South Australia — November 2018
A message from the South Australian (SA) Regional Committee Deputy Chair
As a new Regional Committee term has started, it is important to reflect on the significant contributions that physicians make to the community through professional and social endeavours. The College and Regional Committees provide support, advocacy, and interact with government and stakeholders on behalf of us all. Importantly, it is the members who provide the input, energy and direction.
At the local level, recent activities have included a New Fellow Forum in September, as well as planning for a local Annual Scientific Meeting (ASM) and the Trainee Research Awards Presentations. Visit the event website for more content and registration details. The committee working party has done an exceptional job pulling this together.
I recently had the opportunity to attend Art of Medicine and thoroughly enjoyed the experience of seeing artwork from our professional colleagues on display. More on that later in the bulletin.
We still have a shortfall of SA Regional Committee members. I urge you to consider making your contribution to the state and to the College. Even if you are not a committee member it is important to have your voice heard and the Regional Committee represents one important avenue for this.
Be safe and well.
Dr Peter T Jezukaitis
MBBS, FAFOEM RACP
Deputy Chair, SA Regional Committee
The SA ASM is upon us
SA Horizons – Scanning the next 10 years draws on knowledge and experience from expert speakers focused on the future of medicine in South Australia and across Australia.
RACP President Associate Professor Mark Lane will be joined at the event by Emeritus Professor Paul Worley (Australia's first National Rural Health Commissioner), who will provide insights into rural and remote education.
Topics examined during the day will include:
- scientific medicine – new technologies being introduced via artificial intelligence platforms (presented by Dr Phil Tideman)
- the use of smartphone data to assess patients and what the role will be of expensive and targeted therapies (presented by Dr Sam Gluck)
- future workforce (presented by Associate Professor Grant Phelps)
- how we can best take care of ourselves (presented by Dr Roger Sexton – Medical Director at Doctors Health SA).
To view the program and register please visit the event website.
Managing complaints – a trainee perspective
Dr Benson Pek is an Occupational Medicine registrar, a member of the AFOEM SA State Committee and a trainee representative. Concerned with trainee wellbeing and the significant burdens that registrars may carry through their training, Dr Pek shares an experience which is of current concern in the occupational health of doctors.
Complaints to the Australian health Practitioner Regulation Agency (AHPRA) regarding medical practitioners have been on the increase in recent years. Most relate to poor or misunderstood communication, perceived rudeness, inadequate medical assessment, boundary transgressions and issues arising from treatment such as mismatched expectations.
These communication issues may arise due to time pressures in busy hospital and clinic settings. In some patients, frustration and anger may boil over into verbal or physical aggression. A vexatious complaint to AHPRA can lead to months of investigation and anxiety before the matter reaches its conclusion.
In my case, a patient requested that I delete some examination findings from her medical record on a number of occasions. Though this case was straightforward – I simply could not oblige – the patient continued to agitate for a result, and the matter continued for about a year, through my wedding and honeymoon.
If you find yourself the subject of a complaint, contact your indemnity insurer as soon as possible to obtain medico-legal advice, and act promptly on it.
Rumination, anxiety, insomnia, self-doubt and loss of job satisfaction are not uncommon responses. These could be the signs of depression, demoralisation or burn-out, and they can affect your job performance and relationships with loved ones.
Anxiety can affect your memory and cognitive capacity, resulting in an increased risk of errors at work. Depression and suicidal ideation can develop insidiously and have resulted in doctors’ suicides. Depending on your department and your employer, you may not be comfortable to approach a senior figure at work for help. You can choose from a range of other potential supports. These include the RACP Support Program, Converge (1300 687 327 in Australia, 0800 666 367 in New Zealand) or other doctor’s health groups. Secondary sources of support can include the beyondblue website, an external clinical supervisor, mentors or trusted peers.
It is important to have your own GP, and not to self-treat. Learn to recognise when you need medical help. In each state there are Doctors’ health groups that are able to understand your predicament, and can provide non-judgemental, confidential and objective advice. Rest assured that mandatory reporting is rare and reserved only for the most serious cases where public safety is a risk. Demonstrating the initiative to take care of your health is looked upon favourably.
Through the tough periods, remember to maintain the basic requirements for good health. Eat a balanced diet and ensure you are getting sufficient sleep. Avoid using alcohol or drugs to cope with stress. Stimulate your mind with hobbies, and exercise regularly. Consult an exercise physiologist if you find yourself unfit or uncertain where to start.
Remember that besides administering psychotherapy, psychologists can also function as a coach for you in the way an athlete uses a sports psychologist. They may be able to help you make difficult decisions and guide you to find solutions where none were apparent.
If you need to step aside from your duties for a while, consider being referred to an occupational physician. Occupational physicians have the clinical knowledge and skills to assess your health using a holistic approach considering work, lifestyle and other factors. Temporary collaborative work adjustments such as reviewing your working hours and duties may need to be considered and communicated to your employer. Meaningful and non-discriminatory duties can be negotiated diplomatically.
These processes can be applied to other stressful situations, and not just for complaints. I wish you well in your training.
If this article has raised concerns for you, you can ring Lifeline on 13 11 14.
Powerful Art of Medicine workshop
More than 100 artworks from physicians, GPs, surgeons, psychiatrists, ophthalmologists, anaesthetists and medical students from Adelaide and Flinders Universities were displayed at the Art of Medicine exhibition, launched on 23 September at Praxis ARTSPACE in Adelaide.
Hosted by Doctors Health SA, this popular exhibition included paintings, drawings, sculptures, digital art, and even a short film.
“Art makes you stop, think and step out of your life into another world for a while,” says Dr Roger Sexton, Medical Director at Doctors Health SA.
Roger helped establish this event in 2015 and was surprised at just how many doctors are artists. He aims to spark discussion within the profession and encourages clinicians to explore their creative side.
“If you are going to remain a sustainable individual, personally and professionally, you must have an interest outside of work,” Dr Sexton advises.
“By improving the wider health of the profession, there is a flow on effect to patients. Healthy doctors practice better medicine”.
Visit the Doctors Health SA website to learn more about the work the organisation does.
Pictured (L-R): ;Dr Roger Sexton, Dr Peter Jezukaitis, Dr John Cross.
Physician in Focus
Our SA team caught up with Dr Lalith Gamage, General Paediatrician and Paediatric Emergency Physician, at Port Augusta Hospital. Read our interview to learn more about Dr Gamage's work.
What is the most rewarding aspect of your role?
I am not only providing day-to-day health care to the community but also providing advocacy and leadership, as well as the upskilling of rural generalists and allied health services. It is very rewarding learning from each other and enables me to gain a greater understanding about the facilities available in the smaller hospitals such as Coober Pedy, Wudinna, Port Lincoln and rest of the northern regional area in South Australia.
I quite enjoy the school visits and am able to deliver my care in a multidisciplinary setting having first contact with committee leaders, school principals and people who are concerned about my patients and their safety.
When I am working in the Women's and Children's Hospital Emergency Department, the knowledge gathered from the rural community helps me to build a good rapport with my rural colleagues.
Working in a rural community is quite challenging and sometimes I may have to drive about a hundred kilometres to resuscitate 28 weeks twins at midnight. Sometimes I might be called to attend for immediate delivery, even though the hospital is one hour away. The roads are heavily infested with kangaroos and quite dangerous however it is really satisfying when the job is done. I have the opportunity to attend life-threatening emergencies of adult patients, fracture reductions and assist an obstetrician who is struggling to control postpartum haemorrhage by doing a hysterectomy. The variety of patients is amazing and the experience is outstanding. I never get tired of working in the rural community though I am staying away from my family.
The rural community is supportive and consider themselves as a small family who know each other well. I am welcomed into the rural communities, they appreciate hard work and do not hesitate to acknowledge and validate it even when I meet them in the butchers or supermarket.
What aspects of your work make you want to get out of bed each morning?
Going to either outreach clinics or to the Emergency Department I expect the unexpected. The case-mix and the severity of cases are quite variable and as a rural paediatrician carrying extra qualifications in paediatric emergency medicine, I am able to contribute to the rural community immensely to manage the patients in the same geographical region. There is no monotony at the workplace and I never get bored with my workload.
What does a typical day at work look like for you?
My day begins with morning ward rounds; however my ward round is quite often interrupted and I can be floating in between theatre and the Emergency Department. If I'm lucky, I'll be able to finish my rounds at 10am and start Outpatients at the same time. My patients come from great distances. Driving after 5pm is not that safe so I try to see my patients on time without interruption. Some days, I start work at 5.30am to drive to outreach clinics 300 kilometres away from Port Augusta Hospital, so the day is exhausting and can finish at 7pm and being on call for the hospital.
How do you manage work/life balance?
The geography of the area provides many activities to enjoy such as rock climbing, cycling, swimming. The serenity is outstanding. Though the work is exhausting even with a short break, watching someone fishing or kids jumping from wharf (though it is not legally allowed) can be relaxing.
I work fortnightly in the rural community and so far, I am able to cope up with my work in the metropolitan area simultaneously. I have the opportunity to bring my family with me to Port Augusta during school holidays and introduce them to the community. My family is able to understand my commitment to this area and how important the role is as a rural general paediatrician. They validate my work which reduces my guilty feeling of not able to stay with them even when they are not well.
Are there any patient success stories that you can share?
Working in the Coober Pedy Hospital; a colleague wanted me to see a 16-month-old child with a chronic cough and difficulty swallowing. The mother was not able to provide a good history, which is not uncommon to the patient in that area. The x-ray facility was limited, clinical suspicion of a foreign body was raised. Subsequently, I was able to admit the child to Port Augusta Hospital and transferred to Women's and Children's Hospital for removal of the foreign body. There was an oesophageal stricture as a result of a chronic impact and the child was rehabilitated in the Port Augusta Hospital for an extended duration. The outcome was amazing and the opportunity for the health education of the entire community was outstanding.
A Message from the South Australian Trainees’ Committee
During 2018 SA Trainees' Committee members continued to provide relevant local events to trainees, to help those in all stages of training navigate what lies ahead - from exams, to research, to planning their career pathways.
Notwithstanding working together to represent trainees regarding the examination issues faced earlier this year, our links with our interstate counterparts have allowed learning from one another about tackling local training issues including flexible training pathways and planning of individual training.
More recently, the committee provided input into the proposed RACP Basic Training Curricula Renewal and has been working towards a proposal for a local Fellowship ceremony.
Co-Chair, SA Trainees' Committee
Advanced Trainee workshop
Trainees who attended this workshop on 18 September were given access to information on:
- financial planning by Macquarie Bank
- undertaking research by Professor Michael Horowitz (pictured)
- balancing public and private work by Dr Rabin Bhandari
- tips and tricks on getting through Advanced Training provided by Paediatric Fellow Dr Sally Kellett and General Medicine Fellow Dr Gregory Dubuc.
The evening came to a close with meditation teacher Amanda Goodfellow providing easy and quick relaxation techniques for trainees to incorporate into their daily routine.
SA Trainee Research workshop
Dr Katy Gibb and Adelaide University Research Fellow Clara Pham delivered an engaging research workshop for trainees on 16 October in the RACP Adelaide office.
Twenty trainees attended and left equipped with the tools and skills needed to develop a research proposal. The workshop was fun and interactive, with participants using practical skills to develop their research questions.
Health Benefits of Good Work
The RACP and the Australasian Faculty of Occupational and Environmental Medicine (AFOEM), support an initiative called the Health Benefits of Good Work (HBGW).
The mission of the HBGW is to improve the health of individuals, businesses, organisations and communities through good work. Good work promotes a culture of co-operation and psychological safety, and not just the control of workplace hazards and implementation of safe systems of work.
Over 200 organisations and businesses have become Signatories to the Consensus Statement on the Health Benefits of Good Work and proudly display the Charter of Principles in their organisations.
More information and resources on the HBGW are on the RACP website, including a list of all current Signatories. There is no cost to becoming a Signatory apart from a commitment to implement the principles of this initiative in your organisation.
What 'Good Work' is
'Good Work' is work that is engaging, fair, respectful and balances job demands, autonomy and job security. It is mindful of culture and traditional beliefs and is characterised by safe and healthy work practices. It achieves a balance between the interests of individuals, employers and society.
How you can achieve good work
You need to be aware of the factors that contribute to good work. This knowledge must then be translated into meaningful action, involving an effective change management process, including development of clear and realistic performance indicators. Work should be matched to individuals using transparent productivity metrics. This requires a commitment in thought and practice, with collaboration between many stakeholders including workers, governments, employers, unions, insurers, legal practitioners, advocacy groups and healthcare professionals.
Why it's important for your organisation to have good work
Work related stress claims have increased dramatically over the last decade and are contributing greatly to the cost of workers compensation and workers compensation premiums. Many cases of work related stress can be attributed to lack of support and interpersonal conflict. The importance of mutual respect and appreciation of all workers is now considered fundamental for good workplace relationships.
Studies have shown that 'good work' is a key determinant of the health and wellbeing not only of workers, but also has a positive impact on their families and the broader community. It helps to foster a healthy workplace culture and is aligned with effective and equitable injury management programs. Positive relationships within the workplace not only contribute to individual health, wellbeing and engagement but also productivity.
Long term absence from work, work disability and unemployment may have a negative impact on health and wellbeing that has more far reaching implications for families and society, not just the affected worker and may also impact the employer.
Avoiding such problems by implementing good work principles can positively affect the bottom line for employers. 'Good Work' can make everyone a winner.
Joint Annual Scientific Meeting
The Australian Atherosclerosis Society, the Australian Vascular Biology Society and the High Blood Pressure Research Council of Australia are combining to present a joint Annual Scientific Meeting.
It is being held in Adelaide at Glenelg from Tuesday, 27 November to Friday, 30 November.
Additionally, there is a satellite Clinical Symposium being held on the evening of Wednesday, 28 November, which may be of interest to clinicians, irrespective of whether they are attending the scientific meeting.
Visit the event website for registration information and further details.
Explore discounted dining and attraction offers near you
To save on dining, leisure activities and entertainment benefits, use the benefits map on your RACP benefits website. Once you are logged in, simply click “Benefits Near Me” to bring up a range of offers and venues available around your location.
Traveling somewhere? Move the map to your destination to discover the local offers. Then click on Redeem to access your discounts on the chosen benefits or to bring up the digital benefits card and apply your discount when you are at the venue.
For more information, visit your RACP Member Advantage website or call 1300 853 352.
*Terms and conditions apply.