ePulse V12 number 08

Tuesday 9 February 2010

News

•   Auckland Community Laboratory Testing – Feedback from the College’s Surveys 
•   RNZCGP Quality Symposium 2010 opens Friday
•   RNZCGP congratulates Dr John Adams
•   Prioritisation Meeting
•   Medsafe withdraws dextropropoxyphene-containing medicines Capadex and Paradex
•   GPEP OWL takes flight
•   Quality Improvements to Antenatal Screening for Down Syndrome and Other Conditions
•   Research Dosh
•   MMR-Autism Link Disproved
•   Senior Drivers Forum
•   Journal Watch  

Consultation

•   Day surgery definition
•   Regulation of Health professions: MOH discussion document
•   Aiming for Excellence: Fourth Edition
•   Access to high-cost, highly-specialised medicines in New Zealand
•   PHARMAC altering funding and access arrangements for special foods
•   PHARMAC (2 further consultations)
•   Opioid Substitution Treatment; draft service specifications
•   ACC: Revised Clinical Guideline Recommendations for MRI use in diagnosing soft tissue knee injuries
•   Consultation on the competencies and standards for education programmes for the revised enrolled nurse scope of practice

Representation

Vacancies and advertisements

CME

Conferences

 

News

Auckland Community Laboratory Testing – Feedback from the College’s Surveys
A paper by Associate Professor Susan Dovey providing a report on results from three member surveys late last year is available now on the College website. “I would like to once again congratulate Auckland GPs on their work to ensure high quality care to their patients has been maintained throughout a very difficult period of change,” said College President Dr Harry Pert. “GPs who took the time to respond to the College’s surveys can be assured that their views have been heard.”

RNZCGP Quality Symposium 2010 opens Friday
The RNZCGP Quality Symposium in Wellington 12-13 February opens Friday! The Symposium has been endorsed by RNZCGP and approved for up to 15 hours (= 15 credits) CME for General Practice Education Programme Stage 2 (formerly AVE) and MOPS purposes. The College of Practice Nurses have also approved the Symposium for 15 hours of CNE points. 

RNZCGP congratulates Dr John Adams
RNZCGP congratulates Dr John Adams on his election as the new chairperson of the Medical Council of New Zealand. Dr Adams, a psychiatrist, has been Dean of the Dunedin School of Medicine since 2003. “We look forward to working with Dr Adams,” RNZCGP Chief Executive Karen Thomas said.

Prioritisation Meeting
The Ministry of Health is holding a GP liason meeting on the 19th of March in Wellington. It’s a chance for primary care representatives to be involved re prioritising access to secondary care advice and diagnostic services such as colonoscopy and echocardiograms. Register your interest at policy@rnzcgp.org.nz.

Medsafe withdraws dextropropoxyphene-containing medicines Capadex and Paradex
Follows a safety/efficacy review, Medsafe have announced that all dextropropoxyphene-containing medicines (Paradex, Capadex) are to be withdrawn from the New Zealand market. The withdrawal will not be immediate, so as to allow time for patients to be transferred to alternative medicines. Prescribers are asked to not start any new patients on Paradex or Capadex, and to review at the earliest opportunity the analgesic requirements of those patients currently prescribed them. The Medicines Adverse Reactions Committee (MARC) concluded there is evidence that overall the risks of these medicines exceed their benefits: These medicines have the potential to cause more adverse reactions than similarly effective paracetamol used at recommended doses; these medicines are more dangerous than other simple analgesics in overdose, particularly when combined with alcohol; deaths related to dextropropoxyphene overdose have occurred within one hour of ingestion and before medical intervention could be obtained; and prescribing restrictions introduced in 2006 have failed. A public media statement released today advises patients currently being treated with Paradex or Capadex to continue to take their medicines, and to see their GP at the next opportunity to discuss alternative treatment options. More information is available on the Medsafe website at: http://www.medsafe.govt.nz/hot/MediaContents.asp.

GPEP OWL takes flight
On Friday 12th February the Royal New Zealand College of General Practitioners will launch OWL for GPEP1 2010. OWL is the Online Web Learning site for the general practice vocational training pathway we operate. OWL is being developed for Registrars and their Educators involved in GPEP1 for 2010.  By the end of the year it is envisaged that it will also be a learning tool for those moving into GPEP2.  And in time for all College members undertaking professional development.GPEP1 Registrars and their Educators will have access to all programme, curriculum and seminar details, and the resources required to complete their learning. OWL will have interactive components and will enable all users to participate in forums and surveys regionally and nationally. We look forward to delivering GPEP1 through OWL. Contact sue.domanski@rnzcgp.org.nz for more information.

Quality Improvements to Antenatal Screening for Down Syndrome and Other Conditions
From 8 February 2010 the two screening options are: First Trimester Combined Screening (blood test 9 -136/7 plus NT scan 11 - 136/7); Second Trimester Maternal Serum Screening (blood test 14 -20 weeks). Resources to support the offer of screening are: guidelines for maternity care providers with a laminated summary sheet; three new consumer resources with an additional resource for those women who have an increased risk result; five online education modules (approved for two hours per module); and new pre-carbonated combined/maternal serum screening laboratory form. For more information please go to www.nsu.govt.nz.

Research Dosh
The RNZCGP’s Research and Education Charitable Trust is inviting applications for research and travel grants. Please complete the application forms and either post them to the College or email it to pam.berry@rnzcgp.org.nz. The forms are available here: http://www.rnzcgp.org.nz/Research-Applications-2.

MMR-Autism Link Disproved
“'Final chapter in the MMR-autism scandal' reads the headline over Peter Griffin's summary of the devastating ruling by Britain's General medical Council against Dr Andrew Wakefield and his colleagues,” writes Russell Brown. More here: http://publicaddress.net/6444#post6444.

Senior Drivers Forum
AA Driver Education Foundation (AADEF) is hosting a seminar at Newlands Community Centre 1 - 2 March 2010 to discuss senior driver issues and ways they can be addressed. The aim is clear and low-cost information, professional assessment, and coaching available to senior drivers. A leading older driver expert from USA, Elin Schold Davis, will attend.  Members of the College interested in attending can contact heather.watt@rnzcgp.org.nz.

Journal Watch
• Partner's social position an important determinant of risk of death

• Real patients and simulated patients beneficial in undergraduate medical education

• Individuals who self-harm have a high risk of repetition

• Many heart transplant patients develop numerous skin cancers

 

Consultation

Thank you to those members who found time to provide comment on the issues in the previous edition of ePulse.

Day surgery definition
The Ministry of Health is consulting on a proposed definition of day surgery that can be used for regulatory purposes.  This will affect general practices and GPs that provide day surgical procedures outside of hospital settings. They want a definition that will include high risk procedures while avoiding inadvertent inclusion of low risk procedures. An expert working group, which had Dr Hans Raetz as our representative, came up with the following proposed definitions: 1.Day surgery is the same day admission and discharge of a consumer to a facility or service for a planned surgical and/or diagnostic procedure by a registered health practitioner. 2.Day surgery is the admission and discharge, within 24 hours, of a consumer to a facility or service for a planned surgical and/or diagnostic procedure by a registered health practitioner. Please let us know at cathy.webber@rnzcgp.org.nz which definition you prefer by Thursday 25 February 2010.

Regulation of Health professions: MOH discussion document
The MOH have released a discussion document How do we determine if statutory regulation is the most appropriate way to regulate health professions? The Health Practitioners Competence Assurance Act 2003 (the Act) provides a framework for regulating health professions to ensure the public is protected from harm when receiving health services. This discussion document discusses the criteria for regulating health professions and seeks comment on proposed revised criteria. Submissions to the MOH close 5 March 2010. Please email your views to contribute to the College submission by 22 February to policy@rnzcgp.org.nz

Aiming for Excellence: Fourth Edition
In preparation for the fourth edition of Aiming for Excellence, Royal New Zealand College of General Practitioners seeks your views on its third edition by the end of April 2010. Your advice will help us understand whether Aiming for Excellence still measures what it was intended to measure. Our full consultation document can be found here. Contact Maureen.Gillon@rnzcgp.org.nz with feedback.

Access to high-cost, highly-specialised medicines in New Zealand
The three person panel Review of Access to High-Cost, Highly-Specialised Medicines in New Zealand has released a preliminary report intended to promote discussion and elicit feedback. The report is available here. Members’ thoughts on this issue would be appreciated and can be sent to policy@rnzcgp.org.nz.

PHARMAC altering funding and access arrangements for special foods
The College will be making a submission on this consultation. It includes the proposal that vocationally registered general practitioners become eligible to authorise Special Food Special Authorities. Members comments on this and other recommendations can be sent to policy@rnzcgp.org.nz by Wed March 3rd, to inform the College response. The consultation document is available at:

•    Consultation on altering subsidies for Special Foods. Closes Friday 19 March 2010  

PHARMAC (2 further consultations)
Members wishing to comment on the proposals below can click on the link for further information and respond directly to PHARMAC by the closing date indicated. If you consider that this proposal requires a formal RNZCGP response please let us know by emailing policy@rnzcgp.org.nz.

•    Proposal to fund ambrisentan (Volibris). Closes 4pm, Thursday 11 February 2010  

•    Proposal to fund donepezil and decline memantine applications. Closes 4pm, Thursday 25 February 2010

Opioid Substitution Treatment: draft service specifications
The Ministry of Health and DHBNZ have released draft service specifications for specialist services and for shared care with Primary Health Care. Those wishing to provide feedback on the draft can request a copy by sending an email with Opiod Substitution in the subject line to policy@rnzcgp.org.nz prior to 18 February.

ACC: Revised Clinical Guideline Recommendations for MRI use in diagnosing soft tissue knee injuries
ACC have provided the following information for e-Pulse: ACC seeks your feedback on updated clinical guideline recommendations about the use of MRI for diagnosing internal derangements of the knee.  ACC is consulting with professional organisations/associations/colleges, and their members, who have an interest in the diagnosis and treatment of knee injuries. You are a valued provider of services to ACC and as such we would like to hear your views on the revised recommendations. We would like to hear from both groups and individuals. Please go to http://www.acc.co.nz/news/PRD_CTRB132893 to access the consultation document and feedback form.  On the same weblink you will also find the evidence-based report that informed the revised recommendations. Your feedback will be considered by the group of experts who developed the draft recommendations, and any necessary changes will be made before the recommendations are finalised. We will inform you of the final recommendations and seek formal endorsement from your professional group. ACC will do a final dissemination to the sector using several approaches, including a publication in ‘ACC Reviews’. If you have any queries related to this consultation please feel free to contact me by email at sarah.clark@acc.co.nz.

Consultation on the competencies and standards for education programmes for the revised enrolled nurse scope of practice
The Nursing Council will be introducing a revised scope of enrolled nurse practice for all second level nurses and has revised the competencies and the standards for education programmes. The consultation documents can be downloaded from http://www.nursingcouncil.org.nz. Responses are required by March 15. 

Representation

RNZCGP Representatives are required:

MEDSAFE STATUTORY AVDVISORY COMMITTEES
Medsafe requires GP representatives for the following committees:

    1. Medicines Assessment Advisory Committee
    2. Medicines Adverse Reactions Committee – Chair of this committee.
    3. Medicines Review Committee

Terms of reference are available. The appointments are for a three year term. Closing date: 22 February for RNZCGP endorsement

PHARMAC
PHARMAC requires a GP representative for the PTAC Anti Infective sub committee. Closing date is Monday 15th February

If you are interested in these following committees please contact Annie.Fleetwood@rnzcgp.org.nz for further information.

Vacancies and advertisements

King Country GP Locum – Part/Full time
Do you want to enjoy lifestyle, leisure activities, rural practice in the heart of King Country, close to Mt Ruapehu, part or full time for long term? Then it’s for you – two Doctor GP practice, located in the local hospital. Medtech, very friendly staff to work in an attractive environment.  Ph: 0064 7 895 3333; email: manager.tmc@xtra.co.nz.

Clinical Leader RHM
The Clinical Leader RHM will contribute to the College’s Strategic Focus of a high performing, sustainable workforce for general practice and rural hospital medicine through providing clinical leadership for the DRHM’s training programme. It is a 3/10 position but this can be negotiated. If you have any questions regarding this role please contact Lana Henderson, Rural Hospital Medicine Administrator. Complete cover letter and CV should be emailed to lana.henderson@rnzcgp.org.nz.

Aviation Medical Officer (Wellington based)
Medical Registrar/Trainee or Aviation Medical Officer position. If you have an interest in Occupational Medicine this could be the opportunity you have been looking for. This position offers a high degree of flexibility and may be attractive to an established Aviation Medical Practitioner or junior doctor interested in training in this field. The position may be suitable to anyone seeking to work full-time or part-time in this industry focussed on a regulatory function. You will provide specialist advice and training to medical staff, developing procedures and documentation and actively enhancing the activities of our Central Medical Unit. Applications close on 7 February 2010 and should quote vacancy number CAA 10/02. For a position description and/or application form please go to Vacancies on our website www.caa.govt.nz.To apply send a covering letter, curriculum vitae and CAA application form to the Human Resources, Civil Aviation Authority, PO Box 31-441, Lower Hutt, 5040.

Christchurch GP
Ferrymead Medical Centre has a fresh opening for a new partner (female preferred). We are a three person practice in large, purpose-built facilities, situated within the Ferrymead retail district and in a rapidly growing area of Christchurch. A great opportunity is open for a motivated and dedicated replacement for our outgoing partner. A permanent long term locum would also be considered. Contact Dr Brendan Smith at brendan.smith@ferrymead.pegasus.net.nz.

Miramar GP
Locum required for July 2010 to cover leave in a friendly four doctor family practice, 8 or 9/10ths preferred. Locum also required for July school holidays (5th to 16th) to cover leave, 4/10ths or more considered. Contact Raewyn, practice manager, on 04 388 7018 for more information on either position, or send CV to manager@miramarmedical.co.nz.

South Island – Solo GP
Available in a delightful South Island town, a solo general practice. Pleasant, well equipped premises, well managed, with excellent staff, contact joeballs@es.co.nz or phone 03 434 7697 or 021 349721.

Rotorua - Senior Registrar (GPEP 2)
Rotorua’s Ranolf Medical Centre has a vacancy for a GPEP2 Registrar to join us for a year or two. This is a busy Cornerstone accredited practice with great opportunities for further training in a very supportive, team oriented practice. Excellent conditions and remuneration. For further information talk to our current registrar, Eloise Fry at efry@rgpg.co.nz, or contact Debbie Morris, Practice Manager at dmorris@rgpg.co.nz.

Newtown GP
Newtown Union Health Service, Wellington, seeks GP to cover sabbatical leave from 25 March – 1 June 2010, or up to 12 months. We are an innovative, interesting, multicultural, and multidisciplinary community-owned practice with great staff and positive learning environment. The position is salaried and will be fixed-term contract, for up to 32 hours per week. Flexible hours and conditions considered.  Enquiries to lesley@nuhs.org.nz or ph 04 380-2015.

Blenheim & Rural Havelock GP
Long term locum/salaried position, with a view to shareholding, available in 5 doctor, modern, purpose built, teaching practices, nurse led clinics, minimal after hours, happy, enthusiastic doctors and staff.  Email address: lis_grant@xtra.co.nz.  Ph: 021-474041

West Auckland GP
Part time GP wanted (Female preferred) for practice in West Auckland (10 minutes from Central Auckland). Flexible hours, good remuneration. We are a friendly practice, well supported with experienced nurses. Please email strevallyan@wuhealth.co.nz for more details.

Click here to go to the College website for more vacancies.

CME

Southern Balint
A Balint weekend workshop will be held in Christchurch on February 20th & 21st, 2010.The workshop offers the opportunity for GPs, GP Registrars and other health professionals to experience a Balint group with a focus on the doctor-patient relationship. This workshop has been endorsed by the RNZCGP, and has been approved for 9 hours CME for General Practice Educational Programme Stage 2 (formerly AVE) and Maintenance of Professional Standards (MOPS) purposes. To register, please contact Cecile Pilkington at c.pilkington@auckland.ac.nz.

Palliative care forum for medical practitioners
The Australian and New Zealand Society of Palliative Medicine (ANZSPM) invite you to attend one of 3 forums being held in New Zealand in March 2010. The invited speaker, Professor Janet Hardy, (BSc, MBChB, MD, FRACP, FAChPM) is palliative medicine specialist from Brisbane, Australia, and will be discussing What's new in pain control in palliative care - the science behind the myths. This workshop has been endorsed by the RNZCGP, and has been approved for 9 hours CME for General Practice Educational Programme Stage 2 (formerly AVE) and Maintenance of Professional Standards (MOPS) purposes. The forums will be held in 3 locations from 6.15-9pm (a light meal will be served):  Christchurch on 29 March 2010, convenor Dr Kate Grundy; Palmerston North on 30 March 2010, convenor Dr Joy Percy; Auckland on 31 March 2010, convenor Dr Cathy Miller. For more information or to register: ANZSPM website www.anzspm.org.au or email Karen Cooper: karen@anzspm.org.au.

OBSTGYN 712 & 715
Want to update your knowledge in contraception, pre and early pregnancy or medical gynaecology? Click here for more information.

Postgraduate Diploma in General Practice
The Postgraduate Diploma in General Practice is designed to meet the needs of GPs and the Postgraduate Diploma in Rural & Provincial Hospital Practice is designed to meet the needs of doctors working in rural hospitals. Click here for more information or visit www.otago.ac.nz/dsm/gp.

Advanced Wilderness Life Support Course
Host; Southland Wilderness Medicine Group (WildMed).  Venue: Crown Plaza, Queenstown, New Zealand.  Dates 12-14 March 2010 or 16-18 July 2010. Approved by the RNZCGP for up to 17 hours endorsed CME.  More information; www.wildmed.co.nz or wildmed@xtra.co.nz.

Spine in Action: Low Back Pain - Can Chronicity be Prevented? Auckland March 27-30, 2010
The NZ Association of Musculoskeletal Medicine is holding a Scientific Conference examining the factors that contribute to, or predispose to the development of chronic low back pain and how these factors can be managed. The neurobiological & anatomical substrate, as well as the clinical basis to the identification and management of low back pain will be explored. Internationally renowned speakers include Prof Lars Arentdt-Nielsen, Prof Johan Vlaeyen, Prof Paul Watson, Prof Jacob Patijn as well as local and Australian speakers. Visit www.musculoskeletal.co.nz for program and speaker details and registration. Earlybird rates apply until end January. The NZ Association of Musculoskeletal Medicine is an RNZCGP endorsed CME provider.

Skin Cancer Courses
HealthCert and the University of Queensland, Australia, have released the dates for skin cancer certificate courses. Essential theory and practical aspects are covered in basic or advanced workshops. 2010 courses include Certificates in Primary Care Skin Cancer Medicine; Surgery; Advanced Dermoscopy and Dermal Imaging. The workshops are presented by highly qualified, experienced lecturers and include hands-on practical sessions. Local expert presenter, Dr Sharad Paul (NZ) will be conducting the Surgery course and an Advanced Surgery Workshop. Dr Paul covers highly relevant and concise information for GPs. 2010 courses start in Melbourne, 20-21 Feb with the Certificate in Primary Care Skin Cancer Medicine and Primary Care Skin Cancer Surgery. The Certificate courses are individual short courses or they can be part of the Master of Medicine (Skin Cancer Medicine) programme. Now in its third year, this dynamic programme has seen over 180 students enrol and 75 students graduate. The programme offers doctors the chance to formalise and develop vital skills in Skin Cancer Medicine through an internationally recognised institution. For course information please visit www.skincancercourses.com.au or email christine@healthcert.com.au or call +61 7 3137 1399.

Mindfulness Training for Clinicians
14–18 February, Te Moata Retreat Centre, Coromandel Peninsula. The importance of mindfulness in reducing levels of stress and in supporting the well-being of clinicians and patients has been shown in a number of trials. Mindfulness is a profoundly simple and accessible way of using attention and supports the capacity of clinicians to cope with the everyday demands of practice and be compassionately engaged with the most difficult parts of themselves and their patients. James Carmody Ph.D is Associate Professor of Medicine at University of Massachusetts Medical School. He teaches and researches effects of mindfulness training on symptoms, immune function and well-being and is principal investigator on several NIH-funded clinical trials. He is a New Zealander and has practiced in mindfulness-based traditions for forty years and was an instructor in the UMass Center for Mindfulness Stress Reduction program. Tuition: $900. Contact Pat Wood pat.wood@xtra.co.nz.

Managing Sexual Problems for Medical Practitioners
An evidence-based up-to-date online training programme specifically designed for GPs and approved by RNZCGP for 12 hours CME credits: download in writing to produce a surgery reference;  download in audio form to listen to as you travel to work and back. Access all three forms for the same cost plus make the most of email access to ask tutor, Clinical Psychologist Robyn Salisbury, director of Sex Therapy NZ about your patients’ sexual dysfunctions. Enquiries: admin@sextherapy.co.nz or ph 0800 739843 (0800 sextherapy) or register on www.sextherapy.co.nz.

Smoking Cessation in Practice – E-learning tool
An e-learning tool for registered health workers is available online at: www.smokingcessationabc.org.nz. The tool introduces ABC, the new approach for managing people who smoke (as outlined in the New Zealand Smoking Cessation Guidelines), and contains practical information about giving brief advice and Nicotine Replacement Therapy.  The tool takes between 20 and 40 minutes to complete.

Otago Study Options 2010
Otago 2010 study options. Semester one: primary health care, longterm conditions management, Maori health, tropical medicine and travel medicine. Semester two: longterm conditions management and wilderness medicine. Enquiries: Johanna.meaclem@otago.ac.nz. Then there’s Health Research Ethics BITX 406, introducing the basic ethical aspects of health research on humans. Enquiries: Vicki.lang@otago.ac.nz. 

Conferences

Doing the Right Thing – The New Zealand General Practice Conference
This year’s RNZCGP conference will be held at the Christchurch Convention Centre, 2-5 September 2010. Book the date in your diary now.

Infant Toddler Preschool Mental Health Conference                          
The University of Auckland, 18-20 February 2010.  International Experts in the Field of Infant and Early Childhood Mental Health will talk about: Relationship Disorders, Premature Birth, Early Behaviour Leading to Conduct Disorder, Autistic Spectrum Disorder.  Further information is available here.

RPGN 2010
NZ’s premiere rural general practice conference looms. With just under six weeks before the start of the annual New Zealand Rural General Practice Network conference, rural general practitioners and other interested medical professionals are urged to register now for this not-to-be-missed event on the calendar. This year’s programme is one the best put together by the conference committee and features workshops and sessions as diverse as Wilderness Medicine and Acupuncture in pain control to Fracture management and Dealing with legal issues in twenty-ten. With an emphasis on the inventiveness and resilience of rural general practice, this year’s theme is, aptly, “Rural Health – No. 8 Wired”. Come and listen to sessions on:

•    fertility in rural versus urban
•    wilderness medicine
•    homecare nursing
•    rural practice management
•    emergency transport
•    asthma control and management
•    pain management
•    and much more

Conference 2010 has been endorsed by The Royal New Zealand College of General Practitioners (RNZCGP) and has been provisionally approved for up to 16 hours (= 16 credits) CME for General Practice Education Programme Stage 2 (formerly AVE) and Maintenance of Professional Standards (MOPS) purposes .The conference runs from March 11-14 at the Christchurch Convention Centre. If you have any questions or queries please call Network communications manager Rob Olsen on 04 495 5887, 021 82 2468 or email rob@rgpn.org.nz. Visit www.rgpn.org.nz to register.

Evolving Communities Beyond Services, Building Bridges National Conference for Community Mental Health and Addictions 2010
Conference summary: Transcending barriers, cultures and differences in our approach to community mental health and addictions services. 14 – 16 April 2010, Wellington Convention Centre, Wellington. For more information, go to www.buildingbridges.co.nz.

International

19th Wonca World Conference of Family Doctors, Cancun, May 2010
For the first time in the history of the World Organization of Family Doctors (Wonca), a Latin American country will be the venue for the World Conference of Family Doctors: the Mexican College of Family Medicine is designated organizer of the 19th Wonca World Conference of Family Doctors, to be held in the city of Cancun, Mexico, from 19 to 23 May 2010. The Conference will spread the latest scientific and technological breakthroughs and will lead to the reflection on the technical and social role that Family Medicine must have to achieve the international goals that were proposed in the 2000 Millennium Summit: the Millennium Development Goals (MDGs). For more information visit http://www.wonca2010cancun.com.