NZMA, New Zealand Medical Association, Rotorua
 
GP CME South 2010 Speakers

 

Dr Robert Allison, Otolaryngologist, ENT Surgeon, Christchurch Public Hospital
Mr Brian Almand, Pharmacist, HVDHB Hutt Hospital Pharmacy, Wellington
Dr John Apps, General Practitioner, Westport
Dr Adrian Balasingam, Radiologist, Christchurch Radiology Group, Christchurch
Dr Alex Bartle, Director, Sleep Well Clinic, Auckland
Dr Philip Bird, Otolaryngologist, Christchurch Public Hospital, Christchurch
Dr Jim Borowyzck, Musculoskeletal Physician, Christchurch
Dr David Bowie, Intensive Care Specialist, Specialist Anaesthetist, Canterbury DHB
Dr David Bratt, Principal Health Advisor to the Ministry of Social Development
Mr Andrew Carmody, General Manager NZ, Medtech
Dr Peter Chapman-Smith, Skin and Vein Clinic, Whangarei
Dr Daniel Ching, Consultant Rheumatologist, Timaru Hospital
Dr Richard Chisholm, Obstetric radiologist, Christchurch Women's Hospital
Dr Sean Every, Ophthalmologist & Vitreo-Retinal Surgeon, Christchurch Eye Department
Dr Richard Fisher, Medical Director and Co-founder, Fertility Associates
Dr Peter Foley, Chairman of the New Zealand Medical Association, Hawkes Bay
Associate Professor Ed Gane, Hepatologist, Auckland City Hospital
Mr John Glue, Senior Advisor, Medical Assurance Society, Dunedin
Dr Brendan Gray & Dr Tim Cookson, Medical Protection Society
Dr Katherine Grundy, Clinical Director, Christchurch Hospital Palliative Care Service
Dr David Hammer, Clinical Microbiologist, MedlabSouth
Dr Nigel Harrison, Consultant Physician and Head of Cardiology, Whangarei Hospital
Linda Hill, Registered Nurse and Regional Immunisation Advisor, South Island for the Immunisation Advisory Centre
Dr Shaun Holt, Research Review, Tauranga
Associate Professor Gary Hooper, Associate Professor and Head of Department, Orthopaedic Surgery and Musculoskeletal Medicine, Christchurch School of Medicine and Health Sciences
Professor Hamid Ikram, Clinical Professor of Medicine, University of Otago, and Consultant Cardiologist, Christchurch
Dr Rosemary Ikram, Clinical Microbiologist, MedlabSouth
Dr Peter Joyce, Dean of the University of Otago, Christchurch
Dr Ai Ling Tan, Gynaecological Oncologist at, ADHB and Ascot Central Women�s Clinic, Auckland
Dr Ken Macdonald, Dermatologist, Dermatologic Surgeon, Christchurch
Dr Roland Meyer, Respiratory Physician, Southern DHB, Southland Hospital
Dr Philip Parkin, Consultant Neurologist, Christchurch Hospital, Christchurch
Dr Mark Peterson, Chair NZMA GP Council, Napier
Dr Claude Preitner, Senior Medical Officer, Civil Aviation Authority of NZ
Mr Sanjeewa Samaraweera, Chief Operating Officer, Medtech
Dr Sara Souter, Occupational Medicine Specialist, Christchurch
Dr Ian St George, General Practitioner, Medical Director, McKesson New Zealand, Wellington
Dr Bruce Sutherland, General Practitioner, Warkworth
Tony Ward, Senior Helicopter Crewman, Advanced Paramedic/RN, Christchurch
Dr Phil Weeks, Director of Ultrasound, Middlemore Hospital, Auckland
Dr Anton Wiles, General Practitioner, Auckland
Chris Wills, Business Advisor, Medical Assurance Society 
Dr Heather Young, Sexual Health Physician,Christchurch Sexual Health Clinic, Christchurch Hospital
Dr Rob Young, General Physician, Associate Professor of Medicine and Molecular Genetics

 

BIOGRAPHIES & ABSTRACTS
GP CME South 2010 - Dr Robert Allison
Dr Robert Allison
 
Robert Allison (MB ChB DCH FRACS) Consultant ENT Surgeon works in both public and private practice in Christchurch. He completed fellowships in the UK and Holland in Head and Neck Surgery. In addition to his clinical activities, he has positions as Adjunct Professor (University of Canterbury) and Clinical Lecturer (Christchurch Clinical School of Medicine) and is involved in undergraduate teaching. He is also actively involved in Registrar teaching. He is an examiner with the Royal Australasian College of Surgeons. 

His clinical interests include Paediatric Otolaryngology, Thyroid and Salivary gland surgery and the management of Head and Neck tumours. 

He and wife, Sue, have four children (12-19 years) and live on a lifestyle block of 30 acres north of Christchurch with 137 animals (at last count!).

Email: rob.allison@chchorl.co.nz 
Phone: 03 355 3299

 

 

Lumps and Bumps in the Head and Neck - Concurrent Workshop Repeated 
 
Saturday, 7 August 2010 Start 11:00am Duration: 55mins Chancellor 1
Start 12:05pm Duration: 55mins Chancellor 1

Lumps or swellings in the Head and Neck can have a wide range of causes. This talk aims to provide a logical way of approaching these, leading a likely diagnosis and management plan in general practice. 

The presentation is divided into four main areas, with some degree of overlap. 

1. Neck lumps in children.
2. Neck lumps in adults.
3. Salivary gland disorders.
4. Head and Neck cancer presentation.

1. Lateral paediatric neck lumps are commonly inflammatory nodes which can be managed in general practice, unless they persist. Midline paediatric neck lumps are usually developmental and require referral.

2. In adults, the presence of a painless lateral neck mass can often indicate a metastatic malignant node. Midline neck masses are usually of thyroid origin. Fine needle aspiration (FNA) is a useful investigation but does have a significant false negative rate. If the FNA is not consistent with the clinical picture there should be a low threshold for repeating the FNA, or considering referral 

3. Head and Neck cancers are relatively common, but present with a wide range of 
symptoms and can masquerade as benign disease, necessitating a high index of suspicion to make a diagnosis. Treatment is multi-disciplinary and usually curative. 

 
 
GP CME South 2010 - Dr Brian Almand
Dr Brian Almand

I have fourteen years of pharmacy practice, with less than one year in community pharmacy. For the past eleven and a half years I have been working in and out of the Hutt Hospital Pharmacy, all of that time associated with the Acute Psychiatry Ward. Within the pharmacy I am an Intern Preceptor and supervise a number of our functions including regular House Surgeon education by our team of pharmacists, I am also involved with the Hutt Hospital Drug and Therapeutics Committee and the Hutt Valley District Health Board Pharmacy Reference Group. For the last five years I have been employed half time by the Hutt Valley District Health Board Community Mental Health Services working closely with the various teams and responding to General Practitioner referrals where specific medicines information is appropriate. Most recently I have completed studies toward the Postgraduate Certificate in Psychiatric Therapeutics by correspondence through Aston University in the United Kingdom.

My role in psychiatry includes medication review usually associated with my regular attendance at six of adult mental health Multiple Disciplinary Team meetings each week, including that of the Psychogeriatric team; frequent medication and therapeutics education for various professional groups and question & answer session with a number of outpatient groups, individual inpatients and their families; provision of medicines information for psychotropic medications, maternal mental health and neurology; full time availability for consultation by anyone, I carry a pager and a cellphone! I am also involved in a good deal of behind the scenes communication between the various teams.

I have received speakers honoraria from the NZ Healthcare Pharmacists Association, Epilepsy New Zealand, Eli Lilly & Co. and have consulted for Parkinson�s New Zealand and Weltec.

 

Dispensing to the Elderly - Practice Nurses Programme
 
Saturday, 7 August 2010 Start 11:25am Duration: 25mins Holiday Inn Ballroom 2
A review of particular concerns with respect to older adults and psychiatric medications including common adverse effects, interactions and dealing with polypharmacy. Bring your questions.
 
A Prescribers Guide to the Galaxy - Concurrent Workshops Repeated 
 
Saturday, 7 August 2010 Start 2:00pm Duration: 55mins Christchurch
Start 3:05pm Duration: 55mins Christchurch
This is a revealing response to doctor�s prescribing from the person responsible for the interpretation of your requirements and the subsequent realisation of that treatment modality, your most frequent reviewer, the Community Pharmacist. Along with a few insights from the District Health Board angle we will, ever so briefly, look into the Pharmaceutical Schedule. There will be a concurrent review of the predictive value of the original fictional work with respect to the New Zealand prescription reimbursement scheme, and some points of astronomical value. 
 
Prescribing for Anxiety and Depression - Concurrent Workshops Repeated 
 
Sunday, 8 August 2010 Start 8:30am Duration: 55mins Chancellor 5
Start 9:30am Duration: 55mins Chancellor 5

Frequently Asked Questions Answered, Occasional Problems Solved and Points of Interest with New Medications: 

Covering a range of common questions from General Practice including antidepressant dosing, when to switch and how to switch; common recommendations from specialist services and why they sometimes appear unhelpful; a reminder about anxiolytics, leading to a quick look at new and imminent antidepressant medications, what they are and how to use them. Bring your questions.

 
GP CME South 2010 - Dr John Apps
Dr John Apps
Dr John Apps has been a rural GP in Westport for 4 years. Trained in the UK, he worked in NHS General Practice & A&E Medicine, in addition to running a vasectomy clinic and delivering advanced pre-hospital emergency care. Frustrated with the lack of effective treatment for musculo-skeletal pain, he trained in western style acupuncture focussing on trigger point identification and needling.

After 19 years, he left the NHS to concentrate on his main clinical interests of pre- hospital emergency & wilderness medicine, event medical cover, vasectomy service provision and trigger point needling. Due to lack of attention, he somehow ended up with an Occupational Health business as well!

Wilderness experience includes six Antarctic seasons, high altitude Himalayan trips, extreme marathon events and a recent military tour in Afghanistan's Helmand province.

John lives with his partner, Sue, on a 50 acre forestry block on the wonderful West Coast, where they experiment with self-sufficiency & home-brew.

johnapps58@gmail.com 
mobile: 021 055 8369 
work: 03 788 8230

 

How to .. Trigger Point Needling - Concurrent Workshop Repeated
 
Friday, 6 August 2010 Start 11:00am Duration: 55mins Wellington
Start 12:05pm Duration: 55mins Wellington

Also known as Intramuscular Stimulation, this will be a practical, hands on workshop, so come prepared to be demonstrated on! Participants with musculo-skeletal pain are welcome.

I will give a brief overview of how it seems to work based on the concept of muscle shortening (no science involved), review some cases, show some typical pain referral diagrams and then demonstrate trigger point identification and treatment by examination & needling. The main skill is examination technique to find the painful bits and the only essential knowledge is knowing where NOT to needle!

I use this technique during normal GP consultations: it is rapid and effective in about 70% of cases. Typical problems treated include neck, shoulder and back pain (including those with radiculopathy), chronic headaches and migraine, trochanteric bursitis and epicondylitis.

GPs who have introduced needling techniques into their usual practice, generally report a reduction in referral rates and decreased prescribing of analgesia and anti-inflammatories, not to mention some increased work satisfaction! Some patients even return to work after years on the benefit system!

If time allows, we can include acupuncture treatments that have been shown to be effective for the nasal symptoms of hay-fever and OA of the knee.

 
Performing Vasectomies - Concurrent Workshop Repeated (with Dr Bruce Sutherland)
 
Saturday, 7 August 2010 Start 11:00am Duration: 55mins Auckland
Start 12:05pm Duration: 55mins Auckland

Bruce Sutherland together with Dr John Apps will run a one hour workshop on how to do Vasectomies in General Practice. They will discuss the Preoperative consultation. Then, how to do the procedure, with some short video clips and demonstrations. Followed by Postoperative care discussion and potential pit falls for the vasectomist.

Vasectomy is a procedure that should be performed by General Practioners. They will discuss how this can be facilitated and how we can support the incorporation of this skill into the General Practice model.

 
Wilderness Medicine
 
Sunday, 8 August 2010 Start 9:45am Duration: 25mins Chancellor 1

This session will explore the depth & breadth of wilderness medicine as an emerging discipline, illustrated with cases from around the globe. So, whether you are going as the medic on a charity bike ride, pushing the survival limits at altitude or near the poles, volunteering for disaster relief work or going into a war zone, come along for a light-hearted sharing of experiences, where necessity really is the mother of invention!

We will look at the vital importance of the 7 Ps (proper planning & preparation prevents p*** poor performance), information sources, suitable training, the common problem of pre-departure concealed illness, realistic medical kits, evacuation options and working with local health care providers.

I will bring along some of my treasured items of equipment that I would not leave home without.

 
GP CME South 2010 - Dr Adrian Balasingam
Dr Adrian Balasingam
Dr Balasingam is a subspecialist Gastro-Intestinal Radiologist working at Christchurch Hospital and is a partner of the Christchurch Radiology Group. He is lead radiologist for the Canterbury Colorectal Cancer Multi-Disciplinary Team. He sits on several CT Colonography (CTC) and Bowel Cancer committees both in New Zealand and Australia and has also contributed to the International Collaboration for CTC Standards. He has also involved with the establishment of CTC in Canterbury and around New Zealand which has included both registrar and consultant training. Dr Balasingam is currently Director of Registrar Training at Christchurch Hospital.

 

A review of CT Colonography - A bum test or not?
 
Sunday, 8 August 2010 Start 8:55am Duration: 25mins Chancellor 1
CT Colonography (CTC) otherwise known as Virtual Colonoscopy has stormed to the forefront of radiological imaging of the colon over the past decade. As rates of Colo-Rectal carcinoma increase in New Zealand and with limited access to conventional colonoscopy, CTC has become and even more important tool.

This talk will include a discussion on technique, examples of common conditions, pitfalls, complications and �no bowel prep� regimes for infirmed patients who are unable to tolerate colonic catharsis. The relationship of CTC and conventional colonoscopy will be included including when CTC is not appropriate. The goal is to provide conference attendees a general overview of CTC and to gain a better understanding of its strengths and weaknesses.
 
GP CME South 2010 - Dr Alex Bartle
Dr Alex Bartle
 
Alex was a GP in Christchurch from 1978 until 2007, and in 2000 began a sleep medicine practice, The Sleep Well Clinic, alongside his General Practice.

In April 2007 Alex left General Practice to concentrate on the Sleep Well Clinics in Christchurch, Auckland and Wellington. He now has additional clinics in Tauranga and Whangarei. The Sleep Well Clinic is designed to offer assessment and treatments for all sleep disorders from Snoring and Sleep Apnoea to Insomnia, from Shift Work to children�s sleep difficulties and the Parasomnias. 

Alex is on the Education Sub- Committee of the Australasian Sleep Association, and an inaugural member of the Asia Pacific Paediatric Sleep Alliance. He was a co-author of the NZ Guidelines for sleep disordered breathing in children. In 2009 he completed his Masters Degree in Sleep Medicine through Sydney University. Alex regularly presents seminars to international and national conferences, and industry. 

www.sleepwellclinic.co.nz 
doctor@sleepwellclinic.co.nz  
Phone: 0800 22 75 33

 

 

Why Won't my Child Sleep? - Concurrent Breakout 
 
Friday, 6 August 2010 Start 2:00pm Duration: 55mins Holiday Inn Ballroom 1
Start 3:05pm Duration: 55mins Holiday Inn Ballroom 1

The impact on both the child and the family of a child or adolescent with a sleeping disorder is huge. Approximately 25% of all children in New Zealand experience some type of sleep disorder at some time in their childhood. These range from difficulty falling asleep and frequent nightwakings, to the more serious primary sleep disorders such as sleep apnoea and narcolepsy. Almost 1/3 of primary school children and approximately 40% of adolescents suffer from significant sleep complaints. 

The consequences of sleep disorders in children can be serious, and range from cardiovascular problems and failure to thrive, to behavioural concerns and academic failure. 

The importance of recognising and diagnosing these disorders is vital, as most are treatable with effective medical and behavioural interventions.

At this workshop, a range of children�s sleep disorders will be discussed and will include: 
1. Signs and symptoms of these disorders. 
2. Relevant history and examination to be undertaken, with further investigation if required. 
3. Treatments, both medical and behavioural, that can be undertaken.

 
 
GP CME South 2010 - Dr Phil Bird
Dr Philip Bird

Philip Bird is a otolaryngologist at Christchurch Public Hospital and a Senior Lecturer in Surgery at the University of Otago. He received his specialist training in Wellington and Christchurch and then undertook a fellowship in Otology, Neurotology and lateral skull base surgery at the University of Miami. He is actively involved in research with colleagues at the universities of Otago and Canterbury, specifically in drug delivery to the inner ear and inner ear effects of middle ear interventions. He is in private practice in Christchurch with a special interest in paediatric and adult otology.

Contact (Private rooms): 
Specialists at Nine
Level 2, 9 Caledonian Road
Edgeware
Christchurch 8014
Ph: 962 6020
Fax: 962 6019
Email: phil.bird@chchorl.co.nz 

 

Practical Management of Dizziness and Deafness - Concurrent Workshop Repeated
 
Friday, 6 August 2010 Start 11:00am Duration: 55mins Chancellor 1
Start 12:05pm Duration: 55mins Chancellor 1

This presentation includes a brief overview of the important issues in hearing loss in adults and children stressing the need for early diagnosis of prelingual deafness and management of severe to profound deafness. A pragmatic way of considering the �dizzy patient� is also presented, aiming to have an interactive session.

 
 
GP CME South 2010 - Dr Jim Borowczyk
Dr Jim Borowczyk
 
Jim Borowczyk is a Musculoskeletal Physician based in Christchurch. He works in private musculoskeletal practice, and is Academic Coordinator for Postgraduate Musculoskeletal Studies, Christchurch School of Medicine and Health Sciences, University of Otago. A graduate of Edinburgh, he has been in New Zealand for over 30 years, and has postgraduate qualifications from both the University of Otago, and the University of Newcastle in New South Wales. 

His principal clinical and research interests include the use and assessment of pain intervention techniques for spinal pain. His other interests include improving the delivery of postgraduate medical education to students, both in New Zealand and worldwide. Jim is married to a general practitioner. They have four children.

 

MusculoSkeletal Medicine Workshop - Concurrent Workshop Repeated

Spondylosis, Facet Joint Arthropathy, and Pain

 
Friday, 6 August 2010 Start 4:30pm Duration: 55mins Chancellor 5
Start 5:30pm Duration: 55mins Chancellor 5

Do age related changes in the spinal column cause or contribute to chronic pain? Spondylosis and altered facet joint morphology are commonly seen on imaging of the spinal column, and are increasingly prevalent with advancing age. Some authorities maintain that they are, per se a cause of spinal pain. Major insurance agencies worldwide, including the Accident Compensation Corporation in New Zealand, covering work and other accident related injury often use the presence of �spondylosis� and �facet joint arthropathy�, to decline further cover for a particular incident.

The question arises as to how legitimate this stance is. This presentation will define the meaning of spondylosis and its prevalence, and examine the medical literature for the relationship between this and pain.

 
 
GP CME South 2010 - Dr David Bowie
Dr David Bowie
 
David is a specialist in Intensive Care and Anaesthesia. He graduated from Otago Medical School in 1978 and has been a specialist since 1985. He works in Christchurch Hospital where his main work commitment is to Intensive Care but he is also the Clinical Leader of the Canterbury Air Retrieval Service and the Intensive Care liaison officer to the Burwood Spinal Unit Home Ventilation Service. He also maintains his Anaesthesia practice in Christchurch Hospital. He is married with 3 children. It is worth noting that all of the female members of his family are either nurses or nurses in training and his son is a secondary school teacher.

Email: david.bowie@cdhb.govt.nz 
Phone: 027 290 0834

 

Pre Hospital Care for Trauma 
 
Friday, 6 August 2010 Start 4:30pm Duration: 20mins Chancellor 1

Since 1998 the focus for the provision of pre hospital management of trauma ( and medical) emergencies in New Zealand has been the PRIME (Primary Response In Medical Emergencies) system. Although its adoption has been inconsistent across the country and there has been controversy regarding funding methods it is still the most important system for the training and coordination of emergency response outside the metropolitan areas. The guidelines for the Roadside to Bedside initiative based on the work of the Australasian College of Surgeon Trauma Committee contains valuable information for the management of emergency situations and are currently being revised and updated. The introduction this year of a Regional Trauma System led by Waikato Hospital in the Midland region will go some way to improving provision and co-ordination of trauma response in that part of New Zealand. The improvement in service and the reduction of �turf wars� such a system can offer will hopefully see their adoption across the country in the near future. Some specific management scenarios will be provided to illustrate potential benefits.

 
 
GP CME South 2010 - Dr David Bratt
Dr David Bratt
 

Dr David Bratt, Principal Health Advisor to the Ministry of Social Development

 

Ready Steady Crook
 
Friday, 6 August 2010 Start 3:15pm Duration: 25mins Chancellor 1

Are we killing our patients with well-intentioned but misguided management? We will use examples to explore how GPs can cope with pressures from patients for certain services. The evidence to support a firmer approach will be highlighted. The results of a survey on the understanding of Work and Income by GPs will be discussed. 

 
 
GP CME South 2010 - Mr Andrew Carmody
Mr Andrew Carmody
 
Andrew has a strong IT / Software sales, Project Director and executive management background with roles in the last 10 years as General Manager, Chief Operating Officer and Chief Technology Officer with ECN Group and Sopheon NZ. Prior to this he was a senior manager at New Zealand Post undertaking HR, Marketing and Business Development roles.

An experienced project manager and director he has been responsible for the design, development and successful delivery of numerous software and IT service based projects.

Andrew also brings a wealth of change, process and business improvement expertise and experience and is passionate about ensuring that a high quality service is consistently delivered to customers.

He holds a Masters of Management from Victoria University (Wellington).

 

Medtech User Group  - Concurrent Workshop Repeated
 
Friday, 6 August 2010 Start 11:00am Duration: 55mins Christchurch
Start 12:05pm Duration: 55mins Christchurch

 
Medtech User Group - Concurrent Workshop Repeated
 
Saturday, 7 August 2010 Start 2:00pm Duration: 55mins Holiday Inn Salisbury
Start 3:05pm Duration: 55mins Holiday Inn Salisbury
 
GP CME South 2010 - Dr Peter Chapman-Smith
Dr Peter Chapman-Smith
 
Dr Peter Chapman-Smith is a Fellow of the Australasian College of Phlebology, an appearance medicine physician, performing skin cancer and minor cosmetic surgery, tumescent liposuction and directs a skin laser suite. Phlebology is his main field of current practice, having performed over 900 endovenous laser ablation (EVLA) under tumescent anaesthesia and 7000 ultrasound guided sclerotherapy (UGS) procedures. With regular clinics in Whangarei, Hibiscus Coast and Queenstown, he started the Otago non surgical varicose veins service in 2006. He has presented vein papers internationally in Rio de Janiero 2005, Tucson 2007, Monaco 2009, and regularly for the ACP in Australasia. He published a 5 year prospective research report on foam UGS in Phlebology in August 2009, and is a teacher appointed by the Australasian College of Phlebology. Peter is an affiliated provider of non surgical varicose vein treatment as well as for skin cancer surgery for Southern Cross Healthcare NZ. 

Dr Peter Chapman-Smith
Skin and Vein Clinic
chappie@clear.net.nz
 
Phone 0800 1 4 VEINS

 

 

Healing Leg Ulcers - Practice Nurses Programme
 
Saturday, 7 August 2010 Start 2:25pm Duration: 25mins Holiday Inn Ballroom 2

Leg ulcers are 80% venous in origin and consume 1-2% of Vote Health each year. Effective healing requires treating the underlying chronic venous insufficiency and venous hypertension, use of adequate class 2 compression and good nursing. Secondary infection and necrotic debris may need attention. The vast array of available ( expensive) dressings make little difference to healing times. 

Compression aids healing, reduces interstitial oedema and needs to be worn 24 hours daily until healing occurs. Frail elderly patients can use various devices to assist the wearing of compression hose which need to be a minimum of class 2 strength ( 35-40mm Hg at the ankle). Peripheral vascular disease can complicate this.

Non surgical treatment of varicose veins is the first line option in most western countries, not yet available in the NZ public health system. Endovenous laser ablation (EVLA) has become the most effective, safe option with high patient acceptance, and is funded by private medical insurance. Foam ultrasound guided sclerotherapy (UGS) is used concurrently to occlude distal trunks and tributaries. Careful post treatment surveillance with duplex ultrasound is necessary to exclude thrombotic sequelae, and to document efficacy of treatment. 

Post thrombotic syndrome (PTS) following deep venous thrombosis (DVT) has been recognised for some time but is poorly understood. This is a debilitating condition with life long discomfort, leg swelling and oedema. More common with proximal DVT but seen also after mere calf DVT, it is reduced by 50% by simply wearing class 2 compression hose for 24 months post DVT, rarely prescribed by GPs. TED stockings continue to be widely prescribed consuming health funds � completely useless in the ambulant patient. 

 
 
GP CME South 2010 - Dr Daniel Ching
Dr Daniel Ching
 
Daniel Ching is a Consultant Rheumatologist at Timaru Hospital but also provides a private rheumatology service from Ashburton to Stewart Island. He runs a rheumatology Clinical Trials centre in Timaru, testing the new targeted therapies. He also has clinical interests in polymyalgia rheumatica, giant cell arteritis, patient education and enjoys seeing patients with fibromyalgia! He is the Honorary Secretary of the New Zealand Rheumatology Association.

Dr Daniel Ching, Consultant Rheumatologist, Timaru.
d.a.ching@xtra.co.nz 
Tel/fax: 03-6861994
Cellphone: 027-2771983

 

Hot Tips in Rheumatology - Concurrent Workshop Repeated 
 
Sunday, 8 August 2010 Start 8:30am Duration: 55mins Holiday Inn Ballroom 2
Start 9:30am Duration: 55mins Holiday Inn Ballroom 2

Biologics in Inflammatory Rheumatic Diseases
 
Sunday, 8 August 2010 Start 11:00am Duration: 25mins Chancellor 1

The era of biologics or targeted therapies in rheumatology started in 1998 with the use of tumour necrosis factor alpha inhibitor in the treatment of rheumatoid arthritis. As a result of more intensive monitoring and treatment (similar to tight control of blood glucose in patients with diabetes), combination DMARDs (disease modifying anti-rheumatic drugs) and biologics, remission in rheumatoid arthritis and other inflammatory diseases, is now achieveable. There are currently nine different biologics approved by the FDA for the treatment of inflammatory rheumatic diseases. In NZ, Etanercept is available for the treatment of juvenile idiopathic arthritis (JIA) or adult patients with a history of JIA. Adalimumab has been available for the treatment of rheumatoid arthritis since 1.1.2006 and available for the treatment of ankylosing spondylitis and psoriatic arthritis since 1.8.2009. As well as new strategies and treatments, the other major factor in achieving remission in patients with inflammatory rheumatic diseases is early and aggressive treatment. GPs are an important player in this process with early referral to a Rheumatologist of any patient who they are suspicious of developing early inflammatory rheumatic diseases, regardless of the ESR or CRP.

 
GP CME South 2010 - Dr Richard Chisholm
Dr Richard Chishom

Diagnostic radiologist, Christchurch Radiology Group, with special interest in ultrasound and breast imaging.

Obstetric radiologist, Christchurch Women's Hospital

Clinical Director, Breastscreen South, the lead provider for The National Breast Screening Programme covering Nelson,Marlborough,Canterbury and West Coast.

Postgraduate fellowship in Gastro-intestinal interventional radiology and ultrasound, Vancouver General Hospital 1983-84.

 

Optimal Breast Cancer Screening
 
Friday, 6 August 2010 Start 9:20am Duration: 25mins Chancellor 1

The National Breast Screening Programme in New Zealand began in December 1998. The process and results of screening will be described with emphasis on the very succcessful recruitment strategies involving general practices used in the Breastscreen South area.

For detailed analysis of results presented go to http://www.nsu.govt.nz/

Select Screening Programmes > For Health Professionals > Breastscreen Aotearoa > Independent Monitoring Reports . National and regional figures are available there.

 
Breast Cancer Diagnosis - Concurrent Workshop Repeated 
 
Saturday, 7 August 2010 Start 11:00am Duration: 55mins Wellington
Start 12:05pm Duration: 55mins Wellington
A series of case presentations highlighting the use of various types of imaging for breast problems. An informal session planned with opportunity for discussion and some imaging diagnoses made by those attending.
 
Screening for Breast Cancer  - Practice Nurses Programme
 
Saturday, 7 August 2010 Start 2:00pm Duration: 55mins Holiday Inn Ballroom 2
The National Breast Screening Programme in New Zealand began in December 1998.The process and results of screening will be described with emphasis on the very successful recruitment strategies involving general practices and practice nurses used in the Breastscreen South area. 
 
 
GP CME South 2010 - Dr John Apps
Dr Sean Every

Dr Sean Every is an ophthalmologist specializing in vitreo-retinal surgery. He is a graduate of Auckland Medical School and (following a year of GP registrar training in Dunedin) entered ophthalmology training in Christchurch and Dunedin.

Following a year completing a MMedSci he did a two year fellowship in vitreo-retinal surgery in Oxford returning to Christchurch in 2006. He divides his time between the Christchurch Public Eye Department and private consulting at Southern Eye Specialists.

His research interests include the surgical management of retinal vein occlusion. Achieving mediocre results in the Coast to Coast race keeps him busy on the weekend.

www.southerneye.co.nz 
seanevery@xtra.co.nz 
021 477800, 03 3556397

 

Eye Pot Pourri - Practice Nurses Programme
 
Saturday, 7 August 2010 Start 12:15pm Duration: 25mins Holiday Inn Ballroom 2
 - How to test Visual Acuity
 - How to pad an eye
 - How to irrigate an eye following a chemical injury
Eye case Studies - Concurrent Workshop Repeated 
 
Saturday, 7 August 2010 Start 2:00pm Duration: 55mins Chancellor 5
Start 3:05pm Duration: 55mins Chancellor 5
 - Examination of the adult eye in General Practice
 - Examination ot the paediatric eye in General Practice
 - Transient loss of vision
 - Flashes and floaters
 - Approach to the red eye
 - Macular degeneration update
Glaucoma 101
 
Sunday, 8 August 2010 Start 9:20am Duration: 25mins Chancellor 1

Is glaucoma relevant to General Practice? Despite being the most common cause of irreversible blindness in the western world there is no screening programme. It does not fulfil the WHO criteria for screening because there is no single screening test. Consequently 50% of glaucoma in our community is undiagnosed. Most screening is opportunistic and done by optometrists. 

A brief summary of glaucoma is presented.

Take home messages:
1. As primary health care providers General Practitioners can recommend glaucoma screening for their patients when they reach 45 years, repeated 5 yearly until 60 years, thereafter 3 yearly. This can be done by optometry or private ophthalmology.
2. Having a family history of glaucoma is a significant part of the family history.
3. Long term steroid treatment is a risk factor for glaucoma.

 
GP CME South 2010 - Dr Peter Foley
Dr Peter Foley

Dr Peter Foley is a third generation Hawkes Bay doctor, who graduated in medicine from Otago University in 1981. He has practised as a GP in Hawkes Bay for over 25 years. In a historic first, he is serving a second term as Chairman of the New Zealand Medical Association. Dr Foley has vast experience in medical politics, having been the chair of the NZMA�s General Practitioner Council, and then the General Practice Leaders Forum. He was first elected to the overall chairmanship of the NZMA in 2007. 

 

Better Health for All New Zealanders - NZMA Breakfast Session
 
Saturday, 7 August 2010 Start 7:00am Duration: 45mins Chancellor 1

 
GP CME South 2010 - Dr Richard Fisher
Dr Richard Fisher
 
Richard is a co-founder of Fertility Associates, New Zealand�s largest provider of infertility services. He remains primarily a clinician whilst building a significant research effort within Fertility Associates. He is the country�s foremost spokesperson on fertility matters and has an active interest in the integration of public and private health care across the disciplines of clinical medicine, research and teaching. Richard was the first New Zealander to be President of the Fertility Society of Australia (FSA) and was recognised in the New Year Honours as a Companion of the New Zealand Order of Merit for his services to medicine.

Dr Richard Fisher
Reproductive Medicine
Co-founder, Fertility Associates 
www.fertilityassociates.co.nz  
info@fertilityassociates.co.nz 
Phone: 0800 10 28 28

 

Issues in Fertility
 
Friday, 6 August 2010 Start 8:55am Duration: 25mins Chancellor 1
Healthy eggs and healthy sperm are the most important gift you will ever give your children. Creating these is an issue for Primary Care. Although one cannot alter age and intrinsic biology, there is mounting evidence that lifestyle factors influence not only the chance of conception, but also the health of the embryo through to subsequent adulthood.

A new concept in the time management of fertility delay will be presented.

Outcomes for Assisted Reproductive Technologies continue to improve. New options for ovarian stimulation have been developed, which both improve outcomes and reduce risks.

Significant changes have occurred in the investigation of male infertility, which may allow more focus on treatment. The assessment of ovarian reserve has been greatly enhanced with the development of robust assays for AMH. 

At a time when survival is becoming common following the treatment of cancer, continuing fertility in the interests of long-term quality of life can now be addressed. 

Children born following ART procedures show both morphological and endocrine differences from control groups. This information and a growing knowledge about epigenetic influences giving exciting insights into potential future beneficial outcomes both in natural and in ART conceptions.
 
 
 
GP CME South 2010 - Associate Professor Ed Gane
Associate Professor Ed Gane

Ed Gane is Associate Professor of Medicine at the University of Auckland, New Zealand and Deputy Director of the New Zealand Liver Transplant Unit at Auckland City Hospital. 

Ed trained in hepatology at the Institute of Liver Studies, King�s College School of Medicine, London, where he completed a thesis on the pathogenesis of hepatitis C-related liver injury. On his return to New Zealand in 1996, Ed was appointed Chief Transplant Physician for the first New Zealand Liver Transplant programme. In addition, he runs the National Hepatoma Clinic as well as hepatitis clinics at both Auckland and Greenlane Hospitals.

Ed has been the Government Clinical Advisor to the National Hepatitis B Screening Programme since its inception in 1998. Since 2007, Ed has chaired the Ministry of Health Hepatitis C Treatment Advisory Board and this year was appointed MoH Champion for HCV.

Ed is Principal Investigator for many international clinical trials of therapies for chronic HBV, HCV, and hepatocellular carcinoma and runs a phase I research centre focusing on new molecular agents targeted against viral hepatitis. 

Ed has written 10 chapters and published over 120 papers in peer-reviewed journals including The Lancet and The New England Journal of Medicine

 

Hepatitis B and C 101 - Practice Nurses Programme
 
Saturday, 7 August 2010 Start 11:50am Duration: 25mins Holiday Inn Ballroom 2
The Ministry of Health Hepatitis C Implementation Plan
Ed Gane, HCV Champion, MoH HCV Project Team

In September 2005 a commitment was made by the government, to resolve the longstanding concerns of those infected with hepatitis C through the blood supply. Within this commitment a variety of measures were promised, including provision of an enhanced treatment package. Additional funding was sought and secured for this treatment package and a Hepatitis C Treatment Advisory group, comprising of clinicians, DHB managers and community representatives and chaired by Ed Gane was established to advise the Ministry of Health. 

The terms of reference of the Hepatitis C Treatment Advisory Group were to develop a costed and prioritised Implementation Plan, supported by district health boards (DHBs) and the Ministry of Health. This group first met on 17 April 2007. During 2008, they conducted a comprehensive Stocktake of current HCV treatment services provided at each of the 21 DHBs. Following analysis of these results and other information, the committee identified barriers to accessing this treatment and geographical gaps in service provision. They identified priority interventions to improve services and patient outcomes throughout NZ and developed a costed and prioritised implementation plan for improving the access to and uptake of Hepatitis C treatment in New Zealand. The subsequent Health Report and the Hepatitis C Plan was submitted to Hon. Tony Ryall by HCTAG in January 2009. 

On 28 July 2009, the Minister approved the �Strategic Directions for Hepatitis C � improving access to and uptake of hepatitis C treatment services� and signed off the funding allocation to address the key action areas within the document. These four key action areas, identified within Strategic Directions for Hepatitis C, are: (i) improving HCV treatment services;(ii) improving knowledge of HCV among primary health care providers; (iii) increasing the percentage of all people with HCV who have had the disease diagnosed; (iv) improving the knowledge of HCV prevalence in the New Zealand population and within subgroups.

During this presentation, I will briefly outline the plans for primary care, including the new e-learning tool for GPs and Practice Nurses, designed to improve knowledge and encourage opportunistic screening for HCV.
 
A new screening tool for Hepatitis C
 
Sunday, 8 August 2010 Start 11:25am Duration: 25mins Chancellor 1
 
 
GP CME South 2010 - Mr John Glue
Mr John Glue
 
John has been with MAS for 6 years, firstly as a Senior Advisor in Dunedin, then Lending Advisor for all of the South Island. He is now a Senior Advisor, based in Christchurch with a mix of Southland, Otago and Christchurch Members.

John joined MAS with a background in Business & Property Banking with DFC, the TrustBank Group, and Westpac. 

Several of the MAS member groups that John looks after have used Medical Securities funding to develop merged practices and have subsequently developed new premises to accommodate those larger new entities.

 

MAS Financial Session - "The Essentials of Financial Management" - Concurrent Session (with Chris Wills)
 
Saturday, 7 August 2010 Start 11:00am Duration: 120mins Holiday Inn Glouchester

General practice has changed significantly from the traditional small business model where all revenue flowed directly from the GP/Patient consultation. Most of these changes have added layers of complexity to those responsible for financial management including capitation and the transfer of financial risk, increased group practice compliance and quality standards, less direct GP/Patient consultation revenue, PHO projects, workforce shortages, different GP needs and many more. Business models have also changed with DHB, Community Trust, PHO and corporate ownership now being more commonplace alongside the traditional GP owner/operator. And we continue to see more amalgamations with the development of purpose built medical centres providing a broader range of primary care services. To be financially viable and successful general practice now needs good financial management and business planning skills.

This session will cover three key areas of good financial management:
1. Maximising income � including managing the practice register, consumables, debtors, fee policy and other revenue opportunities;
2. Managing expenses � including non-owner GP/staff costs and financial risks;
3. Business planning and budgeting � to help determine the future direction and performance of the practice and how this will be funded.

 
 
GP CME South 2010 - Dr Brendan Gray & Dr Tim Cookson
Dr Brendan Gray & Dr Tim Cookson

Drs Brendon Gray and Tim Cookson are both medico-legal consultants with the Medical Protection Society.

Tim has been a GP in a central Wellington city practice for many years and joined MPS as a medicolegal consultant in 2005. He lectures at Wellington Medical School and is involved in the GP Registrar training programme nationwide. His other interests include biking, wine tasting and high country adventures with his two sons.

Brendon is a public health medicine specialist and former GP with a specialist interest in medical law. Brendon has an LLB from the University of London and is a Fellow of the Australasian College of Legal Medicine. He joined MPS in 2009. His particular interest is in health law policy and he has worked for the government in the past on a review of the national cervical screening programme register, the Public Health Bill and the review of the storage and use of Guthrie cards. He has two young children and lives in Wellington. 

Brendon and Tim will review recent health law policy development that affects general practitioners and cover some recent court and tribunal decisions.

 

Hot Issues : What's new in the Medicolegal Workplace? - MPS Session
 
Saturday, 7 August 2010 Start 4:30pm Duration: 90mins Chancellor 1

 
 
GP CME South 2010 - Dr Katherine Grundy
Dr Katherine Grundy
 
Kate Grundy is the Clinical Director of the Christchurch Hospital Palliative Care Service which she established in 1999. She works alongside three Specialist Nurses and supervises both basic physician trainees and advanced trainees in palliative medicine. Her main academic interest is education with a significant undergraduate teaching commitment both in the field of palliative medicine and ethics. She also teaches nursing and Allied Health staff as well as travelling throughout the South Island conducting lectures and workshops. Current areas of interest are Advance Care Planning, methadone as an analgesic, intra-spinal analgesia and motor neuron disease.

Kate is the current Chair of the Palliative Care Council of New Zealand and is a member of Cancer Control New Zealand. She is the immediate past President of the Australasian Chapter of Palliative Medicine which is part of the RACP.

Kate lives on a 10 acre lifestyle block near Oxford, North Canterbury, with her husband and two daughters.

 

 
Palliative Care as a Team - Concurrent Workshop Repeated
 
Saturday, 7 August 2010 Start 2:00pm Duration: 55mins Auckland
Start 3:05pm Duration: 55mins Auckland
Recent achievements and developments within the NZ Palliative Care sector will be outlined. The definition of palliative care continues to evolve and associated terms such as �end-of-life care� and �advance care planning� have emerged. NZ is the third best place to die according to a recent international survey but we still have a long way to go. Challenges include the need to ensure consistent access to and quality of specialist palliative care and the requirement to make sure that all palliative care is integrated seamlessly across services. Palliative care education, guaranteed back-up and support for complex cases and a universal elevation of the status of palliative and end-of-life care in primary care, aged residential care and acute care is needed.

We must consciously identify palliative care as being the complete picture. The role of GP teams is critical, with specialist services there to provide a solid, dependable framework. Work done recently in Canterbury known as �HealthPathways� will be presented. This is a joint initiative between primary and secondary care, assisting GPs with clinical problems, planning and coordinating care and improving the interface with specialist services. The ultimate aim is that patients and families receive the care they need in the location of their choice whenever possible.
 
GP CME South 2010 - Dr DAvid Hammer
Dr David Hammer
 
Since the age of eight, when he saw a television documentary on rabies, David has been fascinated by microbes. He entered medicine for the bugs. He studied for his MBChB on the slopes of Table Mountain and after working for a year at Groote Schuur Hospital, he undertook a four year tour of duty in the warzone that is the UK NHS. During that time he passed MRCP. He then made one of the best decisions of his life and immigrated to New Zealand, along with his wife and two moggies. After a brief spell in Auckland, he moved to Christchurch and undertook the FRCPA. He now works part time as a clinical microbiologist and travel health advisor for MedlabSouth. He is also pursuing interests in multidrug resistant bacteria and infection control. 

 

Travel medicine - not just bugs
 
Saturday, 7 August 2010 Start 8:55am Duration: 25mins Chancellor 1

General Practitioners are well placed to provide travel health services to their patients because (usually) they know the patient�s background and have established a trusting relationship with them. Also, many travellers book their trips without the slightest idea that they should have some medical input before they depart and GPs may have the opportunity to raise this awareness.

Whilst travel vaccinations are important, they only prevent a small number of deaths and a more holistic approach is called for. Advice on avoiding murder, suicide, assaults, road accidents and drowning may seem painstakingly obvious but people do the stupidest things when abroad. Although most travellers know that they should only drink bottled water and that they may need to take malaria pills, many seem to think that they have somehow opted out of the �meet a rabid dog� encounter. Sure, many patients won�t listen to you anyway but simple advice can mean the difference between life and death, or at least between a good trip and a disaster. 

 
Travel Medicine Case Studies - Concurrent Workshop Repeated
 
Saturday, 7 August 2010 Start 11:00am Duration: 55mins Chancellor 5
Start 12:05pm Duration: 55mins Chancellor 5
 
Vaccinations for Travellers - Concurrent Workshop Repeated
 
Sunday, 8 August 2010 Start 8:30am Duration: 55mins Holiday Inn Ballroom 1
Start 9:30am Duration: 55mins Holiday Inn Ballroom 1

 
GP CME South 2010 - Dr Nigel Harrison
Dr Nigel Harrison
 
Nigel qualified in London at Charing Cross Hospital Medical School in 1979. While serving in the Royal Air Force he trained as a physician and specialised in Cardiology. On leaving the RAF in 1996 he served as the sole Cardiologist on the Isle of Man for 10 years before emigrating to New Zealand in 2006. He is currently a consultant physician and Head of Cardiology at Whangarei Hospital. He has a special interest in Integrative Medicine, combining evidence-based natural therapies with orthodox medicine. He is studying with the Australasian College of Nutritional and Environmental Medicine (ACNEM) and is a member of the Australasian Integrative Medicine Association (AIMA).

 

Hypertension and Vitamin D
 
Friday, 6 August 2010 Start 2:25pm Duration: 25mins Chancellor 1

While pharmacological management of hypertension is well understood and relatively easily practiced, the trigger for its development can often be traced to poor nutritional and lifestyle choices and practices. Lack of exercise and excess salt intake are cited as contributors but nutritional deficiencies and can play a significant part. This paper discusses the evidence around this neglected aspect of care.

 
The Joys of Vitamin D - Practice Nurses Programme
 
Saturday, 7 August 2010 Start 2:50pm Duration: 25mins Holiday Inn Ballroom 2
There is much excitement in the research and clinical environments about Vitamin D. Deficiency and insufficiency, far from being unusual is now recognised as being almost universal within certain age-groups and sectors of society. Through its controlling influences on many thousands of genes, Vitamin D plays a profound role in not only bone health but immune function, cardiovascular health, diabetes and cancer prevention. The widespread deficiency now demonstrated as being present from cradle to grave could well be at the root of many of the chronic disease epidemics we are currently battling.
 
Cardiac Case Studies
 
Saturday, 7 August 2010 Start 11:00am Duration: 55mins Holiday Inn Salisbury
Start 12:05pm Duration: 55mins Holiday Inn Salisbury
 
GP CME South 2010 - RN Linda Hill
RN Linda Hill

Registered Nurse and Regional Immunisation Advisor, South Island for the Immunisation Advisory Centre. Linda comes from a strong Practice Nurse background, and has worked closely with children and their families who have complex health issues with an aim to improve their overall health and wellbeing. Linda represents the Immunisation Advisory Centre.

Regional Immunisation Advisor
Immunisation Advisory Centre
University of Auckland
Phone: 03 357 4289
imacsth@ihug.co.nz  

 

 
Immunisation Workshop - Practice Nurses Programme
 
Saturday, 7 August 2010 Start 4:00pm Duration: 60mins Holiday Inn Ballroom 2
One of the strongest evidence-based medical interventions we have is immunisation. Despite this, New Zealand currently has mediocre immunisation coverage and reasons for this range from issues around access to services, systems and a lack of community confidence in immunisation generally. However many practices can and do maintain high immunisation coverage rates in their childhood population. A crucial component is a confident provider. 

This presentation will focus on the key issues and some resources that are useful for us as PNs at the practice level when dealing daily with immunisation systems, issues, parental and community concerns.
 
GP South CME 2010 - Professor Shaun Holt
Professor Shaun Holt


Professor Shaun Holt is the founder of Clinicanz, New Zealand�s only clinical trials Site Management Organization. Previously, he was the founder of P3 Research, an independent clinical trials unit based in Wellington and Tauranga, and Research Review, a company that produces regular reviews of the medical literature for health professionals. He is Ex-Medical Director of Clinical Trials in the Wellington Asthma Research Group. Shaun holds Pharmacy and Medicine degrees, has been the Principal Investigator in over 50 clinical trials and has over 80 publications in the medical literature. He is Honorary Research Fellow at the Medical Research Institute of New Zealand, an Advisor to the Asthma and Respiratory Foundation, a regular contributor on TVOne's Breakfast programme and national radio shows and lectures at the Victoria University of Wellington. 

Professor Shaun Holt
Clinicanz, Medical Research Institute of NZ, Victoria University of Wellington
http://flavors.me/shaunholt 
holtshaun@gmail.com 
Phone: 029 200 11 11

 

How to ACT to Improve Asthma Outcomes
 
Sunday, 8 August 2010 Start 7:30am Duration: 45mins Chancellor 1
There is a major gap between what can be achieved with modern asthma management and what is currently being achieved. One of the main reasons for this is a lack of recognition of asthma severity and the requirement for more effective treatment - it is only through identifying those patients with uncontrolled asthma that appropriate treatment will be prescribed.

In part the difficulty in the assessment of control relates to the lack of a clear therapeutic target in asthma. This contrasts with other chronic diseases such as hypertension or diabetes where treatment is prescribed in order to achieve a definite therapeutic target. One approach to this difficulty is to develop a simple test which is a screening tool to identify patients with poorly controlled asthma.

The Asthma Control Test (ACT) has been developed and validated for this purpose. It involves patients completing a simple written questionnaire of five questions, from which a score (out of 25) is obtained. It has been shown that the ACT is a simple, quick and accurate tool for assessing asthma control and it has been shown to be responsive to changes in asthma control over time.
 
 
GP CME South 2010 - Associate Professor Gary Hooper
Associate Professor Gary Hooper
 
Associate Professor and Head of Department, Orthopaedic Surgery and Musculoskeletal Medicine, Christchurch School of Medicine and Health Sciences. Current president of the New Zealand Orthopaedic Association. He has been a consultant Orthopaedic Surgeon with the Canterbury District Health Board since 1985. His main areas of interest include knee injuries and adult reconstructive hip and knee surgery. He runs a research group specialising in bioengineering of articular cartilage, spinal regeneration, joint replacement outcomes and fracture healing.

Married to Leigh (General practitioner) with 3 adult daughters.

Interests include golf, fishing, wood turning, and holidays in the sun.

 

Fracture management - Concurrent Workshop Repeated
 
Friday, 6 August 2010 Start 11:00am Duration: 55mins Chancellor 5
Start 12:05pm Duration: 55mins Chancellor 5

This session will discuss fracture management with an emphasis on forearm fractures.
Participants should learn:
1 how to assess fractures, both clinically and radiologically
2 how to manage simple fractures with casts
3 the principles of cast immobilization
4 to recognise the common complications following fractures and cast immobilization

Participants will learn how to apply a below elbow cast.

 
New Ideas for an Old Problem - OA Knees
 
Friday, 6 August 2010 Start 2:50pm Duration: 25mins Chancellor 1

The pathogenesis of OA, with particular reference to the knee, will be explained and the recent advances in bioengineering for repairing articular cartilage defects will be covered.

Cartilage transplantation, meniscal repair, meniscal transplantation and osteochondral grafting will be discussed. The more controversial aspects of total joint arthroplasty and tibial osteotomy with respect to a more active and younger patient population will be covered.

Following this session participants should have a better understanding of the current surgical options for the treatment of early and late OA of the knee.

 
Skiing Injuries
 
Friday, 6 August 2010 Start 5:30pm Duration: 20mins Chancellor 1

The increased incidence of snowboarders on the ski field has changed the injury patterns of alpine trauma. Skiing injuries traditionally involved lower limb injuries including tibial fractures and knee ligament injuries, now there is a much higher incidence of upper limb trauma with AC joint, shoulder and wrist injuries predominating.

Initial assessment of severe trauma will be discussed with emphasis on the musculskeletal system followed by the assessment and management of the common upper and lower limb injuries. There will be an emphasis on the shoulder and knee. 

Following this session participants should have a better ability to assess and manage acute shoulder and knee injuries from �skiing� accidents.

 
 
GP CME South 2010 - Professor Hamid Ikram
Professor Hamid Ikram
Clinical Professor of Medicine, University of Otago, and Consultant Cardiologist.

Medical education in the United Kingdom, and Canada.

Cardiological training in the General Infirmary at Leeds, the Charing Cross Hospital , London, the Hammersmith Hospital, London and the University Hospital, Edmonton, Alberta, Canada. 

Appointed Consultant Cardiologist to the North Canterbury Hospital Board in 1974. 

Served as Head of Department from 1978 to 2002. Since retirement and have continued with private practice at St George�s Hospital.

Chairman, Cardiac Society of Australia and New Zealand (New Zealand Region)

Extensive experience with undergraduate and postgraduate medical education all over the world.Over 300 publications chiefly in peer-reviewed journals, presentations at congresses and postgraduate courses. Other interests include cricket at provincial, University and club levels in Pakistan, the United Kingdom and New Zealand. Liaison officer for the Pakistan and Sri Lankan test teams touring New Zealand and Australia.

Extensive speaking engagements in non-medical functions and after-dinner speeches.

Territorial Army service in the United Kingdom and New Zealand. Retired as Commanding Officer off a Field Ambulance based at Burnham military camp.

 

Heart Failure Revisited
 
Friday, 6 August 2010 Start 8:05am Duration: 25mins Chancellor 1

Another of the major cardiovascular epidemics, with the increasing prevalence, high mortality and morbidity.

The diagnosis is based on clinical suspicion, but that alone is not sufficient as it lacks specificity. Diagnosis has to be further refined by the use of special tests. The most useful of these is echocardiography, but unfortunately there are difficulties of access in primary care. Measurement of natriuretic peptides is a very useful �rule out �test heart failure is unlikely to be present if the test result is normal.

Management of heart failure is increasingly a multidisciplinary approach, with close coordination between members of nursing as well as primary and secondary care physicians. Many centres have established specialised heart failure services.

Sudden arrhythmic death occurs in half the cases. This has led to the increasing use of implantable defibrillators in high-risk patients. These devices have definitely reduce the mortality, but have done little to improve the quality of life or the trend to recurrent hospitalisation which is one of the major drivers of cost in heart failure.

The use of cardiac resynchronisation therapy has improved the quality of life in selected patients with advanced heart failure. Sophisticated devices which incorporate implantable defibrillators together with resynchronising pacemakers, have been shown to reduce hospitalisation, improve quality of life, and by the defibrillator incorporated in the device, also reduce sudden death mortality.

Cardiac transplantation continues to be advocated in a highly selected cases. Whilst optimal pharmacological therapy continues to be the mainstay of heart failure in general, these device-based therapies have been shown to improve both symptoms and survival above anything achievable by optimal medical therapy.

As the heart failure population in most countries continues to grow, the steady increase in device-based therapy is well set to cause a further cost benefit debate in a field which is already one of the most expensive clinical indications in public health.

 
Interpreting ECGs - Concurrent Workshop Repeated
 
Friday, 6 August 2010 Start 11:00am Duration: 55mins Holiday Inn Ballroom 2
Start 12:05pm Duration: 55mins Holiday Inn Ballroom 2

 
Cardiac Emergencies
 
Friday, 6 August 2010 Start 4:50pm Duration: 20mins Chancellor 1

Cardiac emergencies in primary care include many conditions, ranging from these so-called, �caf� coronary� to acute coronary syndromes presenting with major arrhythmias, acute heart failure, cardiogenic shock and sudden death. Other conditions, including massive pulmonary embolism,haemopericardium and cardiac tamponade complicating a variety of conditions.

Clearly, time does not permit one to cover all these conditions in any detail. Particularly, the role of the primary care physician in this situation is limited to a rendering emergency first aid, securing the airway, establishing a diagnosis and stabilising the patient�s heart rate and blood pressure prior to removal to hospital.

The most frequent emergency that the rule of primary care physician encounters, and for which he should be trained is the management of acute coronary syndromes. The diagnosis of these conditions may be relatively straightforward in the presence of a typical history and ECG changes. However, frequently this is not the case. A high degree of clinical suspicion is essential.

The interpretation of the electrocardiogram is most important, as it is the most readily available diagnostic tool. ST segment elevation in a collapsed patient indicates a large transmural myocardial infarction. Current guidelines require that this patient being moved to a centre with facilities for percutaneous revascularisation. If such a centre is too far away, then thrombolytic therapy offers the best prospect of myocardial salvage. Patients should be pre-treated with buccal aspirin and given appropriate thrombolytic therapy.

Stabilisation of the patient prior to movement to the hospital is vital in preventing the development of major rhythm disturbances. A vital ingredient in this stabilisation process is the relief of pain. If the patient has a resting tachycardia, then small doses of beta-blockade should be used to slow the rate. Likewise, in the presence of significant bradycardia, the administration of atropine will help to elevate the heart rate.

Control of nausea and vomiting, which is a frequent concomitant of acute myocardial infarction is important in preventing further myocardial necrosis and the development of life-threatening arrhythmias.

Other cardiac and vascular emergencies include acute hypertensive emergencies and acute heart failure.

 
Hypertension - Concurrent Workshop Repeated 
 
Saturday, 7 August 2010 Start 2:00pm Duration: 55mins Holiday Inn Ballroom 1
Start 3:05pm Duration: 55mins Holiday Inn Ballroom 1

Another CV Epidemic- In danger of being the �Forgotten Killer� as opposed to the � Silent Killer� of old.

Focus has moved from the obsession with numbers of the blood pressure towards the assessment of absolute cardiovascular risk. This entails putting blood pressure into the context of multiple cardiovascular risk factors. Inevitably, the management of hypertension also entails the control of these other risk factors.

Lifestyle measures underpin all management strategies in the hypertensive patient. Increasingly however, it is necessary to use drug therapy to achieve optimal levels of blood pressure reduction. Only by this approach, can worthwhile reduction in real clinical events be achieved. Patients with significant hypertension, are therefore often on complex medical regimes which include two or three antihypertensive agents, together with, lipid lowering therapy, antiplatelet therapy and other agents to control blood sugar and gout. This polypharmacy makes compliant difficult, resulting in drug failure. Simplification of the regime and the close involvement of the patient and his family are essential to achieve adherence to a therapeutic regime.

The very minimum target for successful treatment should be a systolic blood pressure below 140 mmHg and a diastolic of less than 90 mmHg. This target should be revised downwards for diabetics and those with manifest organ damage. A search for organ damage with simple measurements of renal function, proteinuria, left ventricular hypertrophy and diabetes should form a part of the essential preliminary evaluation. These points are of particular relevance to patients of Maori, Pacific and South Asian origin.

 
Atrial Fibrillation
 
Sunday, 8 August 2010 Start 11:50am Duration: 25mins Chancellor 1

Atrial fibrillation is the commonest sustained rhythm disorder encountered in clinical practice. It is broadly classified as �paroxysmal or intermittent� or �sustained�.

The most important clinical consequences are:-
1. Haemodynamicdecompensation
2. Thromboembolism

Atrial fibrillation carries a 5 to 7 times increased risk of stroke, which is much greater if there is impairment of left ventricular function or rheumatic valvular heart disease also present.

Currently, the major strategies for managing this condition consist of 1 restoration of normal sinus rhythm (Rhythm Control) or 2. Control of the ventricular rate ( Rate Control). 

Both these have their place in individual cases, but as regards outcomes, they are equivalent.

Thromboembolic prophylaxis is mandatory in most cases. This is assessed by the CHADS2 Score. { C= CHF; H= Hypertension SBP>160mm Hg; A=age > 75yrs; D= Diabetes all these are 1 point each., while S= previous stroke or TIA and has 2 points} Patients with !point can be treated with Asprin but Warfarin is indicated for all others in the absence of contraindications.

Newer advances with drugs and devices are available but may not be seen in NZ for some time.

Clinical Quiz 
 
Sunday, 8 August 2010 Start 12:30pm Duration: 30mins Chancellor 1

Not telling!

 
GP CME South 2010 - Dr Rosemary Ikram
Dr Rosemary Ikram
 
Dr Rosemary Ikram is a Clinical Microbiologist who is employed at Medlab South Ltd. Christchurch. She graduated from Charing Cross Hospital Medical School and started training as a Microbiologist prior to leaving the UK in 1974. In New Zealand she worked in General Practice and Family Planning for 7 years prior to completing her pathology training at Christchurch Hospital in 1986. She worked as a specialist in Christchurch Hospital until taking up a full time post at Medlab South Ltd. Her key areas of interest are community microbiology and epidemiology. Research topics have included epidemiology of resistant Streptococcus pneumoniae in New Zealand, epidemiology and laboratory diagnosis of infectious diarrhea and more recently antimicrobial resistant organisms in New Zealand. She also runs an Infection Control Service which has a community focus. 

 

Appropriate Use of Antibiotics - Concurrent Workshop Repeated
 
Friday, 6 August 2010 Start 2:00pm Duration: 55mins Wellington
Start 3:05pm Duration: 55mins Wellington

 
Microbiology in Infectious Disease
 
Saturday, 7 August 2010 Start 8:00am Duration: 30mins Chancellor 1

A large number of infectious diseases present in primary health. The role of the microbiology laboratory will be outlined. Key points will be illustrated with examples. Firstly taking a relatively well defined area such as urinary tract infection. Then exploring the introduction of a new test for gonorrhea. Finally exploring the role of the microbiology laboratory in surveillance for antimicrobial resistance and its control.

 
Epidemics
 
Saturday, 7 August 2010 Start 9:45am Duration: 25mins Chancellor 1

Epidemics will be defined. Factors causing these will be explored . Recent epidemics which have required a response from primary health will be used to illustrate the epidemiology of these infections notably severe acute respiratory syndrome (SARS), influenza, norovirus and antimicrobial resistance. The knowledge of the epidemiology of these infections is the key to interrupting transmission and a responsive primary health sector has a major role in this.

 
GP CME South 2010 - Dr Peter Joyce
Professor Peter Joyce

Professor Peter Joyce is the Dean of the University of Otago, Christchurch. Prior to taking up this position he had been Professor and Head of the Christchurch Department of Psychological Medicine since 1986. He has had longstanding and continuing clinical and research interests in bipolar disorder and depression. His research has also included work on eating disorders, personality, suicide, epidemiology, neurobiology and molecular genetics. He is also the current Editor of the Australian and New Zealand Journal of Psychiatry.

 

Bipolar and Depresion - Concurrent Workshop Repeated
 
Friday, 6 August 2010 Start 2:00pm Duration: 55mins Holiday Inn Ballroom 2
Start 3:05pm Duration: 55mins Holiday Inn Ballroom 2

Over the past decade there have been significant improvements in the recognition and treatment of depression in primary care. However, there remain further challenges in both diagnosis and management. One of the challenging areas is the recognition of bipolar disorder amongst those whose primary clinical presentation is with depressive symptoms. Understanding the similarities and differences between depression and bipolar depression, and implications for management will be highlighted.

 
GP CME South 2010 - Dr John Apps
Dr Ai Ling Tan
Ai Ling is a graduate of Adelaide University, having completed her O+G training in Auckland and UK, subsequently sub specialised in Gynaecology Oncology in Australia. Ai Ling works as a gynaecological oncologist at ADHB and privately at Ascot Central Women�s Clinic, Auckland. 

She maintains close links with colleagues by participating and lecturing at conferences and being an active member of local and international gynaecology cancer societies.

Ai Ling is keen to support the community and is involved in charitable work locally and overseas. She is currently a board member of the Silver Ribbon Gynaecology Cancer Foundation.

Website: www.ascotwomensclinic.co.nz 
Email: mary@ascotwomensclinic.co.nz  
Phone: 09 5209361

 

 

Managing Pelvic Malignancy - Practice Nurses Programme
 
Saturday, 7 August 2010 Start 11:00am Duration: 25mins Holiday Inn Ballroom 2

Gynaecological Cancers make up 10% of all cancer cases and 10% of all cancer deaths in New Zealand.

A Cancer Society survey showed that 1/3 of the women could not identify a single symptom of gynaecological cancer. As health professionals it is our duty to educate the public. Today we will go through how these cancers present.

Ovarian cancer is the 4th biggest killer of New Zealand women � with one woman dying every 48 hours from ovarian cancer. Literature has shown that women have the best survival if they are treated by a subspecialist gynaecological oncologist. Appropriate triage of pelvic masses is discussed. Most ovarian cancers are sporadic but in familial ovarian cancers there is a role for risk reducing surgery. 

Diagnosis and management of endometrial, vulva and cervical cancers are also covered in this presentation. Particular emphasis is placed on preinvasive and invasive disease of the vulva as these tend to be missed.

 
Gynaecologic Cancer - Concurrent Workshops Repeated 
 
Sunday, 8 August 2010 Start 8:30am Duration: 55mins Christchurch
Start 9:30am Duration: 55mins Christchurch

The first part of the session will focus on patient pathways after referral to a gynaecological oncology unit.

The second part will focus on the various types of cancers including ovarian, endometrial, cervical and vulva cancer. Clinical presentation, diagnosis and management will be discussed

The third part will cover when to refer in some clinical scenarios as well as the follow up for cancer patients and does this make a difference to survival. . Complications of treatment that could present to primary care will be covered.

 
GP CME South 2010 - Dr Ken Macdonald
Dr Ken Macdonald
 
Dr Ken Macdonald practices as a dermatologist and dermatologic surgeon in Christchurch. He is director of KM Surgical Ltd and Dermatology Associates Ltd and has special interests in skin cancer treatment and cosmetic and laser surgery. He is a fellow of the Royal Australasian College of Physicians and of the Collage of Physicians of Edinburgh and London. He is a Fellow of the American Academy of Dermatology and the American Society for Dermatologic Surgery . Dr Macdonald is a past President of the New Zealand Dermatological Society and was previously Clinical Director of the Christchurch Dermatology Department.

 

Management Options for Skin Cancer
 
Friday, 6 August 2010 Start 8:30am Duration: 25mins Chancellor 1

Before deciding on management options make an accurate diagnosis, decide if histology is required and have an understanding of skin cancer biology and behaviour. Recognise invasive and high risk cancers.
� Non melanoma skin cancer is the most common malignancy in humans
� Surgery is the mainstay of treatment
� Mohs surgery conserves tissue and optimises cure rates
� Destructive modalities require careful selection
� Immunomodulators, photodynamic therapy and drugs that address genetic defects and normalise keratinisation show promise
� Radiotherapy and chemotherapy in selected situations
� To and T, melanoma must be managed surgically
� Lymphomas, sarcomas, vascular and adnexal neoplasms can be complex to manage
� Strong collegial associations advised if you treat skin cancer. 

 
Case Studies in Common GP Skin Conditions - Concurrent Workshop Repeated 
 
Saturday, 7 August 2010 Start 2:00pm Duration: 55mins Chancellor 1
Start 3:05pm Duration: 55mins Chancellor 1
 
GP CME South 2010 - Dr Roland Meyer
Dr Roland Meyer
 
Originating from Belgium, medical training at the University of Heidelberg / Germany, post-graduate and specialist training in the United Kingdom and New Zealand. Physician in Respiratory and General Medicine at Christchurch Hospital between 1997and 2009, Clinical Director of the Respiratory Services after 2006. First NZ Community Respiratory Specialist helping to set up the Canterbury Initiative, working towards a truly integrated respiratory service for the region. This included the development of web-based clinical pathways, the establishment of primary care and community based diagnostic services, i.e. spirometry and sleep assessments in the first instance, also primary care and community based specialist assessments and clinics and a Pulmonary Rehabilitation programme.

Currently Respiratory Physician for the Southern DHB , based at Southland Hospital.

I have a strong interest in clinical systems design, a strong belief that integrated services are the basis for good patient outcomes and a more efficient and sustainable health system. 

 

Spirometry - Concurrent Workshop Repeated
 
Friday, 6 August 2010 Start 11:00am Duration: 55mins Holiday Inn Ballroom 1
Start 12:05pm Duration: 55mins Holiday Inn Ballroom 1

For some health professional spirometry is an under used and under utilized investigation in general practice. This workshop will address issues of the technique of undertaking successful spirometry, and will outline use of the procedure in diagnosis and management of respiratory conditions as well as interpreting the patterns.

 
Guidelines v EBM: Respiratory case Studies - Concurrent Workshop Repeated 
 
Saturday, 7 August 2010 Start 11:00am Duration: 55mins Christchurch
Start 12:05pm Duration: 55mins Christchurch
Does this apply to my patient with a respiratory problem ? Case Studies 

Chronic respiratory diseases (CRD) are very common. Most GPs encounter these on a daily basis although frequently several other issues need to be addressed during the same patient consultation. In particular patients with COPD often have several co-morbidities. Published disease-specific guidelines (e.g. for asthma or COPD) may either be very comprehensive but too long and impossible to apply during a patient consultation. The abbreviated versions may be too narrow with a focus on the pharmacological components of the patient management. Guidelines often are said to be �evidence-based� but in reality the evidence may be derived from clinical studies that included patients quite unlike the patient in front of you. 

The controversial issue of inhaled corticosteroids for the management of COPD is discussed as are 2 examples of the published so-called �mega-trials� for COPD. 

A systematic approach to the individual patient is required: What are the symptoms due to? Is the diagnosis correct, do I need additional information or tests ? Are there additional factors? Has the treatment made any difference � if not , should it be discontinued? Do my patient�s beliefs match my own? What non-pharmacological considerations are required ? 

Cases of �COPD with frequent exacerbations �, �asthma with poor control and persisting symptoms� are presented and analysed with reference to published treatment algorithm.

 
Better Community Respiratory Care
 
Sunday, 8 August 2010 Start 8:30am Duration: 25mins Chancellor 1

Chronic respiratory diseases (CRD) are very common. Most GPs encounter these on a daily basis although frequently several other issues need to be covered during the same patient consultation. Good self management will generally result in better disease control and better patient outcomes. The education required to achieve this however may be time-consuming . So called �Life style� factors such as smoking and obesity, social determinants of health such as poor housing have significant impact on respiratory health and need to be addressed more effectively. 

COPD often is not diagnosed until half of the patient�s lung function has been lost. 2/3 of the �burden� of COPD may as yet need to be to be diagnosed. Case finding, better and earlier community care may prevent patients from progressing to a more severe stage. 

Hospital and Specialist Services usually are overloaded and unable to respond in a timely fashion to anything but urgent referrals . Significant barriers for patients to attend hospital services exist, in particular in larger cities. Numerous �silos� exist, often providing quality patient care but without sufficient integration between providers and different specialities. Frequent acute presentations do not necessarily result in better chronic disease management . 

It is crucial to have dedicated resources to identify enrolled patients with CRD, to allow proper diagnosis, patient education and the development of a CRD management plan which is based on a holistic approach � including pharmacological and non-pharmacological treatments. 

Locally adapted, web-based pathways, easy access to community based diagnostics such as spirometry testing or sleep studies, community based and integrated education, pulmonary rehabilitation have been set up in Canterbury as part of the Canterbury Initiative and some gains have already been made. Further strategies need to address the development of better incentives for all providers and further reduce barriers for better integration and for patients to access services.

 
GP CME South 2010 - Dr Philip Parkin
Dr Philip Parkin

Philip Parkin is a full-time consultant neurologist at Christchurch Hospital. He has been Clinical Director of the department of Neurology since 1994 and has been active in a number of national neurological organisations over a number of years, including a 20-year term as Councillor of the New Zealand Neurological Foundation and a member of its Scientific Advisory Committee. He regards his interests as covering the breadth of Clinical Neurology and lists music and the keen spectator pursuit of motor sport amongst his non-neurological interests. 

 

Is it really epilepsy?
 
Friday, 6 August 2010 Start 9:45am Duration: 25mins Chancellor 1

Because it is the most common primary disorder affecting the brain, it is hardly surprising that epilepsy is the diagnostic possibility so frequently considered whenever a patient presents for review having undergone a blackout or other transient neurological event. While it is a diagnosis easily made in many patients, family practice-based studies in the UK have suggested that in up to a quarter of those believed to have epilepsy, the diagnosis proves to be incorrect. Of the wide array of disorders that can be mistaken for epilepsy, two of them in particular probably account for the majority of epilepsy mis-diagnoses. My review of how to diagnose epilepsy will therefore include particular focus on how to avoid being misled by these two epilepsy look-alikes. 

 
Pearls of Neurology - Concurrent Workshop Repeated
 
Friday, 6 August 2010 Start 2:00pm Duration: 55mins Chancellor 5
Start 3:05pm Duration: 55mins Chancellor 5

 
GP CME South 2010 - Dr Mark Peterson
Dr Mark Peterson
 
Dr Mark Peterson has been a member of the NMZA GP Council since 2003 and the Chair since 2007. He is a full-time GP in Napier, as a partner in a large General Practice. He is also Chairman of the Hawkes Bay Sub-faculty of the RNZCGP and deputy chairman of the Hawkes Bay PHO. 

 

Welcome - Chair GPC
 
Friday, 6 August 2010 Start 8:00am Duration: 5mins Chancellor 1
 
GP CME South 2010 - Dr Claude Preitner
Dr Claude Preitner
 
Claude first graduated as a mechanical engineer, obtaining a MSc in Switzerland, his country of origin. He then completed Medical School and moved to New Zealand, where he obtained FRNZCGP status. Holder of a commercial pilot licence he worked as part time flight instructor, �the best student job there is�. He spent 16 years in his own general practice at Rotorua, and obtained a Diploma in Aviation Medicine. He became involved with assessing pilots and with occupational health. He also held a 2/10 position at the local ENT department for some 8 years. Moving to full time Aviation Medicine became a logical progression for him. He has been a Senior Medical Officer with CAA since 2002 and also attends a weekly clinic at the Hutt DHB. He enjoys interacting with GPs, running CMEs for aviation medical examiners, and the national and at time international dimension of his job. He has a special interest in the certification of pilots with complex medical problems. 

Dr Claude Preitner
Senior Medical Officer, Civil Aviation Authority of NZ
www.caa.govt.nz
claude.preitner@caa.govt.nz 
Phone: 04 560 9463

 

 

 
So What if Your patient happens to Fly? - Concurrent Workshop Repeated
 
Saturday, 7 August 2010 Start 11:00am Duration: 55mins Holiday Inn Ballroom 1
Start 12:05pm Duration: 55mins Holiday Inn Ballroom 1

When prescribing, GPs need to be aware of their patients profession and hobbies. GPs have at time to deal with patients who are pilots. Some drugs are either prohibited or require special Civil Aviation approval. In general terms when treating a pilot, fitness to fly determination depends both on the condition being treated and the treatment itself. Dr Claude Preitner discuss particular considerations that Medical Practitioners should give when treating pilots, and conditions that are of particular concern to flight safety. He also addresses Medical Practitioners legal obligations in regard to those conditions and treatments of concern and advises on available resources. 

Air travel is becoming more accessible and the age of the travelling public goes up. This results in an increase in the number of passengers flying with medical conditions. The aircraft environment can exacerbate pre-existing medical problems leading to problems in-flight. Dr Claude Preitner will also discuss practical aspects of assessing passengers� fitness to fly, when confronted with such questions in General Practice.

 
GP CME South 2010 - Mr Sanjeewa Samaraweera
Mr Sanjeewa Samaraweera

Sanjeewa is the Chief Operating Officer of Medtech and Head of Product Strategy, leading Medtech�s eHealth Solution - ManageMyHealth�. He has been part of the Medtech team since December 2007. Sanjeewa brings a wealth of experience in formulating and implementing business strategies, managing projects and programmes, delivering large-scale information systems implementations and complex integrated technology solutions, in addition to managing client and vendor relationships, strategic alliances and leading diverse teams and people.

Sanjeewa holds a Bachelor of Computer Science degree from the University of Auckland and has held senior roles in very successful consulting and systems integration practices at PricewaterhouseCoopers Consulting and Unisys in the Asia Pacific region. 

 

"Manage My Health" over breakfast - Medtech Breakfast Session - Pre-registration required
 
Friday, 6 August 2010 Start 7:00am Duration: 45mins Chancellor 1

 
GP CME South 2010 - Dr Sara Souter
Dr Sara Souter

Dr Souter is an Occupational Medicine Specialist and fellow of the Faculty of Occupational and Environmental Medicine. She works in private practice in Christchurch, but has a background and strong ongoing interest in company based practice. Her subspecialty area is Aviation Medicine, which was born from time spent in the Royal Flying Doctor Service in Australia in the late 1990's, continued with work in the assistance area, and more recently in the airline industry and as a Grade 1 Medical examiner for CAA. She has a keen interest in vocational rehabilitation, and with her business partners was recently involved in a pilot initiative with ACC in this field. She is married to one of the business partners, and they have two young children. Hobbies are few and far between in the little hours that remain in the week!

 

Can I Go back to Work Doc? - Concurrent Workshop Repeated
 
Friday, 6 August 2010 Start 2:00pm Duration: 55mins Auckland
Start 3:05pm Duration: 55mins Auckland

Vocational rehabilitation has never been so important. In our turbulent economic times, illness or injury can be devastating to the employee who may lose their job, or the employer who has to train another. In the last 12 months there has been renewed worldwide interest in health at work from a human, social and economic perspective. This was in part led in early 2008 by the publication of �Working for a Healthier Tomorrow� - Dame Carol Black�s review of the health of Britain�s working age population. The aim of the UK government now followed by ours and other governments as the merits are seen, is to change attitudes to ill-health or injury and work. In particular, the benefits of remaining at work are now overwhelming, yet our current system, and many individual health professionals, focus on what their patient cannot do rather than what they can do at work. Many wrongly perceive that staying away from work during mild-moderate illness or injury is in their patients� best interests. Overall evidence available to-date shows that vocational rehabilitation is effective and cost-effective, and must include both work-focused healthcare and accommodating workplaces. They found that healthcare solutions alone do not provide best outcomes for the individual. A coordinated team approach from the patient, employer, primary medical provider and rehabilitation specialists is the optimal way to achieve desired outcomes in the environment most of our patients are part of.

This workshop aims to present both available evidence and case-based scenarios, and discuss common problems encountered in supporting vocational rehabilitation and examples of how to address them.

 
GP CME South 2010 - Dr Ian St George
Dr Ian St George
 
Ian St George is a Wellington general practitioner, and has been Medical Director of McKesson New Zealand, which operates Healthline for the Ministry of Health, for ten years. Dr St George served on the Medical Council of New Zealand for several years, was chair of its Education Committee, and was Deputy President; he has been Deputy Dean at the Wellington School of Medicine and Censor in Chief for the RNZCGP. He is author of almost 100 papers in refereed journals, is editor of Cole�s medical practice in New Zealand, and has written a number of other books. His current research interests centre on the evolving place of a national telenursing triage and advice line in primary health care.

Email: ian.stgeorge@mckesson.co.nz 
Phone: 027 2407919

 

Healthline - ten years evolution of the national telenursing triage and advice line
 
Friday, 6 August 2010 Start 2:00pm Duration: 25mins Chancellor 1

Healthline was started as a pilot ten years ago, and became the national teletriage and advice line in 2005. Its telenurses now field 1000 calls a day, 700 of them from callers unsure of what they should do about a current symptom. They are questioned according to a highly sophisticated software program, excluding serious causes first, and arriving at a disposition of care that is safe, consistent, and "the right place at the right time". Consistent with similar national lines in UK and Australia, the highest number are triaged to self care at home, with decreasing numbers referred to more urgent dispositions. Adherence to advice is high, and satisfaction similarly high. Complaints are few. Clinical governance procedures ensure continuing quality improvement in the service. There will be many new options and opportunities for such a service over the next ten years.

 
 
GP CME South 2010 - Dr Bruce Sutherland
Dr Bruce Sutherland
 
I Completed a BSc in Zoology in 1982 and went on to qualify in Medicine at Auckland in 1989 and Diploma in Obstetrics in 1994. I have worked in Warkworth as a GP with Kawau Bay Health since then. My interests are in minor surgery, Orthopaedics and vasectomies. A clinic at Mahurangi College has kept me up to date with Adolescent Health.

I have 3 children and am married to Elspeth Dickson, also a local GP.

 

Performing Vasectomies - Concurrent Workshop Repeated (with Dr John Apps)
 
Saturday, 7 August 2010 Start 11:00am Duration: 55mins Auckland
Start 12:05pm Duration: 55mins Auckland

Bruce Sutherland together with Dr John Apps will run a one hour workshop on how to do Vasectomies in General Practice. They will discuss the Preoperative consultation. Then, how to do the procedure, with some short video clips and demonstrations. Followed by Postoperative care discussion and potential pit falls for the vasectomist.

Vasectomy is a procedure that should be performed by General Practioners. They will discuss how this can be facilitated and how we can support the incorporation of this skill into the General Practice model.

 
GP CME South 2010 - Mr Tony Ward
Mr Tony Ward

Mr Tony Ward is an Advanced Paramedic employed with St John Ambulance Service in Christchurch. Tony works primarily on the Westpac Rescue Helicopter and Rapid Response Unit. Actively involved in education, providing both level 5 resuscitation and PRIME tutorage to G.P�s throughout New Zealand. An active member of the Chemical Biological Radiological Nuclear and Explosive (CBRNE) and Specialist Emergency Response Team (SERT) responding as a medical support to the N.Z Fire service and Police AOS/STG.

Educated as a Registered Nurse with 7 years Emergency Department experience before becoming an Advanced Paramedic in 2004. Currently educating through Otago University and studying towards a Masters in Aero Medical Retrieval and Transportation.

 

Road v Fixed Wing v Rotary Wing Response
 
Friday, 6 August 2010 Start 5:10pm Duration: 20mins Chancellor 1

Rural practitioners are faced with difficult and life altering decisions on a daily basis, throw into the mix the foreign environment of emergent pre-hospital care, unfamiliar equipment, inclement conditions and multiple casualties! Who goes? Where do they all go? What levels of care do they require? And who will provide all these resources? Decisions like these require a considered and co-ordinated response appropriate to the scene. This session hopes to provide you with some tools in order to help make a sometimes tricky decision, simpler and justified. Pre-Flights assessment, stabilization and some tricks of the trade will see you decrease stress and increase patient care in this sometimes overwhelming environment.

 
GP CME South 2010 - Dr Phil Weeks
Dr Phil Weeks
 
Phil graduated from the University of Otago in 1980 and completed his training in radiodiagnosis in 1991. 

He spent time in Vancouver and Cambridge during his training, concentrating on ultrasound, scintigraphy and MRI. 

He then spent eighteen months as a fellow in Cardiac Radiology at Green Lane Hospital.

Phil is currently Director of Ultrasound at Middlemore Hospital, with full involvement in the MRI, interventional, angiographic services provided there.

He is a visiting specialist at Manukau Radiology Institute, and with The Ascot Radiology Group.

He has particular interests in musculoskeletal and breast imaging, and is involved in the Auckland Access To Diagnostics group, endeavouring to improve primary care access to imaging.

 

 

Ultrasound in Primary care Workshop - Concurrent Workshop
Saturday, 7 August 2010 Start 11:00am Duration: 120mins Wellington
Broad overview of likely future trends in adoption of ultrasound in primary care
Machine purchasing � what to look for.
Mandatory features, desirable features, traps and pitfalls
Servicing and maintenance
Tailoring equipment to need image guidance and diagnosis.
Scope of practice
Getting started
Training, clinical oversight, image sharing
Training opportunities and clinical partnerships
Clinical pathways their utility and integration in primary care

Musculoskeletal; US and Radiology - Pre-conference Workshop Repeated
Sunday, 8 August 2010 Start 8:30am Duration: 55mins Wellington
Start 9:30am Duration: 55mins Wellington

Overview of approaches to musculoskeletal problem solving with particular emphasis on primary care strategies, and available resources.

Plain film, ultrasound, MRI and CT scanning use of nuclear medicine and brief reference to CT PET.
Ultrasound and its practical application for common problems and utility in guiding musculoskeletal intervention.

This will be followed by hands on practical scanning using available laptop based ultrasound platforms. Patients with simple masses, and basic scanning techniques and normal anatomy around tendons and major joints.

 
 
GP CME South 2010 - Dr Anton Wiles
Dr Anton Wiles
 
Born and brought up in Auckland, trained in Otago, then 4 years travel and work in Australia and the UK. In practice in SE suburbs of Auckland since 1980, and took an active involvement with Registrar training and running the Primex examination in Auckland for some years. Also involved as a founding director of CAIPA (later to become ProCare), and elected to the executive of NZMA, becoming Deputy-Chairman in 1996, and then Chairman in 1998. In 2001 moved to join Dr Bill Daniels in Remuera, and started to train and participate in that practice�s high aviation medical workload. Is now designated for New Zealand, Australian and Canadian pilot medicals, and has completed FAA training - should be designated for USA pilot medicals soon. 

 

Aviation Medicals - Expanding Horizons - Concurrent Workshop Repeated
 
Sunday, 8 August 2010 Start 8:30am Duration: 55mins Auckland
Start 9:30am Duration: 55mins Auckland

Having come into Aviation Medicine by chance, I have found it an interesting and rewarding activity, which complements an active general practice very well. It is a branch of occupational medicine, dealing with the medical needs of pilots and their certification for flying aircraft. As such it is highly associated with the ultimate aim of safety in the aviation environment. In the main this is dealing with healthy and motivated individuals, assessing current health status, and encouraging healthy life-styles. This seminar aims to describe to sort of work done, and how a medical practitioner can qualify to become involved.

 
GP CME South 2010 - Chris Wills
Chris Wills
 
Chris Wills is a business advisor at Medical Assurance Society specializing in HR issues. Having had a background in practice administration and management for over 20 years in Wairarapa, Chris moved to Wellington in 2004 to join the Practice Liaison team at Wellington Independent Practitioners Association. In 2008 Chris joined the MAS Business Advisory Service and her principal role is to advise Members on business issues in conjunction with the HealthyPractice� business support service. 

 

MAS Business Summit - "The Essentials of Staff Management" - Concurrent Session
 
Saturday, 7 August 2010 Start 8:30am Duration: 120mins Holiday Inn Glouchester

General practice is a complex and fascinating place to work with many challenges for those managing staff. For example if your new staff member hasn�t worked in this environment before, they won�t just walk in and do the job . . . you need to train and support them.

If you get it right, from the beginning of the employment relationship through to the end and all points in-between, staff will be your most valuable asset. Proactively managing performance will also reduce the cost and time spent on managing underperformance and disciplinary processes.

CORNERSTONE�  accreditation further reinforces the need to have clear documented workplace policies and guidelines in place for the whole practice team - including GPs. And breaching your employer obligations in relation to employment agreements or employment law can land you in serious hot-water. 

Understanding the basics of current legislation and developing good policies and processes will help you manage and develop a confident and motivated team and ensure legislative compliance. 

This session will cover the requirements of:
� Recruiting well 
� Position descriptions & KPIs
� Employment agreements
� Induction
� Staff appraisals 
� Staff retention
� Training and development
� Underperformance and disciplinary procedures

 
MAS Financial Session - "The Essentials of Financial Management" - Concurrent Session (with Mr John Glue)
 
Saturday, 7 August 2010 Start 11:00am Duration: 120mins Holiday Inn Glouchester

General practice has changed significantly from the traditional small business model where all revenue flowed directly from the GP/Patient consultation. Most of these changes have added layers of complexity to those responsible for financial management including capitation and the transfer of financial risk, increased group practice compliance and quality standards, less direct GP/Patient consultation revenue, PHO projects, workforce shortages, different GP needs and many more. Business models have also changed with DHB, Community Trust, PHO and corporate ownership now being more commonplace alongside the traditional GP owner/operator. And we continue to see more amalgamations with the development of purpose built medical centres providing a broader range of primary care services. To be financially viable and successful general practice now needs good financial management and business planning skills.

This session will cover three key areas of good financial management:
1. Maximising income � including managing the practice register, consumables, debtors, fee policy and other revenue opportunities;
2. Managing expenses � including non-owner GP/staff costs and financial risks;
3. Business planning and budgeting � to help determine the future direction and performance of the practice and how this will be funded.

 
 
GP CME South 2010 - Dr Heather Young
Dr Heather Young

I am a Sexual Health Physician (0.4 FTE) at Christchurch Sexual Health Clinic, Christchurch Hospital, and a DSAC doctor for Cambridge Clinic (which holds the Sexual Abuse Assessment and Treatment Service contract for the lower South Island). I am currently on maternity leave and have 2 children aged 3 years and 10 months. I am born and trained in Otago and moved back to the South Island in 2006 after a period overseas and the completion of my vocational training scheme in Auckland.

 

Sexual Health
 
Saturday, 7 August 2010 Start 9:20am Duration: 25mins Chancellor 1
Practical aspects of STI management. This presentation focuses on updated resources, emerging epidemiologic trends and newer antibiotic regimens, with an emphasis on clinical recognition and referral guidelines. Contact tracing will be discussed and a few of the clinical syndromes outlined.
 
 
GP CME South 2010 - Dr Rob Young
Dr Rob Young
 
Dr Young is a medical graduate of the University of Otago and was awarded a Commonwealth Scholarship which enabled him to graduate from the University of Oxford with a PhD in Molecular Genetics. He has been a consultant Physician in the Department of Medicine, Auckland City Hospital for the last 10 years and recently promoted to Associate Professor jointly appointed in the Faculties of Health and Medical Sciences and the School of Biological Sciences at the University of Auckland. Currently he lectures to medical students and post-graduate science students. His research and clinical interests focus on the early diagnosis and primary prevention of smoking related respiratory disease. 

 

 

 
Smoking Cessation Strategies - Concurrent Workshop Repeated
 
Friday, 6 August 2010 Start 11:00am Duration: 55mins Auckland
Start 12:05pm Duration: 55mins Auckland

The new recommendation for smoking cessation is the ABCD of ask 9about smoking), Brief advice (about quitting), Cessation treatment and D for do testing. There is growing evidence to suggest that smokers are interested in their risk of smoking complications. Spirometry and genetic testing are useful tools to engage smokers much like we use cholesterol for assessing cardiovascular risk and initiating lifestyle changes. This presentation will cover recent insights into how this testing helps smokers quit and provide a useful tool of engagement.

 
How Statins improve lung disease - Concurrent Workshop Repeated
 
Friday, 6 August 2010 Start 2:00pm Duration: 55mins Christchurch
Start 3:05pm Duration: 55mins Christchurch

Over the last 5 years there have been a number of studies examining the diverse actions of statins in lung disease primarily chronic obstructive pulmonary disease and lung cancer. This presentation will review the epidemiological, animal and pharmacological studies that suggest statins may, through immune modulating action, be as effective in preventing respiratory disease as they are in reducing cardiovascular disease. 

 
Influenza
 
Saturday, 7 August 2010 Start 8:30am Duration: 25mins Chancellor 1
�Its just the flu� is a common belief by a large proportion of the population. But we must remember that influenza carries an annual mortality in this country of about 150. While it did not happen this time with the 09H1N1 virus, it is not if, but when, there will be a pandemic. This session will cover epidemiology, diagnosis, isolation of patients, and treatment in a general practice setting.