The Society was established in 1981 by practitioners who foresaw the emergence of the specialty of emergency medicine and the future implications for the care of acutely ill patients attending hospital “casualty departments”.
From those beginnings emerged the Australasian College for Emergency Medicine, formally incorporated in 1984.
The Society continues to provide a forum for discussion and debate on issues of relevance to emergency medicine.
We are progressively adding to this site, if the information you are after is not on the website, please click here to contact the ASEM office
AN EMPLOYMENT WARNING FOR QUEENSLAND.
The Queensland State Government is proposing a radical new employment structure based on individual contracts for emergency doctors working in public hospitals in Queensland.
Talks between representatives of the emergency medicine craft group and Queensland Health appears to be reaching an impasse.
The current offer is deeply flawed, denies natural justice and leaves individual doctors in a perilous position. Their roles as patient advocates will become degraded.
There will be significant adverse impacts on staff retention, training and CME with the loss of fatigue provisions. The reduction of their employment to quartiles of managerial expediency is all about bureaucracy, rather than optimal care.
Members are advised to defer any decision to work in Queensland public hospitals until this issue has been resolved.
Cairns health staff protest against doctor contracts
Published ABC News 26th Feb 2014, Kirsty Nancarrow.
What you can do right now to fight contracts
ASEM has been closely involved with the efforts of EM doctors in Queensland to oppose the draconian legislation aimed at SMO's in Queensland's Public Hospitals. The IR subcommittee, headed by Dr Marcel Berkhout, endorses this letter and urges all affected medical staff to print and sign this letter immediately and fax/scan/mail it to their local MP.
Want to make a change?
Please consider signing the change.org petition below and circulating to anybody you know who might have concerns about the effect of the current governments plans for the public health system in QLD.
We have been told that your legislative changes are irreversible, and the train carrying these individual contracts has already pulled out of the station, and cannot be stopped.
We sincerely hope that your talks with the SMO representatives around the concerning issues in the contracts result in a successful outcome for all.
If SMOs are not convinced that our ability to continue to practice public health medicine with safety is secured, then the state will be in grave danger of losing its' brightest and best.
Please listen: We say to you that nothing in your legislation, and the individual contracts, is irreversible. This train wreck can most certainly be stopped.
You are dealing with a group of people who understand what is truly irreversible and impossible, as they have stood in the face of death and tried to stare death down, bargained against time with their knowledge, skills, equipment and courage, and sometimes failed, and often times not.
When you have to tell parents that their child has autism and intellectual impairment and that their lives will forever be filled with difficulty and challenge, and watch their grief unfold - that is irreversible.
When you watch a child bleed to death before your eyes as you pump blood in their arm only to see it pour out of the gaping hole in their skull, where it has been sheared off from a motor vehicle accident - that is irreversible.
When you tell parents that their baby has cerebral palsy and will never walk or talk, or even eat independently, because their brain is scarred from a lack of oxygen during birth - that is irreversible.
Nothing here with your individual contract legislation is impossible to change - we'll tell you what is impossible.
When parents beg you to save a child's life after a second failed bone marrow transplant for leukaemia, as you're watching them die from an infection they have no white blood cells left to fight - that is impossible.
When you're trying to bring back a heart beat in a child who has been pulled from the bottom of a pool, an hour after it's heart beat stopped - that is impossible.
Don't you dare sit there and tell us that this legislation is irreversible and that stopping this contract roll out is impossible. Because we know that all it takes is a show of hands in a parliamentary room, and the swipe of a pen across a piece of paper.
No fancy machines, no million dollar drugs, no transplanted tissues, no 12 hour operations, and no miracles of fate.
Just understanding and good will from your colleagues and yourselves. And if you're up all night to achieve that, then welcome to our lives.
We have each others' backs, us medicos - we always have and always will.
Because we have all stood there with the sick and the dying, and we know how lonely that journey is without colleagues at our shoulders, and support and resources at our backs.
So we will stand together, even if we have to walk away, together - until you listen, and pull on the brakes, and stop this train wreck from playing out to it's end.
Please enter the discussions with good will, and open minds and hearts, and leave your egos on the coat rack outside.
The health of the state is in your hands - please don't throw it away.
Sincerely, Senior Medical Officers of Queensland Health.
PS To all of our colleagues - please don't walk away or sign just yet - stand at our shoulders because we've got your backs. PPS Please someone send this to every QLD SMO.
Released 7th March 2014
Pineapple #2 As you know, the Pineapple Meeting #2 was a great success in terms of coming together, and expressing our views and having some discussion about what to do next. A third meeting will be planned for the 19th March, with the venue to be confirmed (we will look to get an appropriately sized venue to hold over 1000 people)
The meeting with Springborg The pressure from Pineapple #2 and the actions of Dr Chris Davis has re-opened discussions which will take place next week to try to resolve the major issues remaining with the contracts.
While it represents a very small positive step, it in no way represents negotiation or resolution. The temptation would be to relax a little now, but we should actually intensify our efforts, as we can see the tangible results from what we are doing (of course, whether this will translate into a satisfactory outcome remains to be seen). Until a meaningful resolution is achieved, we should act as if none of this has happened. We need to achieve a successful outcome that is robust and cannot be reversed.
Don’t sign There needs to be an immediate and complete stop to the QH blitz to get signature on to "contracts" while these discussions are taking place. There is a possibility that these discussions do not reach a satisfactory outcome, or that they are not conducted in good faith, so we need to continue to plan for this, while discussion are taking place.
Don’t sign, resign With regards to resignations, documents will be provided on Monday. We appreciate that some people have been wanting these for several weeks, but there have been many other facets to this campaign, and we have all been very busy handling multiple tasks. We wanted to strike that balance between getting it completely right, and not rushing documents out too early or under-developed.
Remember, for maximum benefit, we have to achieve critical mass by 30 March. More details on what it will take below.
Detailed discussion of our options and strategy The options that we have available to us are: “Sign” - give up now. “Sign with reduced time” - Sign but with reduced hours “Sign and resign” - sign now and resign later “Refuse the contract” - refuse to negotiate outright. “Don’t sign but don’t refuse” - maintain “negotiation”. “Counter offer” - offer an alternative individual contract. “Resign on your own” “Mass resignation” - ASMOF holds your resignation until it can be used for maximal benefit
When we evaluate each option we need to consider the ease of implementation compared to how effective the technique is at forcing the government to resolve the problem. It comes down to pressure, how much pressure will be placed on us and how much pressure will be placed on the government. This will completely depend on the resolve of individuals to act collectively as one and withstand any pressure.
The likelihood of achieving renegotiation of these contracts varies with each option: “Sign” - there is no renegotiation, we give up and lose.. “Sign with reduced time” and “Sign and resign” - Both moderately difficult to implement and put mild pressure on the government as people slowly leave. This will compromise care significantly in time as staff losses exceed recruitment. It will take another Bundaberg to right this problem. That is not fair on the Queensland public. “Refuse the contract” - As we discussed last, refusing the contract outright is worse for us than maintaining negotiation. “Don’t sign but don’t refuse” - Maintaining “negotiations” allows the media and political campaign to continue building and applies moderate pressure on the government. We are already seeing the cracks in the government so we need to maintain this pressure. However, there is significant pressure on individual doctors to maintain this strategy. “Counter offer” - This is similar in that “negotiation” is maintained while the campaign builds. Again it places significant pressure on individuals. “Resign on your own” - This is a very personal decision. You have been advised that for maximum benefits, you should resign by 30th March, three months prior to the loss of private practice benefits. This method is not particularly injurious to the government as individuals can be replaced easily unless you are in a particular subspecialty area. Subspecialty resignations make a significant splash at one site, but often the effects are not as great as anticipated as the system makes adjustments to cope. “Mass resignation” - This puts massive pressure on the government if managed appropriately. The decision to join a mass resignation is individual, but it is about putting the needs of the greater cause above your individual concerns. It is likely to be successful if followed through with fortitude and resolve.
ALL of the options involve the choices and actions of individuals. The group actions rely completely on individuals deciding to act collectively as one.
As discussed at Pineapple #2, the current plan involves maintaining negotiation but not signing, continuing the media and political campaign, and collecting signatures for mass resignation.
To maintain negotiation, we suggest Keep getting information about your overtime and recall, including the source leave forms and AVACs, to correctly calculate your tier 2. Keep negotiating your KPIs to an acceptable form. Ensure that you have union representation at your contract meetings.
To maintain the media and political campaign If you are willing to speak to the media, contact email@example.com We need your stories about how this is impacting you, your hospital, your patients and the community so that we can get it out to the people of Queensland Meet with your MP Tell your friends and family to write to their MPs, or visit them
The paperwork for mass resignation is continuing to be developed but decide: Will you ever feel safe under this contract? Do you think this “Command and Control” management style is going to produce the best patient outcomes? Can you handle the three months of pressure as we serve out the notice period? How long can you survive if the government lets it go through? Can you watch overseas and interstate doctors being flown in to Queensland for huge sums of money while they try to break our resolve? Can you watch our health system work half as well for twice the cost just so that they can crush us? Do you believe the greater good is worth the individual stress we will be under while we force the government to fix this problem?
This strategy relies on individuals working together with a unity of purpose.
The Propaganda Campaign You will have noticed the massive propaganda campaign by QH over the last week or so. They understand that they need to ‘listen’ more and, to that end, they’ve been doing a lot of ‘telling’. The documents anonymously tell us how benign the contracts are while our named lawyers tell us that they are not. We don’t have the manpower to counter each document pumped out this week because of the sheer volume - remember we do not know who the authors of these documents are, and they are not signed by anyone so we do not know what their qualifications are to make such claims.
Our response is simple: They had to change the law governing unfair contracts to be able to bring these contracts in. They have to threaten and bully us to force us to sign these contracts.
Why would they need to do that? We have been legislated out of fair contracts. No matter what they say and do about the contract, the underlying legislation will cause malignancy to recur. We will keep getting cancers because of the bad underlying genetics.
Pineapple #3 Remember, the third meeting will be on 19th March, with the venue to be confirmed.
Released 4th March 2014
A reminder that the Pineapple Hotel Meeting is on Wednesday night, 5th March at 7pm. We need a huge turn-out, as all media (print, radio and network TV) will be there. Bring as many colleagues as you can, and let's see if we can cram more people into the function room than 2 weeks ago. Also, bring your hospital IDs.
As mentioned in previous updates, there will be a series of short presentations, leading into a discussion about all our options, what to do if a contract offer is placed in front of you and how to resist undue pressure to sign - this last part will be presented by our lawyers.
In other news, most of you would have heard about what Chris Davis has done over the last 2 days - standing up to his LNP colleagues over these contracts. Since then, there has been some deliberate confusion of his stance, but we understand he is resolutely standing by his original letter. Please click here to view the original letter. We will see what happens over the next day or two with interest, but we will stay focussed on staying united and supporting the campaign.
Legal Advice Pours Cold Water on Individual Contracts
Released 26 Feb 2014
AMA Queensland has received further legal advice confirming the unfairness and unreasonableness of the individual contracts proposed for SMOs in Queensland.
Senior Counsel Dan O’Gorman describes it as a “draconian contract of employment” and reiterates our key concerns about the unprecedented stripping away of fundamental employment rights.
We strongly recommend you read the advice in full here.
Paragraph 2 in particular summarises the changes to your employment should you proceed to sign or not sign the contract.
If you do not have time to read the document, these are some key parts:
1. The State is able to offer these contracts only after legislating that a number of significant provisions of the Industrial Relations Act 1999 will not apply to SMOs who sign a contract. 2. The State is attempting to unilaterally introduce significant changes to the terms and conditions of employment of SMOs in Queensland, changes that will simply strip away some basic employee rights. 3. There is nothing that guarantees that SMOs will not be worse off under the contract.If the State believes that SMOs will not be any worse off under the contract, it would be easy for the Minister for Health, or for another senior person on behalf of the State, to make a statement to that effect. 4. Remuneration – Remuneration payable under the contractis incapable of precise calculation. 5. Termination - SMOs can be arbitrarily dismissed and unfair dismissal provisions will no longer apply. 6. Dispute resolution –SMOs will no longer have recourse to the Queensland Industrial Relations Commission and no other dispute resolution process is provided. 7. Shift work – SMOs may be required to undertake shift work and extended rosters and the State may vary or amend rosters or shifts as required by the service. Penalty rates are absorbed into vaguetiered remuneration arrangements. Overtime and recall may only be paid on an exception basis (which is not defined). 8. Directives and Contracts – The contracts are subject to any applicable Directives. It is not known whether any other Directives (apart from the current Directive which requires that SMOs be engaged under the contracts) will be issued at any stage that might affect SMOs who sign the contract. 9. No certainty – SMOs are to a large extent required to take the State on trust in a number of areas. For example, the State has unilateral power to vary the contract in relation to a number of matters including remuneration, hours of work and performance review. Mr O’Gorman suggests a number of changes are needed to make the contract more in line with modern employer/employee relationships including: 1. Aspects of the contract that have not yet been determined should be determined and the details provided to SMOs before they are requested to sign the contract. 2. The State should disclose whether it intends to issue any further Health Employment Directives that might affect SMOs’ contracts. 3. The remuneration package should be made more certain and, importantly, by outlining how the remuneration to be paid pursuant to Tier 2, Tier 3 and Tier 4 of the SMO’s Total Remuneration Framework is to be calculated. 4. The State should confirm or deny whether SMOs are, in reality, being forced to enter the contract, in that, not to do so could result in termination of his/her employment with consequential loss of entitlements. 5. The State should outline the types of circumstances in which SMOs could be arbitrarily dismissed, especially in view of the following comments of Lord Millett of the House of Lords:
“Contracts of employment are no longer regarded a purely commercial contracts entered into between free and equal agents. It is generally recognised today that “work is one of the defining features of people’s lives” and that “loss of one’s job is always a traumatic event;” and that “it can be especially devastating” when dismissal is accompanied by bad faith…”
In light of this advice, AMA Queensland continues to urge members not to sign the SMO contract in its current form, after considering your personal situation including individual risks. Public support for our campaign is growing through media coverage and via the ASMOF website of keepourdoctors.com.au.
Please share the link and encourage your networks to get behind the public health system.
AMA Queensland remains confident a workable, acceptable contract can be achieved if Queensland Health returns to the consultation table.
For more information visit www.amaq.com.au; call the AMA Queensland contract information hotline - 1300 356 155 or the ASMOF hotline -1300 362 193
AMA URGES QUEENSLAND DOCTORS TO REJECT DODGY CONTRACTS
AMA President, Dr Steve Hambleton, is urging all Queensland hospital doctors to reject Queensland Government contracts in their current form and is calling on the Queensland Government to return to the negotiating table in good faith to reach a fair and balanced agreement. Read more....
If you would like to view media releases and petitions regarding this matter please click here to visit the ASEM Industrial Relations Committee page.
Searching for a Tasmanian and New Zealand Councillor on ASEM Council
Council is looking for interest to fill the positions of Tasmanian and New Zealand ASEM Council representatives. This is an opportunity to become more involved with the Society and an opportunity to have a voice for Council. This involves participation in a teleconference every 6 weeks and an invitation to the Strategic Planning Day, held annually.
On behalf of ASEM Council, we wish to thank Dr Ian Brandon (QLD Council Rep), Dr Peter Arvier (Tasmanian Council Rep), Dr Sandra Rattenbury (NZ Council Rep) and Dr Joe Rotella ( Trainee Rep and Newsletter Editor) for their contribution as Council representatives. Thank You!
Attention All Medical Students!!
Are you a medical student studying in Australia or New Zealand? Are you interested in Emergency Medicine? Then this offer is for you!
ASEM is proud to announce COMPLIMENTARY electronic membership to the Society for any medical student studying in Australia or New Zealand!
Please note: Ensure the box marked ‘Student’ is ticked and then send your form to ASEM, Reply Paid, PO Box 627, Noble Park Vic, 3174 OR email to $Qfirstname.lastname@example.org.
After joining, you will receive free access to the Members Only section of the ASEM website as well as an electronic copy of the ASEM Quarterly Newsletter. In future, ASEM aims to offer a host of student-focused resources including information about training, career options, clinical tips and tricks, and competitions.
ASEM now on Facebook!!
The ASEM Facebook page has been created to allow members and the public to become more involved with ASEM and see what is being accomplished and done about Emergency Medicine around Australia and New Zealand.
Registrar Positions at Bass Coast Regional Health
Wonthaggi in beautiful South Gippsland Victoria
The positions are accredited with ACEM for 6 months under Rural Health Special Skills and made up of a 43 hour week with no night shifts. Ideally suited to those studying for upcoming exams.
We expect to have 3 positions in 2014, 2 of which will be 50:50 split between anaesthetics and ED and the third, full time ED.
For further information about this fantastic opportunity, please click here.
The Conference will be held at the Langham, New Zealand
The theme for the 2014 Symposium is “Stronger Networks: Learn Today, Use Tomorrow”. We want you to leave the Symposium with practical and useful information that you can take back to your workplace and implement to not only improve patient outcomes, but also how you and your team interact together.
We are very pleased that our key partners are returning for 2014 including MercyAscot, the Royal New Zealand College of Urgent Care, The Royal New Zealand College of General Practitioners and St John. We are particularly pleased to have Nurse Practitioner New Zealand in partnership with us for 2014.
This course will be held at Ultrasound Training Solutions, Melbourne, Vic
Are you a physician wanting to gain practical proficiency in performing and interpreting cardiac and lung ultrasound scans? Are you seeking to utilise cardiac ultrasound for assessment of valvular disease? Do you want to apply ultrasound in a critical arrest scenario?
Then this advanced goal directed course is for you. This specialised three day course will give you practical proficiency in attaining advanced echocardiography views, with plenty of opportunity to apply these skills through our peri-arrest simulation exercises.
Our training philosophy optimises your learning experience with:
• Course development and delivery overseen by consultant emergency physicians
• Small class sizes maintaining a 3:1 student:trainer ratio
• A focus on practical skills acquisition with real patient models
**ASEM Members will receive $100 discount at time of booking**
Dr Sashi Kumar (ASEM ACT Council Member) is a CTLS International Faculty Member. Below you will find further information regarding the course and about Dr Sashi Kumar and his speech presented at the 2013 CTLS course in India.
The Comprehensive Trauma Life Support (CTLS) Course is an authentic course on Acute Trauma Management being organised in India by International Trauma Care (Indian Chapter). This is the only comprehensive course catering to Critical Care Specialists, Anesthesiologists, Surgeons, Emergency Physicians, Facio maxillary & Dental Surgeons, Physical Thereapists, Trauma Care Nurses & Rehabilitation Specialists.
Below are some links that may be of interest. Please click here to view all.
Australian Emergency Medicine Research Review
This Review features key medical articles from global Emergency Medicine journals with commentary from Professor Anne-Maree Kelly. The Review covers topics such as paediatric emergency medicine, emergency medicine guidelines, wilderness emergency medicine, traumatic injuries, sports injury, head injury, and penetrating trauma.
Research Review publications are free to receive for all Australian health professionals.
If you would like further information, or subscribe to receive publications via email please click here
Patient Blood Management Guidelines 2013
Please click on the link below to view the progress update for 2013's Patient Blood Management Guidlines.
The National Blood Authority (NBA) is pleased to announce that the Patient Blood Management Guidelines: Module 4 - Critical Care and accompanying Quick Reference Guide are now available and can be downloaded or ordered free of charge from the NBA website.
Federal Government Grants for Rural Emergency Medicine Doctors
The Federal Government has recently announced an increase in funding for procedural GPs in rural areas (RRMA 3-7) to access ongoing training and skills maintenance in emergency medicine under the "Strengthening Medicare" Program. This can include travel costs, locum relief and associated expenses. The maximum amount is $2000 per day for 3 days. To be eligible, GPs must provide evidence they providing emergency medicine services to a 24 hour emergency department or similar facility.
Funding is also available for skills maintenance in obstetrics, anaesthetics and surgery.
Further information is available from: ACRRM or RACGP
Free access to BMJ Learning for all NSW Health Professionals
BMJ Learning is a CPD website which contains hundreds of learning modules covering over 70 specialties and both clinical and non-clinical topics. The online modules are in a range of different formats including audio, video and animations, and are all written by experts. Modules can be paused and restarted at any time, making them a convenient and flexible way for healthcare professionals to keep up-to-date and test their knowledge.
The Childhood Fracture Management Project is a collaboration between the Victorian specialist paediatric orthopaedic hospitals: The Royal Children’s Hospital, Monash Children’s, Western Health and Barwon Health.
Led by the Victorian Paediatric Orthopaedic Network (VPON) and Developed by Emergency Physicians and Orthopaedic Surgeons, the Childhood Fracture Management Project provides all Victorian hospitals with best-practice guidelines and education for identifying and managing paediatric fractures.
To access the Childhood Fracture guidelines resources go to: ww2.rch.org.au
Life in the Fast Lane
This Medical Blog was born out of passionate (and usually unresolved) debate pertaining to the elements of eLearning; clinical cases; ECG interpretation; medical education; toxicology; medical history and information sharing strategies in the open source era.