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Annual Presidents' Reports

2005 - Dr Ian Scott (cont...)

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Awards and Fellowships

Travelling Scholarship.

Dr Patrick Gladding, an advanced trainee in general medicine from NZ, was the recipient of the 2004 IMSANZ Travelling Scholarship which allowed him to attend the 7th European School of Internal Medicine meeting in Alicante Spain in October. Patrick’s experiences of this meeting were summarised in the December newsletter.

Research Fellowship

The first of our $10,000 research fellowships has been awarded to Dr Alison Mudge, an advanced trainee in general medicine at Royal Brisbane Hospital in Queensland. This award recognises young members who are pursuing postgraduate studies in health services research, clinical epidemiology or quality improvement science. Alison’s many achievements to date were profiled in the April newsletter and we wish her every success as she pursues a PhD degree analysing the outcomes, cost-effectiveness and generalisability in hospital practice of a new model of unit-based multidisciplinary teams combined with formalised communication structures that facilitate early patient evaluation and agreed team management plans. In an era of chronic illness in aging populations and booming demand for hospital care, this work has great importance, and IMSANZ is very pleased to support it.

Excellence in Clinical Education

This award worth $1,000 is bestowed on an IMSANZ member who is regarded by his or her peers as being an exemplary role model in general medicine for young trainees and who has expended more than expected effort in furthering their clinical education. It gives me great pleasure to announce that Dr John Henley from Auckland, NZ is this year’s award recipient.

Advanced Trainees Award for Best Paper presentations

These awards continue to be given at both this ASM and the IMSANZ ASM in Alice Springs and I thank Roche Pharmaceuticals for their continued sponsorship. I encourage everyone to attend tomorrow’s IMSANZ free papers session and hear 8 very interesting presentations from our advanced trainees.

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Communications

While it has not happened as fast as I would like, the changes to the website have been worth waiting for and I wish to thank Anne Kovach for her assistance in this. The newsletter continues to go from strength to strength and once again many thanks are due to our hard-working editor, Michele Levinson, for helping produce such a terrific product. Last year we published our first Annual Report which was distributed to all members and which we have included in invitation packs to those who have expressed interest in joining our society or collaborating with us on specific projects.

The database on hospital advanced training positions in general medicine continues to grow with entries from another 10 hospitals being included in the latest CD version which are available from the IMSANZ booth. As president of IMSANZ I have been invited to speak on the future of general medicine and career opportunities as a general physician at a forthcoming forum in Sydney which attracts large numbers of trainees still pondering their choice of vocation, and thus affords us another opportunity to make young folk aware of the professional rewards of being a general physician.

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Consultancies and Representations

Over the last 12 months, IMSANZ Council has again been active in reviewing and endorsing several guidelines and policy documents received from several agencies including: revised guidelines in heart failure and rheumatic heart disease from the National Heart Foundation/Cardiac Society of Australia and New Zealand; national service improvement frameworks in asthma and osteoporosis and arthritis from the Australian Health Ministers Advisory Committee; revised RACP ethics guidelines on physicians’ relations with pharmaceutical companies; draft RACP guidelines on chain of information custody with respects to laboratory investigations; draft guidelines for the Victorian coroner’s office inquiries into hospital deaths possibly related to radiological investigations; to and consumer resources for reducing risk in heart disease from the National Heart Foundation.

IMSANZ has also been very pleased to collaborate with the National Institute of Clinical Studies, the Cardiac Society of Australia and New Zealand, and the National Prescribing Service (NPS) in a joint heart failure program which aims to raise awareness among general practitioners, consumer support groups and the general public about ways for improving the diagnosis and management of heart failure. This program was detailed in the April newsletter. Members of IMSANZ have also been involved as expert facilitators at evidence-based rational use of medicine seminars organised by the NPS on a range of different drug classes. IMSANZ has been invited to nominate a representative on the NSW Health Shared Scientific Assessment Committee which aims to provide one central ethical review process for trial protocols which apply across several hospitals. We have also been invited to contribute to a Senate inquiry into services and treatment options for cancer patients. IMSANZ members have also been assisting the RACP Clinical Indicators Working Group in formulating a set of valid, reliable indicators for internal medicine that could be used by the ACHS for their 2006 accreditation program and which would replace those currently being used which are regarded by most physicians as being next to worthless. In New Zealand IMSANZ has been asked to comment on the national policy document that provides projections over the next 20 years of demand for health and disability services and workforce implications as a result of ageing of the NZ population.

In addition to all this work I wish to acknowledge the efforts of many of our councillors who represent IMSANZ on various college committees and working groups, as listed in the appendix. I have included this information to remind members of the work that these folk do on our behalf, and to demonstrate the wide representation that IMSANZ has across the spectrum of college affairs.

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Links with other GIM societies

Ours is not the only society of general internal medicine (GIM) in the world that is grappling with the need for less subspecialisation and fragmentation of care with its attendant costs, and its replacement with a more integrated, patient-centred care continuum which gives equal emphasis to prevention and maintenance care as it does to care of acute illness. There is now a recognition that GIM societies around the world might benefit in their efforts to advance our discipline if we were to come together and form a global network in which we could share insights and experiences, collaborate in training and research activities, and assist each other in lobbying our subspecialty colleagues and governments for more recognition and support.

IMSANZ has forged strong ties with European societies through our long-standing involvement with the European School of Internal Medicine annual scientific meeting and more recently with our preparation in hosting the 2010 ICIM congress. We now need to turn our focus to build similar links with our US, Canadian, Asian and South American colleagues, especially the Canadians as the practice and training of general physicians in that country, as well as its health care system, most closely resemble what happens here in Australasia.

A number of us will have the opportunity to discuss this issue with Eric Larson, regent of the American College of Physicians, who is giving a presentation on the future of general medicine at a session tomorrow and who comes from a country where the debate on how to reinvigorate general medicine practice has become a national obsession at various levels – university, college, government, health plans, and the public.

In a similar vein, I was very happy to accept the invitation from the US Society of General Internal Medicine (SGIM) to attend and speak at their May 2005 annual scientific meeting in New Orleans in a special session titled “The Globalisation of Internal Medicine.” This will give me an opportunity to describe the Australasian experience and compare our situation with what happens in other countries. Peter Greenberg has co-authored an article which is to be published in the SGIM’s Journal of General Internal Medicine later this year which compares the evolution of GIM in Australasia, the US, Canada, Argentina, Japan, and Switzerland. The organisers of the meeting are keen to formally convene a global network of GIM societies and an international congress of GIM societies is mooted for 2010. I will be doing everything I can to support the establishment of an international federation of GIM societies and to offer the assistance of IMSANZ in organising the congress.

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New Members and Councillors

On behalf of the society I give a very warm welcome to the 22 trainees and 25 fellows that have joined IMSANZ over the last 12 months. I would also like to express the gratitude of council to the efforts over the last 4 years of Simon Dimmitt, David Hammill, Bruce King, Diane Howard and Les Bolitho who today have completed their terms as councillors. We wish them well and know they will continue their ongoing interest in society affairs. In turn I welcome to council Gabriel Shannon from NSW, Jaye Martin from WA, Alasdair MacDonald from Tasmania, Emma Spencer from NT and Andrew Bowers from NZ.

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A Special Thanks

Finally I would like to give my special and final thanks to the society’s unsung hero, our secretariat, Mary Fitzgerald. Once again Mary has endured another relocation of her office during this past year, has absorbed an ever increasing workload which has included organising not one but two scientific meetings, and has coped with an exponential rise in the numbers of e-mails. Throughout this time she has never failed to impress me with her quiet and cheery approach to life and her dedication to looking after the best interests of this society. Once again you and I owe her a huge debt of gratitude and I’m sure you will join with me in acknowledging our appreciation.

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Closing Comments

In closing I thank the Council and members of IMSANZ for the opportunity to serve as your president over the past 2 years. It has been a very gratifying experience and I hope that my efforts are perceived as having been worthwhile. I have only one real regret – that we have not been able to make any substantial headway in advancing the cause for general medicine in tertiary hospitals in NSW. In my last annual report I had indicated that the Greater Metropolitan Transition Taskforce, with IMSANZ representation from Michael Kennedy, held promise in bringing about the return to Sydney teaching hospitals of general medical units staffed with full-time general physicians. I was also hopeful that meetings involving Jill Sewell and college executive with the NSW health minister in August last year, together with efforts of the NSW Health Workforce Roundtable and the Commission of Clinical Excellence, would galvanise action in reinstating general medicine. I am very disappointed to report that much of this early promise has dissipated, with the exception of some commitment to medical registrar training within regionalised hospital networks, and creation of general medicine training positions at Coffs Harbour and Armidale.

But let me finish on an upbeat note. Our society is strong, it has respect and influence, and we are making full use of the opportunities that present themselves to us in shaping the agenda of college and government policy in a way that allows general medicine to flourish. I hope that all of us, as a community of physicians, will continue to act as role models to others and articulate in word and in deed our vision of the future for general medicine.

In some respects I feel our colleagues here in New Zealand are a little closer than we are in Australia to the ideal state of affairs and I therefore find it very fitting that here in Wellington, I now ask you to warmly welcome our new president, Phillippa Poole.

Dr Ian Scott, MBBS, FRACP, MHA, MEd.
President, IMSANZ (2003-2005)
9 May 2005

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