North East Valley DGP eNews

No 1030: August 26, 2010
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/.
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In this issue:

Editorial                                                Pakistan Flood Emergency   

Chronic Disease Management            Community Asthma Program Survey

Professional Development                 CPD events   

HMR                                                      Calcium Supplements and Heart Disease, Caffeine

Immunisation                                       Pertussis Epidemic & Zoster Vaccine Update, Cease using Panvax H1N1 2009 Junior pre-filled syringes, Measles Alert        

Information Management                  Medical Director Tips

Items of interest                                  Fast Track Your OA Hip and Knee Patients to Surgery, Referral Guidelines for Top 5 Conditions Causing Vision Impairment, Cancer in My Family: New Online Support, GP Network News  

Mental Health                                      HeaD-ON project     

News for Practice Staff                       Orientation Program, Practice Nurses CPD Scholarships, The Benchmarque Group eNewsletter   

Paediatrics                                           Referring for Child Mental Health, Male Circumcision       

Women’s Health                                  Menarche to Menopause ALM, GP Update in Gynaecological Oncology             

Positions vacant/wanted                            

Fun stuff                                                        

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A Word from the Editor

Pakistan Flood Emergency

Call for GP Volunteers to join AusAID for 30 day deployment. The need is for primary care, maternal and child health and midwifery care. GPV is assisting the Department of Health to establish a register of GPs who are interested in volunteering for a 30 day deployment to Kot Addu (North of Multan in Punjab Province). See here for more information. Expression of Interest form.

 

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Chronic Disease Management

Community Asthma Program Survey

The Community Asthma Program (CAP) provides an important service to families in the community, offering free education and support for children with asthma and their families. The program is currently undergoing an evaluation to assess their model of care & patient outcomes. GPs across our catchment who have referred clients to the CAP program will soon receive an electronic, on-line survey to complete. It would be of great benefit to CAP if you can take the time to complete the survey to assist us with continuing to provide this valuable service.

 

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Continuing Professional Development

Term 3 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. Tea and Coffee provided. Course Leader: Dr Vin Nursey Phone: 9457 1736. Allocated CPD: 2 points/hour.

Aug 31 - Pertussis Epidemic & Zoster Vaccine Update - Dr Peter Eizenberg.

For full term Tuesday lecture program click here

 

Austin Health - Division of Medicine Grand Round

“Global bugs for global travellers: The role of travel medicine” Speaker: A/Prof Joe Torresi

Wednesday 1st September, 12:30pm at John Lindell Lecture Theatre, Level 4, Lance Townsend Building, Opposite Medical Library. Lunch is now at 1.15pm outside the Lecture Theatre.

 

Doctor, do I have ME/CFS?

Latest research & clinical practice for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome for medical practitioners.

Wednesday 15 September 7-9.30pm at General Practice Victoria, Level 4, 458 Swanston Street, Carlton. Flyer & registration form here.

 

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Home Medicines Review

Calcium Supplements and Heart Disease

“MI risk prompts calcium rethink”- A recent paper published in the BMJ 2010;341;c3691 (published on line July31,2010) found supplementation was associated with an increased risk of MI. Caution is advised but Osteoporosis Australia have published practice comments to help practitioners to assess risk in older women with osteoporosis. See here or visit Osteoporosis Australia website. Foods containing calcium with a downloadable calcium content table can be found here. 

 

Caffeine

GPs may be interested in a new product being widely advertised - Panadol Extra which contains paracetamol 500mg and caffeine 65mg per tablet. A cup of instant coffee contains 60mg and a short black 107mg. No Doz tablets favoured by some footballers contain 100mg per tablet. A detailed listing of caffeine containing drinks from the RGH Pharmacy Bulletin together with concerns about adverse effects, tolerance and withdrawal and interactions with other medications can be found here

 

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Immunisation

Pertussis Epidemic & Zoster Vaccine Update

This is next week’s Tuesday lecture presented by Dr Peter Eizenberg. See under CPD.

 

Cease using Panvax H1N1 2009 Junior pre-filled syringes as the vaccine has expired

The Chief Medical Officer (CMO), Professor Jim Bishop has advised that stability testing by the Therapeutic Goods Administration of Panvax H1N1 2009 Junior vaccine, for children between 6 months to < 3 years of age, has shown a decline in potency in the 0.25 ml pre-filled syringes. Therefore the vaccine should now be considered expired. To ensure the vaccine is no longer administered, quarantine your stock of Panvax H1N1 2009 Junior pre-filled syringes immediately. CSL is retrieving this stock and will contact you shortly.

Safety of the vaccine is not affected - The Australian Technical Advisory Group on Immunisation (ATAGI) has advised the CMO that revaccination of children who have already received 2 doses of Panvax H1N1 2009 Junior is not necessary. The potency of the vaccine administered to date is considered adequate to induce an immune response. If a child aged 6 months to <3 years of age is due to receive a second dose of H1N1 containing vaccine, this can be provided by using the age appropriate dose (0.25ml) obtained from a Panvax multi-dose vial. Alternatively, the 2010 seasonal influenza vaccines (Vaxigrip and Influvac) are also suitable for use. Panvax multi-dose vials and Vaxigrip and Influvac influenza vaccines are not affected.

ATAGI's full advice will be available shortly on www.healthemergency.gov.au  and www.immunise.health.gov.au.  

 

Measles Alert for GPs and Emergency Departments

The Department of Health (DH) has been notified of 2 confirmed cases of measles in travellers who returned from South Africa on 3 August 2010.

With an average incubation period of 10 to 14 days until onset of rash, secondary cases may now be appearing.

Children or adults born during or since 1966 who do not have documented evidence of receiving 2 doses of a measles containing vaccine or documented evidence of laboratory confirmed measles are considered to be highly susceptible to measles. See full alert.

 

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Information Management

Medical Director Tip - Quickly adding a test name for an investigation request

Don’t scroll through the long list of test names when creating an imaging or pathology request – this takes far too much time.

For a radiology test click on one of the top items of the list (painful you have to do this first step) and then type in the first letter only of the test name. This will then jump to those tests beginning with that letter. Double click on the item to add to the request list.

For pathology test click in the Search box and type the first few letters of the test name. This will then jump to those tests beginning with those letters. Double click on the item to add to the request list.

 

This weeks IM problem - Writing scripts for deceased patients

Question: On the rare occasion I need to write a prescription for a deceased patient, for example when a phone order has been placed to a nursing home and then the patient dies.

Answer: Yes you can but you need to know how to call up the record of a deceased patient. Nake sure there is no patient record open.

  1. From the Patient menu select List…
  2. From the drop down box that shows Current patient by name select Deceased patients
  3. Select the patient by clicking ONCE on their name (don’t double click as this opens the Patient details screen.
  4. From the File menu select Open.
  5. Proceed to write and print a script as per normal.

 

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Items of Interest

Fast Track Your OA Hip and Knee Patients to Surgery

You are now able to directly refer your patients to the Elective Surgery Access Service (ESAS) at St Vincent’s Hospital. Your patients benefit with potential fast tracking to TKR and THR surgery, compared to other Tertiary Services, with all the benefits of early management and have an alternative Tertiary Health Service to access, if they are beyond the primary catchment area for your local tertiary health service. Go to the Dept. of Health website to compare waiting times for different Health Services.

To refer: Download and complete the Referral Forms from website (VSRF and Hip and Knee Form). Fax completed forms to ESAS on (03)9288 3709. Your patient will be triaged at ESAS, and if not suitable for ESAS, e.g., due to significant co morbidities, will be referred to the SVH Orthopaedic Service. For ESAS enquiries ring (03)9288 2905

 

Referral Guidelines for Top 5 Conditions Causing Vision Impairment

The Royal Victorian Eye And Ear Hospital have launched a resource to assist GPs with when to refer, alternate referral pathways and what to include in referrals for the following conditions: Patients with Diabetes, Cataract, Glaucoma, Age-Related Macular Degeneration, and Refractive Error.  This resource can be accessed via the GP resources page of the Eye And Ear Hospital website.

 

Cancer in My Family: New Online Support

Cancer Council Victoria are inviting GPs to refer patients who are at a high risk of cancer because of a genetic condition or family history to join a new online support group available via www.cancerconnections.com.au

'Cancer in my Family' is a professionally moderated group, enabling people in similar situations to share experiences and common issues via a private online community at any time of day or night. It is also open to people who have been identified with genetic conditions such as BRCA1/2, Lynch syndrome, and FAP.  For more information email Kate Wakelin: kate.wakelin@cancervic.org.au or call 13 11 20.

 

GP Network News

This week’s edition includes: Seasonal influenza vaccines for children; Support Family Doctors petition; Telemedicine an important component of a modern health system; Online resources on doctors’ health and wellbeing.

 

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Mental Health

Does your patient suffer from recurrent headaches/migraines and co-morbid depression?

Please consider referring them to the HeaD-ON project, a randomised control trial of CBT designed for individuals suffering from chronic headache/migraine and co-morbid depression, to demonstrate the efficacy of this approach. We are seeking participants aged 18+ who have been diagnosed with frequent or chronic tension type headache and/or migraine (with or without aura). For further information or to refer a patient, please contact the Project Manager, Dr. Rachele Aiello, on 9594 1483 or Maria Lawlor on 9594 1465.

 

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News for Practice Staff

Orientation Program

28 & 29 October Orientation Program for Nurses New to General Practice is already fully booked.

 

Practice Nurses Continuing Professional Development Scholarships

An Australian Government initiative aimed at assisting nurses to further their careers through short courses and/or conferences. Closing Date for Applications: Friday 1 October 2010. Apply online or download application from the website.

 

The Benchmarque Group eNewsletter

August Edition available here. We are delighted this month to launch our new website. Nurses interested in Benchmarque training can apply for the RCNA scholarships to do these short courses

 

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Paediatrics

Referring for Child Mental Health

Most regions of Victoria have local paediatric mental health services which can be found through these DH websites:

It is vital you send your referrals directly to these services, not to the RCH, even if the child is in the RCH catchment. This will result in a much more efficient service for you and your patient.

 

Male Circumcision

A reminder: According to DH policy (2007), the Royal Children’s Hospital will ONLY accept referrals for circumcision if the child meets the following medical criteria: phimosis, recurrent balanoposthitis or paraphimosis. Please refer non-medically indicated referrals to a suitable private surgeon.

  • For more information parents can contact the Elective Surgery Access Line on: 1300 781 821.

English and other language parent and professional resources are available here, or by calling Information Victoria on: 1300 366 356.

 

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Women’s Health

Menarche to Menopause ALM

Menarche to Menopause: Health Advantages of Monitoring Fertility, an Active Learning Module qualifying for 40 Category 1 (women’s health) points is to be presented at the Novetel Hotel, Glen Waverley on Saturday, 4th September 9.30 – 4.30  by the Ovulation Method Research and Reference Centre for Australia Ltd. This is an ideal opportunity to update your knowledge on the signs and symptoms of fertility and infertility as well as to gain 40 Category 1 (Women’s Health) points for this current triennium. For further information and registration telephone 1800 335 860

 

GP Update in Gynaecological Oncology

Focus on GP follow up & screening guidelines in ovarian cancer – the sixth most common cause of cancer-related death among women in Australia!

Dr Peter Grant – Clinical Assoc Prof. Head, Gynaecological Oncology Unit, Mercy Hospital for Women

Tuesday 7th September, 7-9pm (Registration & Refreshments from 6.30pm) at Level 4 Mercy Hospital for Women, Heidelberg.

Registrations: Merran Mackie 8458 4833 / mmackie@mercy.com.au / or click here for registration flyer

Allocated 4 (Category 2) points in the RACGP QA & CPD Program for the 2008-2010 triennium.

 

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Positions vacant/wanted

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

 

Positions vacant

Doctors

Diamond Creek  ( Near Eltham & Greensborough ) – VR GP wanted full time or part-time to join our lovely established Family Practice, accredited since 2001, computerised & with mixed billing. 1 in 6 Saturdays 8.30am – 12noon. No Sundays or public holidays. Outer Metro area (relocation incentive grants). Pay and conditions negotiable. Opening hours Mon- Friday 8.30am – 7pm. Saturday 8.30am – 12noon. Contact Sheila Bouskill on 03 9438 3888 or e-mail diamondvalleyclinic@netspace.net.au

 

Ivanhoe - VR GP FT or PT required to work in this GP operated accredited medical centre. A friendly and supportive team environment in this computerised medical centre with Psychologists, Physiotherapist, Podiatrist, Dietician, Nursing staff and Radiology on site, no After Hour’s, family friendly, flexible hours . Please contact John or Ken on 03 9497 1188.

 

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

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Humour

More Bloopers Doctors Have Written On Patient's Charts

  • Since she can't get pregnant with her husband, I thought you might like to work her up.
  • She is numb from her toes down.
  • While in the ER, she was examined, X-rated and sent home.
  • The skin was moist and dry.
  • Occasional, constant, infrequent headaches.
  • Patient was alert and unresponsive.
  • Rectal exam revealed a normal size thyroid.
  • She stated that she had been constipated for most of her life, until she got a divorce.
  • I saw your patient today, who is still under our car for physical therapy.
  • The patient was to have a bowel resection. However, he took a job as a stockbroker instead.
  • Skin: Somewhat pale but present.
  • Patient was seen in consultation by Dr. Blank, who felt we should sit on the abdomen and I agree.
  • Patient has two teenage children, but no other abnormalities.

 

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And remember

 

            … Never believe anything until it has been officially denied.