North East Valley DGP eNews

No 0910: April 2, 2009
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      Cardiovascular Outcomes Studies in Type 2 Diabetes  

Professional Development           CPD events         

Information Management            includes General Computer Tip, Medical Director Tips and New on the Web

Items of interest                            The Adamant Swimmers, Accreditation, GP Network News, BECC waiting times   

News for Practice Staff                 Workshop for Practice Nurses, Understanding the PIP eHealth Initiative        

Paediatrics                                     Latest RCH Paediatric Handbook           

Positions vacant/wanted                

Fun stuff                                            

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Chronic Disease Management

Cardiovascular Outcomes Studies in Type 2 Diabetes – what have we learned? 

from Dr Neale Cohen, General Manager, Diabetes Services, Baker IDI
In the last twelve months a number of cardiovascular outcome studies have been completed in patients with type 2 diabetes. These studies were all primarily designed to assess the cardiovascular benefits of intensive glycaemic control in type 2 diabetes. Rather than answer this definitively, these studies have raised further questions about the benefits of tight glycaemic control. The three cardio vascular outcome studies that were completed in 2008 were the ACCORD, ADVANCE and VADT trials. To add to these three trials the ten year follow-up of the UKPDS Study was recently published. Although the benefits of tight glycaemic control are undeniable for microvascular disease, these latest studies provide an uncertain picture for cardiovascular outcomes. The main message appears to be that the effect of tight glycaemic control for very long term cardiovascular outcomes looks promising, however shorter term benefits (i.e. five years or less) look doubtful. Caution should therefore be used for lowering glucose aggressively particularly in the older age groups and more attention should be focused on aggressive treatment of other cardiovascular risk factors.

 

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CPD

Bushfire Recovery Update - An essential evening for those with patients and families affected by the bushfire

TONIGHT - Thursday 2nd April 7.15-9.15pm (meal from 6.45) at John Scott Meeting House, La Trobe University.

The Bushfire response is moving from relief to recovery and the needs and demands of the community are changing. There is significant state and federal funding being provided for services. What is emerging is the need for GPs, Practice Staff and Allied Health Providers to be aware of the systems that are being put in place. This interdisciplinary evening will enable you to get the big picture of bushfire recovery along with specific training in assessment, referral needs, and your role of support and holding strategies with people affected by the bushfires. For further information and registration see flyer or contact Alison on 9496 4333.

 

Understanding the PIP eHealth Initiative - All you wanted to know but were too afraid to ask

An invitation to Practice Managers & their General Practitioner Principals on Thursday 23rd April, 6:30pm – 9.00pm (Dinner Provided) at John Scott Meeting House. La Trobe University. See flyer for more information and registration.

 

Term 1 GP Lecture Program

There will be no lecture for the next 2 weeks.

 

Austin Health - Division of Medicine Grand Round

“What’s a NICE SUGAR IN ICU?” – Speaker: Professor Rinaldo Bellomo, Intensive Care Unit.

Wednesday 8th April, 12:10pm at John Lindell Lecture Theatre, Level 4, Lance Townsend Building, Opposite Medical Library - followed by lunch in Zeltner Hall at 1:00pm

 

St Vincent’s Rheumatology: Hands-on Workshop in steroid joint injection.

Saturday 9th May 9.30am – 12.30pm Learn “who to inject and how to do it” using realistic joint models of shoulder, knee elbow and wrist in small groups of 5 GPs per instructor.

Workshop leader: Dr Keith Lim, Rheumatologist at St Vincent’s. Cost: $30. Maximum of 30 GP participants. RACGP QA&CPD points applied for.

For further information and registration see course flyer

 

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Information Management

General Computer Tip - Adding a hyperlink to a document or email

Sometimes you wan to add a hyperlink in a document that takes you to a webpage or to a document.

1.   In Word type “Click here”.

2.   Open up your web browser and find the webpage or document to which you wish to link.

3.   Copy the web address (URL) – highlight address and then Control + C (to copy)

4.   Return to your document and highlight the word “here”.

5.   From the Insert menu select Hyperlink…

6.   With the cursor flashing in the Address: box, press Control + V to paste in the web address (URL). Then click OK.

7.   Your link will now appear as “Click here”, i.e. it is a hyperlink.

 

Medical Director Tip - Database search – finding patients using PPIs with clopidogrel

“Doctors are being urged to re-evaluate the use of proton pump inhibiters (PPIs) in patients taking clopidogrel (Plavix/Iscover)...” - Australian Doctor, 6 Feb. 2009

With the above alert in mind you may wish to do a search to find those patients are using both PPIs and clopidogrel.

1.   No patient record open

      MD2 – from the Search menu select Database

MD3 – from the Search menu select Patient...

2.   Currently taking drug: Select  Clopidogrel and then press the Add to search criteria button

      Currently taking drug from class: type in PROTO and double click on Proton Pump Inhibiters

3.   Click on the Search button and the list of patients will appear.

4.   Click on the Print button and from the printed list you may wish to work out a strategy to review these patients – letter, phone call, add to action list.

(Thanks to Dr Chris Clifopoulos for this suggestion)

 

This weeks IM problem - Recording medications prescribed by a specialist

Question: How do I record those medications that are prescribed by a specialist?

Answer: Prescribe as normal but when you get to the Enter Dose window, click on the Advised or prescribed elsewhere button. Once you complete the script. the medication will not be tagged for printing.

 

New on the Web

1.    Analysing Near Misses - a “near miss” is an event that could have had adverse consequences. A This Guide is available for RACGP members only – Found under Practice Managers – Useful Links

2.   Pandemic Flu Kit – a free resource as suggested at the Triage PD session for practice staff (March 2009). Found under Immunisation – Resources

3.   Monthly Infection Control Newsletter for Primary Health Care - the newsletter by Marg Jennings was originally for GP practices but now addresses both general and specific infection control issues for primary health. Found under Accreditation – Useful Links

 

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Items of Interest

The Adamant Swimmers

On Saturday 21 February four intrepid colleagues competed in the Rottnest Channel Swim, a 19.7km relay swim from Cottesloe Beach to Thomson Bay, Rottnest Island in Western Australia. The Adamant Swimmers team comprised NEVDGP members Dr Jim Lynch and Dr Ian Wallis, together with Prof Clive Fraser and Colin Brodie. The team placed 12th in the men's 200+ years age group and an impressive 240th out of 700 teams.

After months of training, dieting and planning, the boys made the journey to Perth several days before the race to acclimatise and meet their support crew. Each of the 700 teams was supported by a power boat and skipper, making for a very busy stretch of water following the 7.30am start. A wetsuit-free event, the team had only their Speedos for warmth and buoyancy. Rumour has it they now have their eye on a warmer water event in Fiji later this year.

They completed the channel crossing in 7 hours and 29 minutes.

 

Accreditation

GPA Accreditation plus (GPA) is seeking metropolitan and rural based GPs to join its GP surveyor team to undertake visits to medical practices looking to achieve accreditation.

Applications can be obtained by calling GPA on 1800 188 088 or visiting www.gpa.net.au

 

GP Network News

This week’s edition includes: Government must keep its health promises to Australians, Senate inquiry into compliance audits on Medicare benefits, Proposed national registration and accreditation scheme referred to Senate inquiry, Trial of point of care testing in general practice, Website for personal resilience, New primary healthcare website.

 

BECC waiting times

Waiting times for new referrals to Bundoora Extended Care Centre Inpatient Admissions are currently approximately Gem 0 - 2 days, Rehab 0 - 2 days as of Monday 30 March. Any queries regarding our waiting times please contact Access BECC on 9495 3109

 

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News for Practice Staff

Workshop for Practice Nurses - making $ and sense of the MBS

Tuesday 28th April 09, 6.30pm to 8.30pm (6.15 registration) at John Scott Meeting House, La Trobe University. Presenters – Judy Evans and Lynne Walker from walkerevans consulting. This interactive workshop is designed to give practice nurses an understanding of the MBS and its role in general practice.  In order to support the business of general practice, nurses will develop an appreciation for the MBS, its implications for nursing care, nursing education and nurse’s individual scope of practice. Knowledge of criteria and its application to individual nursing services will help practice nurses apply the process necessary for successful use of current and future item numbers.

For further information and registration see flyer.

 

Understanding the PIP eHealth Initiative

See under CPD

 

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Paediatrics

Latest RCH Paediatric Handbook

The RCH is delighted to announce publication of the 8th edition of the RCH Paediatric Handbook, popular with GPs, paediatricians and other healthcare professionals across Australia and around the world.  The handbook is available in all good medical bookshops including at the RCH, by mail-order or online.  Profits fund scholarships for junior medical staff interested in paediatrics and further study abroad.

·        More information & online supplement

·        RCH Order form (word doc)

·        RCH bookshop - comprehensive list of all RCH publications and much more.

 

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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

Northcote – F/t P/T VR GP or Subsequent Trainee GP position. Fully accredited, computerised, long established doctor owned practice in a new purpose built facility with a fabulous work environment. Ancillary Health , Pharmacy and Pathology  services on site. Inquiries Diane Cronin (Practice Manager) 9481 1214. Visit our website www.doctorsofnorthcote.com

 

Thornbury - We are seeking a dedicated VR GP to join our team at our busy accredited, computerised and long established family medical practice.  Friendly and professional working environment, dedicated staff and excellent nurse support.  For enquiries, please contact Rose on 9484 2007 or email dundasdr@bigpond.net.au

Practice Staff

Ivanhoe - Registered Nurse Division 2: Medication endorsed. Full-time part-time negotiable, with current drivers license. A wide range of stimulating clinical duties assisting our Div 1 nurses, including triage, immunisation, health assessments, chronic disease management, assisting with minor surgical procedures and other duties. Send details of experience and reference to: Mary Howe, Practice Manager, ‘Doctors of Ivanhoe’ - Email: maryh@dr131.com.au

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Humour

The Accident
A woman named Jill stood up at her church's Testimony Meeting, or as some churches call it "Cry Sunday", one Sunday morning, took the microphone from one of the church ushers, and bared her soul to the enrapt congregation:
"I want to tell you about the awful accident that my husband, Jim, has suffered this past month. He was riding his Harley, lost control, ran off the highway and hit a tree. He was rushed to the hospital, and could have died, but thank the Lord, all he suffered was a broken scrotum."
The congregation gasped in horror. The men in the congregation were obviously uneasy and writhed in their seats.

"Jim has been in terrible pain all month since the accident. He has trouble breathing. He has trouble swallowing his food. He can hardly lift anything, he's in so much pain, and he has missed work because of it. He can't lift our children up to hold them and give them the personal love that they need. Worst of all, we can no longer cuddle and have intimate relations. He is in constant pain. I would like to ask you all in the congregation to pray for Jim, and pray for us, that his broken scrotum will soon heal and be as good as new. A dull murmur erupted within the congregation as the full impact of this terrible accident sank in, and the men in the congregation were visibly shaken up with the thought that, "There but for the grace of God go I."
Then, as the murmuring settled down, a lone figure stood up in midst of the congregation, worked his way up to the pulpit, obviously in pain, adjusted the microphone to his liking, then leaned over and said to the congregation:
"My name is Jim, and I have only one word for my wife, Jill. That word is: sternum."

 

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And remember

 

            …nothing is foolproof to a sufficiently talented fool.