RNZCGP ePulse Vol 9 # 12 - Wednesday 11 April 2007

Vol 9 # 12
Wednesday 11 April 2007 ePulse

Content
• News
• New legislation requires input from employers

• Consultation
• Consultation on allowing the MCNZ to elect members to the authority
• MCNZ consultation on managing doctors who exhibit disruptive behaviour

• Medico-legal
• Importance of peer review and peer discussion: Obligations on individuals and hospitals
• RMOs contractual entitlement to non-clinical education hours
• head

• Wonca Daily Alerts
• Journal Watch
UK study showed that women who consumed the most meat had the highest risk of breast cancer
Combined oral contraceptive pills effective at decreasing the risk of epithelial ovarian carcinoma with the strongest risk reduction associated with low-potency formulations
Tai Chi augments resting levels of varicella zoster virus and specific cell-mediated immunity, and boosts varicella zoster virus-cell-mediated immunity of the varicella vaccine
Erectile dysfunction is suggested to be an early symptom of generalised cardiovascular disease and events
Optimal erection correlated positively with emotional well-being and satisfaction outcomes
Female sexual dysfunction, urinary symptoms and depressive symptoms are common in female partners of men with erectile dysfunction

Clinical Reviews
Outpatient management of anticoagulation therapy
Peppermint oil

• CME & conferences

News
New legislation requires input from employers
KiwiSaver is being introduced on 1 July 2007. It is new legislation and there are certain legal requirements that it introduces for your business – in summary these are:
• Any new employees must be enrolled in KiwiSaver when they start with you
• You must give them a KiwiSaver pack (provided to you by IRD) within 7 days of them starting their new job
• You must deduct 4% of their pay and pay it to the IRD.
• They can then decide to stay in KiwiSaver or ‘opt-out’
• They can ‘opt-out’ within 2 to 8 weeks of starting their new job
• If they ‘opt-out’ you must advise IRD.

If any existing employees wish to join KiwiSaver – when they advise you of this you must facilitate it.
KiwiSaver can be a valuable employee benefits tool for you if you want it to, or you can choose to do the bare minimum, as outlined above. It is important that you are aware of what you have to do and the impact that it will have on your business.
The College has arranged access to a White Paper; http://www.moneyworks.co.nz/kiwisaver.htm#kiwi
"Have a good week in general practice"
Jonathan Fox, President, RNZCGP
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Consultation
Consultation on allowing the MCNZ to elect members to the authority

We welcome your input on this important MCNZ consultation – should you wish to comment please contact Andrew Stenson at the Policy Unit by Monday 1 May 2007 so that he can send you more information on what is proposed.
The proposed process for the MCNZ largely follows the rules for holding elections of members previously prescribed by the Council under the Medical Practitioners Act 1995. Should the Minister agree, following consultation, to make regulations, the MCNZ has recommended that the composition of the Council be as follows:
• three health practitioners to be elected by the profession;
• three health practitioners to be appointed by the Minister;
• three laypersons to be appointed by the Minister.

MCNZ consultation on managing doctors who exhibit disruptive behaviour
The MCNZ is working on a guideline for managing doctors who exhibit disruptive behaviour. It is intended to complement an organisation's existing human resource policies, and will be developed around a system of escalated actions. The employer would manage the problem before escalation to the Council.
Having established policies and procedures in place is an essential part of preventing and managing the problem, and ensures that employers do not react passively when disruptive behaviour arises. The guideline will be based around the following steps:

1. Performance management/collegial discussion.
2. Discussion with senior management.
3.
Referral to the Medical Council.

The draft guideline for addressing and managing disruptive behaviour in doctors can be downloaded here in PDF format. Contact Andrew Stenson at the Policy Unit by Monday 23 April 2007.
Top
Medico-legal
Importance of peer review and peer discussion: Obligations on individuals and hospitals A urologist’s decision to carry out a partial as opposed to total cystectomy was held to amount to professional misconduct. The HDPT found that the conduct complained of was both malpractice and negligence, and warranted disciplinary sanction to protect the public and/or punish the urologist. The HPDT commented that the urologist appeared to have practised in isolation. The HPDT held that both the hospital and the urologist had an obligation to ensure that for the safety of the patients some form of peer review, peer discussion, or multi-disciplinary discussion is both available and encouraged for difficult cases. The urologist was censured and the HPDT ordered that conditions be imposed on the urologist’s practice ensuring that he participate in peer review and regular clinical audit. (Dr Bhatia, HPDT, Invercargill, 12 February 2007, 77/Med06/39D)
RMOs contractual entitlement to non-clinical education hours In an earlier decision the Employment Court held that the requirement in the relevant clause in the RMO collective employment agreement (“CEC”) that four hours “rostered duty” weekly for the purpose of medical learning which is not directly derived from clinical work was not personal to an individual doctor. Therefore, if medical learning was held at times when any trainees were on rostered duty the requirements of the clause were held to be met, and it was not a breach of the clause if some of the rostered training opportunities fell outside of the individual doctor’s actual roster. On appeal, the Court of Appeal, whilst dismissing the appeal on this point as it has no jurisdiction to review the Employment Court’s interpretation of an employment agreement raised doubts as to the validity of the Judge’s finding that education provided when the individual doctor was rostered off duty, or was unavailable because he/she was rostered on for surgery for instance, met the requirements of the CEC. Paul v Capital and Coast District Health Board (CA64/06, 29 September, William Young P, Robertson and Arnold JJ)

Top
Wonca Daily Alerts
Journal Watch
UK study showed that women who consumed the most meat had the highest risk of breast cancer
Combined oral contraceptive pills effective at decreasing the risk of epithelial ovarian carcinoma with the strongest risk reduction associated with low-potency formulations
Tai Chi augments resting levels of varicella zoster virus and specific cell-mediated immunity, and boosts varicella zoster virus-cell-mediated immunity of the varicella vaccine
Erectile dysfunction is suggested to be an early symptom of generalised cardiovascular disease and events
Optimal erection correlated positively with emotional well-being and satisfaction outcomes
Female sexual dysfunction, urinary symptoms and depressive symptoms are common in female partners of men with erectile dysfunction

Clinical Reviews
Outpatient management of anticoagulation therapy
Peppermint oil

Top

Coming up
Your opportunities for MOPS & AVE credits
CME
Chair of General Practice Trust Post-Graduate Study Fees Scholarships: Wellington Faculty
The Wellington Faculty Chair of General Practice Trust Postgraduate Study Fees Scholarships are intended to support nurses and doctors currently practising in primary health care settings to undertake postgraduate thesis research in primary health care. The scholarships are to be used for university fees.
The purpose of the fees scholarships is to assist doctors and nurses to undertake a thesis, either a Masters or PhD, in the Department of Primary Health Care and General Practice in the Wellington School of Medicine and Health Sciences, which has direct relevance to New Zealand primary heath care. Closing dates each year are 1 May and 31 October.
For further information please visit: http://www.wnmeds.ac.nz/postgradprimarycare.html
or contact: Jo Meaclem 04 385 5995 email: primarycare.wsmhs@otago.ac.nz

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Conferences
http://www.rnzcgp.org.nz/news/conferences.php
RNZCGP Annual Conference: Meeting the challenge, Kokiringia te Wero
11-14 July 2007
The Royal New Zealand College of General Practitioners invites you to the Annual Conference 2007, to be held at the new Rotorua Energy Events Centre, 11-14 July 2007.
The number, complexity and scope of issues facing general practice and general practitioners increases every year and each of us must prioritise and meet these challenges. It was Charles Darwin who told us "It is not the strongest species that survive, nor the most intelligent, but the most responsive to change".
Meeting these challenges is not only for GPs, but also for practice nurses, practice managers and members of the primary health care team. More details are available on the College website; http://www.rnzcgp.org.nz/news/conferences.php
Alzheimers New Zealand National Conference
Dementia Across the Ages, 26 – 28 April 2007
Michael Fowler Centre, Wellington
To register for the conference either register online http://www.alzheimers.org.nz/ and be in the draw to win an Apple ipod or complete the registration form at the back of the registration brochure and post it to Alzheimers NZ Conference, c/o Conferences & Events Ltd, P O Box 1254, Nelson. Conference Organisers phone +64 3 546 6022 or +64 4 472 0337. The conference has been endorsed for up to 12.5 hours, equivalent to 25 credits for CME for MOPS and AVE purposes.
The Goodfellow Symposium 2007
Tomorrow's Knowledge for Today's Health Professionals
21-22 April 2007, School of Population Health, Tamaki Campus, The University of Auckland
Keynote Speaker – Wendy Fairhurst-Winstanley, Nurse Practitioner and Partner in General Practice, UK
Attend realistic constructive teaching sessions aimed at general practice
Discuss the latest updates on clinical topics: new vaccines, managing pain, starting insulin, skin cancer, CVD risk assessment, insomnia.
Purchase a Practice Pass and share a place with your GP and nurse colleagues
Participate in small group sessions like practical surgery skills workshops – limited places.
More symposium details at www.goodfellowclub.org/2007symposium
Contact The Conference Company, email: goodfellow@tcc.co.nz phone: (09) 360-1240, fax: (09) 360-1242
GP CME 2007
15-17 June 2007 | Energy Events Centre | Rotorua
The programme provides a good general practice update, with short, sharp and to the point clinical content; including key take home messages to change practice behaviour immediately.
Many practical workshops are on offer across a broad spectrum of GP content. A dedicated Registered Nurses programme will also run on Sat 16 June. Resuscitation Courses to level 5 standard are also an option.
Details available at www.qmseminars.co.nz with registration open now. Visit the website or contact leon@conferencematters.co.nz for further details.
Workforce Action: Ready for the Future
A two day Health Workforce Conference
Joint District Health Boards and Ministry of Health event
Dates: Thursday 28, Friday 29 June 2007, Wellington Convention Centre
www.wellingtonconventioncentre.com
Conference Themes:
• Coordinating and Leading Workforce Change
• Growing the Workforce: Promoting Health Careers
• Sustaining and Retaining the Workforce
• Flexible Workforce: New Approaches, New Skills
Health Workforce Conference Flier.pdf (41 KB)
Further information enquiries are welcome
Please contact: Nicola Papps , Phone: 04 495 1782
New Zealand Pain Society Annual Scientific Meeting
17-19 August 2007, Palmerston North
The theme is Pathways: professionals, patients, people and pain which seeks to look ahead to evolving concepts in pain management without losing track of our roots. The conference itself will seek to look at a broad range of topics that break the barriers between the disciplines and provide opportunities to apply concepts existing in one field to related fields. Posters, papers and workshops have the following themes:

• Changes in the science of pain management
• Technological advances in pain management
• Probabilities and possibilities in pain management
• Pain management from a holistic perspective
• Pain and multidisciplinary approaches
• Pain and well being
• Pain partnerships: difficulties for family and whanau
For more info please visit the conference website: http://www.confer.co.nz/nzps/.

The Pacific: Our People, Our Region
Sustainable Solutions for a Healthier future
Pasifika Medical Association 10th Annual Conference 2007, Samoa
17-19 September 2007
First Call for Abstracts: The Pasifika Medical Association and the Samoa Medical Association are pleased to invite you to submit an abstract for the PMA 10th Annual Conference 2007 in Apia, Samoa.
Conference Theme:
“The Pacific: Our Region, Our People – Sustainable solutions for a healthier future”.
Information, contact Linda Mulitalo
Mobile: 021 531 877
Email: pma@pacifichealth.org.nz
Website: www.pacifichealth.org.nz
New perspectives in Mental Health:
17-19 August 2007, Holiday Inn Surfers Paradise
The conference program is now available on the website, along with details of the optional workshops on Sunday 19th of August: http://www.vision6.com.au/ch/8fcczt/180674/2532417nx7.html & http://gcimh.com.au/conference
The conference streams will include, Policy initiatives - Primary interventions - Promoting recovery - Preventing relapse.

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