North East Valley DGP eNews

No 0838: November 6, 2008
eNews is a weekly electronic newsletter sent to all GP practices (with email addresses) within the NEV catchment. The aim is to provide up to date information relevant to GPs and to disseminate the latest activities and resources from the division. All feedback and enquiries welcome and should be addressed to Patty Marshall. You can also visit our website at: http://www.nevdgp.org.au/.
To subscribe to eNews click on subscribe. To be removed from the eNews distribution list click on Unsubscribe

 

In this issue:

Chronic Disease Management      Latent Autoimmune Diabetes of Adulthood, Is Life! a Lifestyle Modification Program?

Professional Development           CPD events         

HMR                                                Increase in HMR

Immunisation                                 Immunisation scenario, Flu vaccine orders – 2009, Varicella-zoster (Chickenpox)

Information Management            RVEEH referral form MD template, General Computer Tip, Medical Director Tips and New on the Web

Items of interest                            Advice on X-rays, Eating disorder webcasts for GPs, Audiology workshops, Occupational violence in general practice, GP Network News 

Mental Health                                BOiMH 2008-09 Guidelines, Review of the Mental Health Act

News for Practice Staff                 Practice Managers final meeting for 2008, Final end of year session for Practice Nurses, Nursing in General Practice Forum       

NPS                                                 Last audit open for enrolment, Now visiting on type 2 diabetes

Positions vacant/wanted                

Fun stuff                                            

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Chronic Disease Management

Latent Autoimmune Diabetes of Adulthood (LADA)

Dr Spiros Fourlanos, Endocrinologist and Researcher, Walter and Eliza Hall Institute for Medical Research Melbourne recently spoke to Norman Swan of the ABC Health Report, on Latent Autoimmune Diabetes of Adulthood (LADA). The transcript can be found at http://www.abc.net.au/rn/healthreport/stories/2008/2399254.htm

 

Is Life! a Lifestyle Modification Program?

The Life! Taking Action on Diabetes Program has been accredited as a Lifestyle Modification Program. This now means that patients aged 40 and above, identified at high risk of type 2 diabetes using the AUSDRISK tool, and who don’t already have diabetes can be referred to a Life! course. For more information & referral click here.

 

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CPD

Term 4 GP Lecture Program

Meetings are held each Tuesday starting at 12.30 in the Lecture Theatre, Ground Floor, Pathology Building, Repatriation Hospital, Austin Health, West Heidelberg. Lunch is provided. Course Leader: Dr Vin Nursey Phone: 9457 1736

November 11 - Immunisation Update - Dr Peter Eizenberg

For full term Tuesday lecture program click here

 

GP symposium

Mitcham Private Hospital invite you to their last GP symposium for 2008 - "Breaking Down" ..an interactive discussion, looking at eye examination in the older patient, fatty liver disease and PSA and the prostate. Tuesday 11 November, 7pm At Beau Monde International, 934 Doncaster Road, Doncaster

Contact Anne Moutsos on 0420 895 910 (QA & CPD 2 points/per hour, unless part of Internal Affairs ALM)

 

STIs in Men

The Burnet Institute will be hosting a 2-hour education session for GPs and practice nurses on STIs in men on 25 November 2008 (see flyer attached). Case studies will be examined and presenters include Dr Louise Owen, Clinical Director, The Centre Clinic, Ms Anne Mitchell, The Australian Research Centre in Sex, Health and Society, and Associate Professor Margaret Hellard and Dr Mark Stoove, The Burnet Institute.

Tuesday, November 25th, 7pm – 9.30pm. At The Burnet Institute, 85 Commercial Rd, Melbourne. Dinner provided. Points: 4 RACGP Category Two points

For further information please call Rebecca Jenkinson on (03) 8506 2311.

 

GP Symposium in Ophthalmolgy

The Royal Australian and New Zealand College of Ophthalmologists invite GPs to attend and participate in a half day symposium on Ophthalmology. The program is intended to highlight developments in the diagnosis and treatment of important ophthalmic disorders encountered in general practice. Emphasis will be given to the role of the general practitioner in the care of patients with these conditions. Five speakers have been invited to participate at the symposium. The format of the symposium will allow ample time for questions and discussion to the topics raised. Registration is free of charge. Registrants are invited to a buffet lunch before the meeting (from 12.30pm) provided courtesy of Alcon Australia.

Wednesday 26 November. 1:30pm - 4:40pm. At Melbourne Convention Centre, Cnr Flinders & Spencer Streets. (Bellarine 5 Room).

Please register with Meredith Damon, Alcon Australia by fax: (02) 9453 7886, email meredith.damon@alconlabs.com or online: www.amlink.com.au/secure/eilite/RANZCO2008.htm .

 

Minor Surgery for GPs

Two-day workshop on Saturday and Sunday, 29 & 30 November. At Skills Laboratory, Level 1 East Wing Skills & Education Centre, Royal Australasian College of Surgeons. Cost: $990.

For enquiries, and to obtain a registration form, contact Dr David Lawrence, Skills Laboratory Manager, Royal Australasian College of Surgeons, on 9276 7455.

 

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HMR

Increase in HMR

Please note increase in HMR (Item 900) for GPs to $140.20 and $96.00 for RMMRs (Item 903)

 

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Immunisation

Immunisation scenario

A 21 yearold women comes into your clinic for her 2nd Gardasil vaccine. Her first Gardasil vaccine was given 12 months ago. Should you start the course again?

No, you do not recommence the course! Give the 2nd dose, then observe the recommended interval of four months for the 3rd and final dose.

Note: In exceptional circumstances, such as overseas travel, the interval may be reduced to three months at the absolute minimum.

 

New - Flu vaccine orders - 2009

The older persons free influenza (flu) and Pneumovax23® vaccination program will commence on 1 March 2009. A new system will be introduced in 2009 in an effort to ensure all clinics will have some flu vaccine for the start of the program. In 2009 each clinic will receive a proportion of flu vaccine related to their previous two year’s initial orders. The new system will strive to be more equitable so that no clinic will miss out on flu vaccines from early March. After the delivery of the initial flu vaccine, a clinic can place further flu vaccine orders to meet their usual requirements using the standard vaccine order form.

Please note: No flu vaccine orders will be accepted prior to March 2009. Pneumovax23® vaccine will also be proportioned for the initial delivery.

 

Varicella-zoster (Chickenpox)

NCIRS has updated their fact sheet titled "Varicella-zoster (chickenpox) vaccines for Australian children". This fact sheet is now available from the NCIRS web site. NCIRS hopes that providers will find this fact sheet useful. This is timely given that all GPs in Victoria are currently being sent a letter from the Communicable Disease Prevention & Control unit of DHS regarding the Health (Infectious Diseases) (Amendment) Regulations 2008. Among the amendments to the regulations, varicella-zoster virus infection (chickenpox and herpes zoster) is now listed as a Group B notifiable disease. (GPs are required to notify cases of infectious diseases within Victoria.)

Further information on what and how to notify can be found on the IDEAS (Infectious Diseases Epidemiology and Surveillance) website

 

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Information Management

Royal Victorian Eye and Ear Hospital referral form MD template.

Apologies to those practices and GPs who had problems with the Royal Victorian Eye and Ear Hospital referral form MD template.  The glitch has been fixed and the template is now working. It can be found at http://www.eyeandear.org.au/healthprofs/gpinfo.asp. Just a reminder, when downloading the template, do not open it in word prior to saving it, as this will cause it to lose its links.  For more information please contact Dr Lina Nido, GP Liaison Officer, RVEEH by email at lina.nido@eyeandear.org.au or phone (Tuesdays and Thursdays) 9929 8187.

 

General Computer Tip - Organising Favorites in Internet Explorer

Once you start bookmarking web site your list of favorites can grow. You need to organise your favorites into folders.

1.   From the Favorites menu select Organise Favorites

2.   Click on the New Folder button of the Organize Favorites window.

3.   Rename the folder from New Folder to e.g. Medical sites.

4.   Drag any previously saved Medical sites into the folder.

 

Medical Director Tip - Forcing Reason for Contact

It is particularly important to record the “Reason for contact” for every contact with a patient. This can be enforced so that you can’t close a patient record until a reason for contact is selected.

·        MD2 – No patient record open >Tools >Options >Clinical tab – check the Enforce reason for contact box. Save

·        MD3 - No patient record open >Tools >Options >Clinical tab – check the Show Reason for Contact box. Save

If you only view a patient record (no notes or measurements recorded) you don’t get the prompt – this is a good thing!

 

This weeks IM problem - Adjusting addresses for window envelopes

Question: There is a template in MD which needs some adjusting.  The margins were set too close to the left hand side of the page, making it a pain to fold so the address appeared in a window envelope.  One of our receptionists managed to move the majority of the text further to the right, but the suburb line refuses to budge.  Any hints?

Answer: Highlight the name and address lines. On the ruler move your left margin a few centimetres to the right - place the pointer on the bottom of the two triangles, hold down the mouse key and drag the 2 triangles to the right. This will change the margin settings only for the name and address lines.

 

New on the Web

1.      Collabratives - using PEN Clinical Audit Tool to complete your CHD and Diabetes Baseline Report. Found under Clinical Audit Tool - Other documents

2.      Is Life! a Lifestyle Modification Program? - The Life! Taking Action on Diabetes Program has been accredited as a Lifestyle Modification Program. Found under Diabetes Resources

3.         The last NPS/QUM clinical audit available for the QPI year: 1 May 2008 - 30 April 2009 titled ‘Optimising management of type-2 diabetes’ is now open for enrolment. Found under Program Support

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Items of Interest

Advice on X-rays - from MDA National Insurance P/L

Usually patients are handed back their films with advice that they should keep them in a safe place in case they are needed for comparison in the future. The reason for this is that in fact the films are owned by the patient, not by the doctor or by the radiology department, except perhaps in the case of a public patient. Therefore a doctor should NOT destroy X-rays, scans etc and they should NOT be "sent back" to radiology for destruction unless the ramifications of doing so is discussed with the patient and the patient gives agreement in writing that he/she agrees to that course of action.

The dilemma is when the patient cannot be found. In that circumstance the time for keeping before destruction is the same as for other records, currently for adults 10 years since the last consultation and for children 25 years (or 7 years after the child reaches the age of majority).

 

Eating disorder webcasts for GPs

The first Medical Update Focus on the topic of Eating Disorders has just launched. The presentations were filmed live at the Centre for Eating and Dieting Disorders’ breakfast meetings held at RPA Hospital, Sydney and are now available “on demand” and free of charge to all doctors throughout Australia. The specific topics covered are: The Neurobiology of Eating disorders - Dr Sloane Madden; Eating Disorders: What can we Learn from Longitudinal Data? - Dr Debbie Franko; Decreasing Risk Factors for Eating Disorders - Dr Debbie Franko; Evidence into Practice - Prof. Philipa Hay; Physiotherapy and Body Orientated Therapies for the Management of Eating Disorders - Felicity Spencer; What can we Learn about Eating Disorders from the Arts - Melinda Hutchings, Alana Ruben Free & Margaret Sheridan. All available here.

Medicalupdate.com.au attends educational meetings all over Australia on behalf of GPs everywhere. They film and webcast presentations including PowerPoint slides from some of Australia's leading clinicians. You get to stay up to date, without physically attending the meeting (and so save hours of your time).

 

Audiology workshops 

The University of Melbourne is currently developing Audiology workshops for medical and allied health professionals. In order for them to provide short courses relevant to your needs and interests we ask for your feedback. Please click here to complete survey.

Audiological Society of Australia, Suite 7, 476 Canterbury Road, Forest Hill. Email:  asaadmin@audiology.asn.au Website: www.audiology.asn.au Tel: 9416 4606

 

Occupational violence in general practice
Occupational violence is a concern for General Practitioners, who report experiencing violence at work, or concerns about their safety and security. A kit has been developed by the Dandenong Casey General Practice Association and funded by WorkSafe. The kit provides people working in general practices with a set of tools to help them improve the safety and security of their workplace. Everyone working in general practices, including GPs and practice managers as well as receptionists, practice nurses, allied health professionals can use the tools in this kit. This resource may be downloaded from the Dandenong Casey General Practice Association website

 

GP Network News

The latest edition can be found here.

 

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Mental Health

BOiMH 2008-09 Guidelines

DoHa have released the: 2008-2009 guidelines for the Access to Allied Psychological Services Component of The Better Outcomes iIn Mental Health Care Program. Take note that under Better Outcomes (i.e. our voucher system which purchases access to no-cost counselling for your patients) you are now able to request 6 sessions initially, six sessions via a review and a further six sessions in the case of exceptional circumstances. That means you can request up to 18 sessions in one year.

The guidelines state: “In addition, the referring practitioner may consider that in exceptional circumstances the patient may require an additional six individual focussed psychological strategies above those already provided (up to a maximum total of 18 individual services per patient per calendar year). Exceptional circumstances are defined as a significant change in the patient's clinical condition or care circumstances which make it appropriate and necessary to increase the maximum number of services. It is up to the referring practitioner to determine that the patient meets these requirements. In these cases a new referral should be provided, and exceptional circumstances noted in that referral.”

For further information please contact Nicky at the Division 9496 4333

 

Review of the Mental Health Act

GPV invites interested GPs to participate in a consultation on the review of the Mental Health Act 1986 on the 16th December at GPV, 1/458 Swanston Street, Carlton. The review will look at the Act’s determination of involuntary admission to Mental Health services, the value of Community Treatment Orders, the role of the Mental Health Review Tribunal, consumer, carer and family rights, and related issues. It is anticipated the new Chair of the Independent Community Consultation Panel will attend, accompanied by staff from the Review team.  GPV is particularly interested to hear from GPs who work with patients with psychoses in their general practice populations. A final submission to the Review will be prepared by GPV in February 2009. Please let Anne know by email on a.diamond@gpv.org.au  or fax 9341 5299.

 

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News for Practice Staff

Practice Managers final meeting for 2008

Put in your diary now - the final meeting for this year will be on Thursday 4th December - NOT 27 November as previously mentioned. More details in the next eNews.

 

Final end of year session for Practice Nurses

Tuesday November 18,   6.30 – 9pm (dinner provided) - Work/Life Balance – Looking after yourself. This workshop will include ideas on how to rejuvenate and help you to consider the importance of your own health and well-being. Guest speaker: Del Lovett, RN, Practice Nurse Leader. At John Scott Meeting House Latrobe University. Contact Janina on 9496 4333 [Application Form]

 

Nursing in General Practice Forum

Registrations are now open - 2009 National Divisions third Nursing in General Practice Forum will be held at The Sebel Albert Park, Melbourne on Wednesday 4 March and Thursday 5 March 2009.  To register online click here. For more information on registration, travel rules and a draft program click here.

 

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NPS

Last audit open for enrolment

The last NPS/QUM clinical audit available for the QPI year: 1 May 2008 - 30 April 2009 titled ‘Optimising management of type-2 diabetes’ is now open for enrolment. You can enrol online on the NPS website or you may download an audit form here.  Audit enrolment closes on Friday January 9th 2009. Note: 1/ this is an electronic audit only & 2/ completed audits must be received by the NPS by 30th April 2009 for the current QPI Cycle.

 

Now visiting on type 2 diabetes (program ends December 2008)

The ‘Early use of insulin & oral antidiabetic drugs’ in type 2 diabetes’ program provides an opportunity to discuss up-to-date, independent, evidence-based information on insulin initiation, particularly in combination with oral therapy; strategies to overcome patient barriers to insulin use; the importance of continued lifestyle interventions in slowing or preventing disease and looks at recent glitazone safety updates.

Benefits include: 1/ a personal update with an NPS Facilitator at a time/place convenient to you - practice visit approx 30 - 40 minutes duration. 2/ a small group interactive case study discussion with your peers: case study meeting approx 50 - 60 minute duration (min of 3 GPs) & 3/ RACGP QA & CPD category 2 points (total 2 points) & QPI PIP credit

To order visits contact Dr Mary Levidiotis (mary@nevdgp.org.au) or Ms Melanie Hay (melanie.hay@nevdgp.org.au).

 

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Positions vacant/wanted

Please note: only new ads, paid ads or resubmitted ads will be posted here. All other ads can be found on the website

 

Positions vacant

Doctors

Bundoora - VR GP assistant required for established 25 year old practice.  F/T or P/T W/WO view.  Mixed billing.  Relocation incentive available.  Start Jan/Feb 2009. Phone Dr Ken Dickinson on 03 9467 5433

 

Ivanhoe Medical Clinic - sessions for PT or FT VR GP. Modern, large group with supportive colleagues and full time nurses, computerised, CDMs, mixed billing, flexible, friendly, no A/H, good remuneration. Contact Dr.Stephen Smith or Dr.David Doig on 03 9499 1245.

Practice Staff

Northcote area Part time Div 1 Practice Nurse required to assist our medical staff in a busy general practice. Duties include wound care, travel health, immunisatons, health assessments, patient triage and all other duties required in a general practice. Commencement date can be negotiable. Visit our website www.doctorsofnorthcote.com for more information or call Diane Cronin 03 9481 1214. To apply forward your resume to manager@doctorsofnorthcote.com

 

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Humour

Financial Planning

Dan was a single guy living at home with his father and working in the family business.

When he found out he was going to inherit a fortune when his sickly father died, he decided he needed a wife with which to share his fortune.

One evening at an investment meeting he spotted the most beautiful woman he had ever seen.

Her natural beauty took his breath away. "I may look like just an ordinary man," he said to her, but in just a few years, my father will die, and I'll inherit $20 million."

Impressed, the woman obtained his business card and three days later, she became his stepmother. 

 

......Women are so much better at financial planning than men.

 

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And remember……

 

            ….. change is inevitable – except from the Coke Machine.