News and events
2017 Winter Edition Newsletter
Emergency training in virtual reality
Investigating adolescent family violence in Victoria
Challenges GPs face in diagnosing and managing patients with work-related mental health conditions
Monash DGP at the forefront of big health data research
Innovative models promoting access and coverage transformation (IMPACT)
Barriers and facilitators to the delivery and uptake of long-acting reversible contraception: What are the views of GPs?
2017 Autumn Edition Newsletter
2016 Annual Report
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Teaching Tips - Parallel Consulting
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Medical students lead diversity education
A group of Monash medical students embarked on a project far greater than university grades.
Following his TEDxMelbourne talk in 2015, Dr. Maithri Goonetilleke, Monash PhD candidate, medical teacher and lecturer was approached by his old high school, Carey Baptist Grammar School, to discuss ways in which they could enhance their diversity and inclusion.
Gathering a group of his committed students, led by Nishani Nithianandan and Hui-Ling Yeoh they delivered workshops to year 10 students, covering topics such as blackface, shopping while black, Adam Goodes and whitesplaining.
This 'out of the class room' project is a great example of the leadership and courage Monash medical students embody, which had an significant impact on both students and teachers at Carey.
2016 Winter Edition Newsletter
The 2016 Winter Edition Newsletter is full of the latest in our world of General Practice at Monash University. Includes up-coming events for your calendar, opportunities to teach medical students and all the latest in our general practice research.
Stay up to date with the latest from the Department by subscribing to our newsletter here.
Increasing the use of long-acting reversible contraception: The Australian Contraceptive ChOice pRoject (ACCORd)': An NHMRC funded randomised controlled trial.
Monash University are seeking GPs who work three or more sessions per week, are based at a computerised practice, and have a receptionist who can assist with re
The primary aim of the study is to increase the uptake of Long-Acting Reversible Contraceptives (LARCs) amongst Australian women. The study involves training GPs to provide "LARC First" structured contraceptive counselling and implementing rapid referral pathways to allow women to access timely LARC insertion.
Participants will receive online training and complete questionnaires and data collection forms. GPs will receive 40 Category One RACPG Quality Assurance and Continuing Professional Development points and $500 for time spent on the study.
For more information, please contact Catriona Rowe and Catherine Savage on 9902 4945 / 9902 4583 or firstname.lastname@example.org
General Practice Students Network (GPSN) Careers Night
The annual Monash GPSN Careers Night was held recently showcasing three of our extraordinary teachers who passionately dedicate themselves to General Practice, Dr. Mrin Nayagam, Dr. Craig Hilton and Dr. Josephine Samuel-King.
Enthusiastic medical students received advice and support on how to balance special interests, how to navigate the world of GP, and how to live and practice compassionately.
Teaching Tips from your colleagues in General Practice, read more
Dr. Maithri Goonetilleke TEDx Melbourne
PhD student Dr. Maithri Goonetilleke presented at the TEDx Melbourne Conference in August of this year, entitled the Art of Dreaming. He speaks about the lessons learnt on his journey as well as the work of Possible Dreams International in rural Swaziland.
GPs seen as soft touch in compo cases
17 August 2015
GPs are not trying hard enough to encourage injured workers to go back to work, according to employers and workers' compensation groups.
Clashing attitudes about the GP's role in promoting return to work in people with compensable injuries have been revealed in a study involving 26 workers' comp personnel, 25 employers, 25 GPs and 17 injured workers from Victoria, say researchers from Monash University.
GPs were accused of allowing patients to have as much time off as they liked, but GPs said that they saw themselves as patient advocates and placed greater value on getting their patients well again than meeting the needs of compensation agents and employers.
Injured workers mostly described their GPs as "good", "supportive", "caring" and with their "finger on the pulse".
However, workers' comp personnel said they often referred to GPs as "Doctor How Long" because they would give injured workers as much time off as they requested, regardless of their capacity to work.
"[GPs] are the best advocates for the clients so therefore they need to have a strong discussion about [return to work] … they really need to promote return to work. I just wish they could open their eyes a little bit and look at it," one compensation personnel told the researchers, who were led by Professor Danielle Mazza, the head of the department of general practice at Monash University.
Compensation personnel also said that GPs were more likely to certify incapacity to work when the patient was experiencing extenuating social circumstances such as lack of available childcare or marital discord, and did not adequately consult employers before writing sick certificates for their employees.
"GPs are really only certifying a worker to what the worker tells them that they can do," one compensation agent said.
"The GP has not gone out to the work site, the GP probably won't have a good understanding of … what a worker's role involves, whether they are a labourer or an office worker … they wouldn't have a good understanding of those duties."
Meanwhile, GPs told the researchers that they often tried to minimise interactions with employers and compensation personnel due to time constraints, lack of remuneration for time spent on the phone with workers' comp organisations, frustration with the compensation system and high paperwork burden.
According to one GP: "The heart-sink patients … are patients — the WorkCover ones — that make us all shudder.
"They've been on WorkCover forever, there's all this conflict between the insurance company itself, the employer, the patient, [and] we are stuck in the middle. You write report after report saying the same thing; it goes nowhere."
Despite these frustrations, most GPs said that they recognised the benefits of injured workers returning to work.
One GP told them: "Work is an antidepressant ... At work, [injured people] get to feel better and they feel that they can contribute again to society as before."
All interviewed parties agreed that improving the layout and content of the certificates for assessing capacity could increase the rates of injured people returning to work.
One of the main suggestions was to provide an option for GPs to state what activities the injured worker can do rather than what they cannot do, for example, how long they can sit or stand and how much they can lift.
More than 40,000 older patients visiting emergency departments unnecessarily
27 July 2015
Ageing patients are visiting Victorian hospital emergency departments more than 40,000 times a year for illnesses that could be treated by general practitioners, researchers have found.
The findings of a preliminary study showed that 19 per cent of visits to emergency departments by people over 70 were for "non-emergency" health problems.
Emergency department presentations for ear and eye infections were among the common reasons for seeking treatment. Mondays at 9am was a peak period for this group of patients.
The findings, which are yet to be published, will be presented at a conference at Flinders University by the Primary Health Care Research and Information Service.
The Monash University researchers examined data sets from hospital emergency departments across Victoria and general practice medical records from residents in the inner eastern suburbs.
The researchers reported that more than 200,000 presentations by older Victorians over a five year period were unnecessary. One of the study's chief investigators, Bianca Brijnath, said she was surprised to find many older people were seeking help at emergency departments first thing on Monday mornings.
"You would think that people would turn up at 12 o'clock at night on a Saturday," she said.
Dr Brijnath said general practitioners were very busy on Monday mornings, forcing some patients to seek treatment at hospitals.
She added that there was also a lack of awareness about other health services, including community health services, nurses on call and walk-in clinics.
"But they're just not being used to the full extent they could be," she said.
Last week Victorian Premier Daniel Andrews said tens of thousands of people could avoid expensive hospital treatment if the health system was more focused on prevention.
He said about 60,000 Victorians were being admitted to hospital every year unnecessarily.
The study looked at the data for five years up to 2012.
The patients were considered non-urgent if they were allocated a low triage category of four or five, did not attend the emergency department by ambulance and were not admitted to hospital.
Fellow lead investigator and practicing GP Danielle Mazza said about 30 per cent of avoidable presentations were by people who visited the emergency department multiple times in a 12 month period.
"There is a sub group that is using emergency departments quite a lot," she said.
Health Minister Jill Hennessy said Victoria's health system was among the best in the world but becoming unsustainable.
"Pressure on the hospital system is mounting, so patients who could be treated in the community, should be treated in the community to free up hospital beds for people who need them the most," she said.
Australasian College of Emergency Medicine president Anthony Cross said increasing resources for GPs would help prevent older patients from turning up to emergency departments.
GPs could have dealt with elderly hospital ailments: survey
24 July 2015
Almost a fifth of emergency department visits by the elderly are for problems that could have been managed by their GPs.
A Monash University study found hospital visits by older people were clogging emergency departments, with more than 40,000 visits a year to Victorian hospitals that could have been managed outside the hospital system.
This comes as premiers debate the need for an increase in the GST rate to 15 per cent to help pay for the nation’s future health funding needs. The research debunked the commonly held belief that most avoidable visits from the elderly were for falls and fractures outside business hours. Rather, it found that most complaints were for eye and ear problems.
The peak of their presentations were on Monday at 9am. Preventive care by GPs was also lacking, potentially accounting for some of the hospital visits by those aged over 70.
Australian Medical Association vice-president Stephen Parnis, an emergency physician in Melbourne, urged caution over the study's findings, saying it was hard to differentiate when the best care should be provided by a primary care physician or an emergency department.
"We are very much interested in what constitutes the most efficient care, but right now I think we have more questions than answers," Dr Parnis said.
He said there needed to be better links and communication between GPs and emergency departments.
"In general terms, there is no doubt the population is getting older and the proportion of people with multiple medical problems is increasing, so the complexity is also increasing," Dr Parnis said. "This means that continuity of care becomes even more important."
Zambian adventure a remarkable research experience
29 February 2012
Fire ants and elephant-friendly traffic were all part of one Monash researcher's recent training stint in Sub-Saharan Africa.
Earlier this year Dr Bianca Brijnath spent three weeks in Zambia as part of a World Bank program, where she supervised a research team interviewing health staff at rural health facilities.
The team conducted 81 interviews as part of baseline evaluation of a World Bank-funded initiative. It is anticipated that the results will shed light on the motivation and job satisfaction of rural health workers in low income countries, the challenges and innovative methods they use to deliver healthcare, and yield a deeper understanding of the social and cultural context in which care is delivered.
“It was an amazing learning experience,” Dr Brijnath said.
“We did four days of theoretical training in Lusaka and then we were into the field. The research settings were very different to how we might do things in Australia.
"Our team had to deal with the rainy season, roads that had been washed away, poor to no mobile coverage, malaria, and lots of wildlife - everything from elephant crossings to spiders and fire-ants!”
For Dr Brijnath, who specialises in cross-cultural research and mental health research, the experience allowed her to appreciate her own work conditions in Australia.
“Working in such settings gives you a totally different perspective and insight into planning and conducting research. You have to think carefully about the science and the logistics of what you are trying to do versus what is feasible."
Dr Brijnath currently holds an NHMRC Early Career Fellowship and is a researcher with the Department of General Practice in the Monash Faculty of Medicine, Nursing and Health Sciences.
Training the trainers
Monash University's Department of General Practice in the School of Primary Health Care, is helping train future Chinese GP 'champions'.
Please see the following story which was published in the Monash Memo on 5 August 2011
Towards an Integrated GP Curriculum at Monash University
Monday June 12th- Wednesday June 14th 2011
Tan Sri Jeffery Cheah School of Medicine
Johor Bahru, Malaysia
In June 2011, staff from Monash's campuses around metropolitan and rural Victoria travelled to our Malaysian campus in Johor Bahru for the Towards an Integrated GP Curriculum at Monash University conference. The conference was convened by our Head and Deputy Head, Professor Danielle Mazza and Dr Peter Barton. The conference provided staff from across all sites with a forum to share their teaching experiences, increasing our collective awareness of the diversity of current 4th Year General Practice term curriculum delivery. The conference provided a timely and unique opportunity for Monash University staff who are involved in the development and delivery of the 4th Year General Practice program across the various campuses to meet, forge relationships and move towards a more integrated course structure. A key outcome of the meeting was the development of "Monash GP", a network of staff involved in general practice teaching and research across all Monash campuses.
Dr Cathy Grech
Department of General Practice
Dr Maimunah Mahmud (Malaysian GP Fellow) publication “Preconception care for women with diabetes: a review of current guideline recommendations” highly accessed for age
Maimunah Mahmud joined the Department of General Practice as a Fellow in 2009 examining general practice aspects of women’s sexual and reproductive health. In Maimunah’s practice in Malaysia she has a large population of women of reproductive age who are diabetic. Her research project sought to define current best practice in preconception care for these women. She chose to publish in an open access journal so that her findings could be disseminated widely in her region and accessed easily by those in developing countries who have a higher burden of disease in this area. Maimunah’s article has subsequently been nominated by the publishers as “highly accessed for age” with the total number of accesses since publication at 2163.
Preconception care for women with diabetes: a review of current guideline recommendations
Maimunah Mahmud and Danielle Mazza
BMC Women's Health, 10:5 (31 January 2010)
Associate Professor Jan Coles leads International Briefing Paper for Sexual Violence Researchers
Associate Professor Jan Coles of the Department of General Practice has recently led the preparation of an international briefing paper for the Sexual Violence Research Initiative (Medical Research Council, South Africa) on researcher safety for researchers undertaking sexual violence research. The paper was a response to the needs of researchers in this area.
Jan began working in this area of research because of patients she was seeing in her clinical practice had difficulties with aspects of parenting because of their past history of childhood sexual abuse. It shows what clinical general practitioners can do when their research is based in responding to their communities.
Department of General practice welcomes 10 visiting Chinese Doctors for training in general practice
From Monday 12 April to the Monday 7 June the Department of General Practice was host to 10 doctors from Shenzhen in China. These senior doctors came to Monash University to learn more about general practice in Australia, general practice training and the Australian health care system. The doctors had a busy schedule of lectures, workshops and discussions accompanied by site visits to general practice clinics, the Victorian Metropolitan Alliance, Monash Medical Centre, the RACGP, the Monash Division of General Practice and the Springvale Community Health Centre. We hope that this will be the first of many visits by Chinese doctors to our department in the future.
The department of general practice supports international research students
Associate Professor Peter Schattner (pictured above, with a second photo showing his audience) recently ran workshops on evidence based medicine in general practice and an introduction to research methods, including survey design to assist several post-graduate fellows from Malaysia and Saudi Arabia. Further seminars are scheduled as part of the DGP Seminar Series to be held at the Notting Hill Campus on Wednesdays at lunchtime. These seminars are open to students and staff, academic colleagues, general practitioners and those involved in primary health care. To be added to our email distribution lists of seminars and events held in the department please contact email@example.com.
New Electronic Log Book
Fourth year medical students attending the Notting Hill program currently complete a paper based log book during their 9 week GP rotation. This provides us an insight into the types of GP conditions our students are seeing, how many problems, and how the student is involved in each patient presentation (i.e. history taking, examination, procedure or overall management).
In this next rotation (rotation 3) commencing on July 5, for a small cohort of students, for the first time we will be trialling an electronic log book that will do all of the above AND also enable us to compare what the student sees with BEACH data. The data can be seen by the Department in real time. If successful, all students will be using the electronic log book at all sites (and hopefully in other rotations (childrens, womens, psych) by 2011. This will enable us to know where students are most likely to come across specific presentations/activities (e.g. asthma, pap smears) and what important patient experiences students may be missing. It will also enable easier comparison between student experiences at different practices including between the urban, rural and Malaysian sites/programs. This exciting development has many other benefits and will undoubtedly open up/facilitate a range of research projects – up to your imagination! I look forward to a successful roll out.
Year 4 GP program co-ordinator
Peter Barton visiting Gifu, Japan as a visiting Professor of communication and medical education
In June this year Peter Barton visited Gifu, Japan, as a visiting professor of communication and medical education. This followed a previous visit (2009) where he had lectured at the Medical Education Development Centre (MEDC) of Gifu University, one of Japan’s two national medical education centres.
Peter provided lectures and seminars on clinical communication curricula (contrasting UK and Australia), feedback and consultation skills teaching, undergraduate ethics teaching, the massive Glasgow 50 station OSCE that he previously ran, and the state of clinical skills teaching in Scotland.
Happy Healthy Women
Every clinic visit provides an opportunity to ameliorate its effects.(1) Primary care providers have a unique opportunity to assist and support women by engagement, high quality coordinated responses and providing access counselling and other necessary services.
Associate Professor Jan Coles from the Department of General Practice was the keynote speaker for the Australian Women's Coalition (AWC) recent launch of the Happy Healthy Women: Not Just Survivors report in Sydney. The report advocates for an improved accessible affordable long-term model of integrated care for survivors of sexual violence and will be used to lobby for improved services with the Australian Government.
"As health professionals we are often unaware of our patient's history of sexual abuse. Routine physical examination can be challenging to survivors and as doctors we may be unaware of the difficulties arising for patients." Associate Professor Jan Coles.
"My work as a therapist has taught me that trauma that is buried is not gone – it gets written in the body as symptoms. Doctors by and large haven't understood the connection between sexual trauma and patients' symptoms – between the body, the spirit and the mind." Dr Raie Goodwach National Summit Introduction.
"Accessing health care can be difficult: The lack of recognition, the cost, the attitudes and the difficulty of finding the right services when necessary across a lifetime. Responses are focused on acute rather than the long-term needs of women" Combined feedback from National Summit.
Some of the recommendations are very pertinent to the education of undergraduate and postgraduate students across Faculty of Medicine Nursing and Health Sciences.
These included Recommendation 16
- Incorporate long-term health sequelae of sexual violence (including assessment, treatment, management, and referral pathways) in undergraduate medical curricula, postgraduate training, and continuing medical education to equip doctors to recognise and respond effectively to the needs of survivors.
Although the report recommendations focused on doctors, they can be applied to all health professionals who provide direct clinical care to survivors of sexual violence. Opportunities exist for Monash University to become a leader in undergraduate and postgraduate health professional education in this area.
The report, which is part of the advocacy work of the AWC, includes AWC membership perspectives, the views of key stakeholders from the National Happy Healthy Women Summit that was led by Dr Raie Goodwach and Associate Professor Coles in Melbourne in May.
(1) Unifem: Main Strategies to End Violence against Women and Girls (Health) p1.