicine Working Group (GEMWG). The GEMWG is being established to develop an understanding of the gender equity issues and barriers experienced by Fellows and trainees and examine what our College can do to better support gender equity in medicine. This is a great opportunity to be involved in an important College initiative and we encourage you to apply before expressions of interest close today.
We are disappointed to have to inform you of some difficult decisions made by the Board. We have had to cancel RACP Congress 2020 and postpone the Convocation Ceremony which were scheduled for May 2020. These decisions were not taken lightly, and the Board is actively exploring how to mitigate the many effects on Fellows and trainees.
Considering the global repercussions of COVID-19, as physicians it is our responsibility to put the safety of our members and the community we serve above all else.
Anyone who has registered for RACP Congress 2020 and related ancillary events through the RACP will be refunded their full registration fee. We encourage you to contact your travel provider for refunds on flights and accommodation – the College is not able to provide refunds for these expenses.
If you submitted an abstract and were expecting to present at Congress, it will still be published in either the Internal Medicine Journal Congress abstract supplement or the Journal of Paediatrics and Child Health Congress abstract supplement. Both supplements are published by Wiley.
We are currently looking at alternative options for delivering the Congress program and will provide an update on this as soon as we are able to.
All New Fellows who have been invited or have registered to attend the Convocation Ceremony in Melbourne in May 2020 will be contacted with further information about this event.
Trainees who are currently working outside of Australia and Aotearoa New Zealand as part of their training program and experience disruption to their training due to the COVID-19 pandemic will have their progression through training considered through special considerations. This includes those trainees who choose to return home prior to completion of their placement. Please see the Special Consideration for Assessment Policy for more information.
We advise all members to follow the advice of the relevant government authorities (Smart Traveller in Australia and Safe Travel in NZ) when making decisions about travel.
We have established a COVID-19 Training Operations and Accreditation Advisory Group which will consider interruptions to training due to COVID-19 for all trainees. The Advisory Group will be meeting in the coming weeks and we will provide more information about the outcomes as soon as possible.
We regret to inform you that the Aotearoa New Zealand Trainees' Day 2020 originally scheduled for 4 April has been cancelled. This was a difficult decision, but considering the COVID-19 pandemic, it is our duty to protect your safety.
Those who have registered will automatically receive a full refund of their registration fee. We encourage you to contact your travel provider for any other refunds on flights and accommodation – the College is not able to provide refunds for these expenses.
In light of the global repercussions of COVID-19, the Australasian Chapter of Sexual Health Medicine Annual Scientific Meeting (ASM) Organising Committee has made the decision to hold its 2020 Annual Scientific Meeting via Zoom at a reduced rate, as an alternative to the face-to-face event.
This decision has been made due to the increased risk of transmission at such events, and the resulting negative impact a potential quarantine of delegates could have on the frontline sexual health workforce. We apologise for any inconvenience caused.
All delegates who have registered for the event will be refunded the gap in the cost of their registration. Please contact email@example.com if you have any questions regarding this process. We encourage you to contact your travel provider for refunds on flights and accommodation – the College is unable to provide refunds for these expenses.
Any Fellows, GPs, trainees, nurses or allied health professionals who did not register for the face-to-face event but would like to attend virtually are welcome to register at the reduced rate.
In light of the developing situation as COVID-19 escalates in global distribution with concerns about infection, quarantine and the provision of health services, the Executive Committee of the Tri-Nation Alliance has made the decision to postpone the International Medical Symposium (IMS) 2020, until a future date to be decided.
All delegates who have registered for IMS or International Medical Education Leaders' Forum events will be refunded their full registration fee. The RACP and the Tri-nation Alliance have no liability for the losses relating to travel, accommodation and other expenses. We encourage you to contact your travel provider for refunds on flights and accommodation.
The member colleges of the Tri-Nation Alliance are 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 Australian and New Zealand College of Psychiatrists.
More needs to be done to address the joint needs of investment in prevention and deep-seated health reform to better connect the Australian health system and address identifiable gaps in care. The College calls for the 2020-2021 Federal Budget to look longer term. Read the College’s 2020-2021 Pre-Budget Submission, which addresses the need for:
- prevention strategies on obesity and alcohol-related harm
- early intervention in mental and physical health of infants and children
- calls for more integrated approaches to care and for fundamental reform of the aged care system.
Read the submission
On Thursday, 27 February 2020, the NSW Government released the four-volume report of the Special Commission of Inquiry into the Drug ‘Ice’ and its interim response a month after the inquiry’s findings were delivered by Commissioner Professor Dan Howard. On 16 February 2020, the RACP had issued a joint media release with St Vincent Health Australia on 16 February calling for the NSW Government to make the Inquiry's report public. The RACP also made a submission to the Inquiry in May 2019 which recommended:
- more medically supervised injecting centres in areas of need to reduce overdose death and increase links to treatment and support services
- the urgent establishment of needle syringe programs in custodial settings to address not only the health of inmates, but also the wellbeing, health and safety of the broader community
- the establishment of carefully designed and evaluated pill testing trials to keep people as safe as possible at music festivals to be employed in conjunction with other harm minimisation measures including a stronger healthcare focus with priority resourcing for ambulance, medical support, protocol development and training so as to improve resuscitation, retrieval and transfer to hospital when overdoses occur
- the development of strategies for early identification of serious toxicity
- public messaging and support to attend a health facility with immunity from police action and positive partnerships between health and law enforcement.
The Inquiry's final report makes 109 recommendations to the NSW Government including more supervised injecting centres, pill testing; retiring its drug detection dogs; implementing a trial of a needle and syringe program in correctional facilities; establishing greater coordination of alcohol and other drug policy; decriminalisation; reframing substance use as a health issue; a greater investment in treatment, diversion and workforce initiatives; education and prevention programs; better data, reporting and research; a clear focus on priority populations, especially Aboriginal people who experience disproportionate impacts from ATS, rural and regional people and people in contact with the criminal justice system.
The NSW Government has already indicated it would not support the Inquiry’s recommendations to open more medically supervised injecting centres, run needle and syringe programs in prisons, allow consumer substance testing (more commonly known as pill testing) and stop using drug detection dogs. Its interim response states that "the Government will carefully consider the Inquiry’s findings and recommendations and will prepare a final response".
Congratulations to the recipients of the 2020 RACP Foundation Research Awards
. Funding of $2.2 Million has been awarded to 50 Fellows and trainees to support their careers in medical research.
We would like to acknowledge the commitment of the Grants Advisory Committee, the Aotearoa New Zealand Grants Advisory Committee and the many other invited and volunteer reviewers.Their generous contribution of time and expertise ensures a robust review process for the ever increasing number of applications.
Thank you also to those who have contributed to the Foundation through donations, gifts, partnerships and bequests making these awards possible.
My Health Record is a secure online summary of an individual's health information available to all Australians. Healthcare providers authorised by their organisation can access My Health Record to view and add to their patients' health information.
Understanding how to register and upload to My Health Record can be challenging. Watch Professor Steven Boyages interview Carey Doolan from the Australian Digital Health Agency, where they explore and provide practical advice to help you register and upload to My Health Record.
Obesity Care Week (OCW) was from 1 to 7 March. OCW seeks to raise awareness not of obesity, but of the need for better care for people with obesity. This year’s themes included weight bias, obesity treatment, access to care, childhood obesity, self-care and caring for others.
World Obesity Day (WOD) was 4 March, which was the first time organisations and individuals from around the world united behind a single day for the cause of care for people with obesity. WOD 2020 focused on the deep roots of the obesity challenge. While obesity is often framed as an outcome of a lack of willpower, we know that there are many drivers of obesity including social, biological and environmental factors which are well outside of people’s control.
As part of OCW, a consortium of organisations and individuals issued a joint international consensus statement for ending stigma of obesity. Professor Francesco Rubino from King’s College led the initiative and said “Weight stigma is a public health problem, undermines human and social rights and is a major stumbling block in the fight against the epidemic of obesity.
The objective of this initiative was to gather a broad group of experts and scientific organisations and, for the first time, speak with one voice to unambiguously condemn weight stigma and expose the misconceptions that contribute to weight bias.”
To highlight this message, RACP joined the Obesity Collective to host a World Obesity Day event that saw a range of experts sharing short presentations on some of the drivers of obesity. We invite members to watch these punchy presentations
We ask you to read the joint international consensus statement
for ending stigma of obesity and you can also sign the pledge
to end the social stigma of obesity. As the motto of World Obesity Day says, the roots of obesity run deep, but together we can create a healthier future.
On Thursday, 27 February 2020, Professor Malcolm Sim, AFOEM President-elect and Dr Graeme Edwards, AFOEM Fellow and College spokesperson on accelerated silicosis, presented at a silicosis summit organised by WorkSafe Victoria in Melbourne. The event was attended by over 600 people from the stone masonry, construction and tunneling industries who came to learn about prevention of silica dust exposure in the workplace.
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 course focuses on the sorts of ethical issues that are a constant feature of healthcare, 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.
RACP Online Learning Resources are free for members and count towards Continuing Professional Development requirements.
Asthma is responsible for considerable morbidity and healthcare costs in Australia, with clinical differences in diagnosing and managing the condition in different age groups. The Global Initiative for Asthma strategy report April 2019 recommended a change to first-line treatment of adults and adolescents with mild asthma.
Through Evolve, the Thoracic Society of Australia and New Zealand and the RACP Paediatrics & Child Health Division have developed recommendations to help medical practitioners reduce low-value care in diagnosing and managing asthma. These have informed the latest NPS MedicineWise asthma education program.
The program will roll out in two phases: the first phase – 'Paediatric asthma: breathing new life into diagnosis and management' focuses on the paediatric asthma population. Phase two commences later in the year and focuses on adults and adolescents.
Find out more
Improving the quality and safety of healthcare is at the heart of Evolve. We regularly consult, collaborate and partner with RACP Fellows and trainees who are part of the Evolve Policy Reference Group. They play an important role in leading and shaping Evolve to make it more relevant and fit-for-purpose.
Join the Evolve Policy Reference Group by emailing your interest to firstname.lastname@example.org.
The March 2020 issue of the Internal Medicine Journal is out now. The Editor's Choice is a review article titled 'New Advances in the Management of Cytomegalovirus in Allogeneic Haemopoietic Stem Cell Transplantation'.
Key highlights from the issue are:
- HIV testing
- Driving with cardiac devices in Australia
- CMV management in stem cell transplantation
- Anaemia and bone marrow harvesting
- Under-detection of acute kidney injury
- Who is afraid of biosimilars?
The Journal of Paediatrics and Child Heath
March 2020 edition is out now. It features an interesting article titled 'teacher rating versus measured academic achievement: Implications for paediatric research'.
Other topics this month include:
Episode 56 – Billing in Byzantium
Australia has one of the best value health systems in the world, but also some of the most complicated health regulation. Between the Medicare scheme, the state hospitals, the private health insurers and the patient, it’s not always clear how a provider should invoice their services.
To explain some of the fundamentals our guest is former nurse and lawyer, Margaret Faux of Synapse Global Medical Administration. She describes areas of ambiguity in the legislation and the Medical Benefits Schedule which creates confusion as to when and where certain services can be billed, or which items should not be claimed together. While there are many traps for well-intentioned providers and loopholes for the less well-intentioned, there are some simple solutions that would make medical billing much more streamlined.
The health insurance reforms will become mandatory as of 1 April and along with a premium increase, it's time to see if your health cover is truly meeting your needs. Through your benefits you have access to the HCF corporate health insurance range, with discounted premiums, limit boosts and 100 per cent back on selected extras.
Plus, an exclusive joining bonus
Get couples or family cover and receive a $200 EFT reward, or get singles cover and receive a $100 EFT reward when you take out HCF Corporate Hospital and Extras between 19 February and 31 March 2020*. Visit your Member Advantage website for more details or call your dedicated consultant on +61 414 559 734.
* Open to Australian residents 18+. Member must provide a valid email address to receive the EFT reward. HCF may take up to 12 weeks from the date an Eligible Person has been a financial member for 3 months to issue the Eligible Person with their EFT payment. Exclusions on entry apply - terms and conditions apply and can be obtained by contacting HCF. Member must pay for 3 months to qualify for EFT payment. Limit 1 EFT payment per policy.
Read other RACP eBulletins: