So What Needs To Happen To Happen?

Firstly we need to know that you are on board with us and with what we’re doing. Email us / other medical bodies to tell us you agree with what we’re doing.  (The Pledge). (We have a stock of standard forms on guvnot.com/forms).

Use a proton mail – a secure email address – if you think you may be involved with us more than just a bit. You can sign up for a new address at protonmail.com . Proton mail is encrypted secure email. I think it is a perfect method for communicating with us and making sure everything is kept safe and confidential. We will look at these emails to see if anybody is particularly willing to go the extra step to help us out.

If you are just interested in some basic involvement/activity with us – your usual email address may be sufficient and appropriate.

In your email state:

• Who you are
• Whether you support our proposals
• Whether you are willing to be involved at a higher level than just yourself. (Proton mail)
  If you think appropriate: – Contact details: email address, fax number, home phone number, work phone number, mobile phone number. Please do check the proton mail address on occasion if you decide to use one.
• Whether you have a story to tell us that you may be willing to share. Whether you have an incident you know about which may be of use to us.
  (See our stock of standard forms on guvnot.com/forms)

 

 

We need a coordinator for – organising to lodge complaints against the AHPRA organisation and its employees. Personally as well, if you were willing to bear the cost of legal appeal (likely up to $15,000 with almost no possibility of any success), perhaps you would be willing to invest some money in some action against AHPRA and its employees on your own behalf. More later. The plan is for a coordinator to assist multiple people lodge a raft of complaints or actions against AHPRA staff.
We need a coordinator for – organising to lodge FOI requests to seek information from AHPRA for consideration of lodging legal challenges, legal complaints or legal actions. More later.

We could do with some funding. The campaign will probably need two employees over a period of up to six months to undertake the necessary political and media representation. For instance, every time a claim is released – I can foresee a need to contact multiple organisations and to push them to make a response. (AMA, RAC GP, TV media, print media, magazine media). A job which has to be done again and again and again to make sure the message gets airplay.

We could do with someone to assist us in acquiring more email addresses/fax numbers to enable us to communicate with more doctors.

 

 

We need a coordinator to pull together doctors who are willing to produce statements for the defence of their colleagues. I.e.
10 minutes is an adequate time for holistic medical assessment in general practice.
The medical records are more than adequate and are typical.

The punishment that would be meted out would inflict time and financial costs of the member to a substantial extent. AHPRA often insists that judgements only require 10 hours. One colleague has undergone the process said it took 30 hours of his time in personal education plus travel and inconvenience time and time off work. To stand before a judge and say it is not reasonable to revoke a judgement because only 10 hours are involved is a flagrant lie. But AHPRA is happy to do it.

An organisation such as AHPRA commonly defaults to mistruths, due to the lack of organised opposition to whatever it says.

The "Jurors"-
an art work at Runnymede

We Say:
Yes it is reasonable to examine patients.
Yes it is reasonable to ask people to come back for return or follow-up appointments.
Yes there is a limit to how much work can be done at one consultation time and is appropriate to stop undertaking further work.
Yes the patient’s actions indicate exploitation or harm to a practitioner and are not reasonable.
Yes only a certain level of medical records is adequate or necessary in the circumstances.

 

 

We need a coordinator to look at the issue of medical education. I am loath to believe that AHPRA is a trustworthy body to allow manage/enforce or setting standards for continuing medical education. I believe there is only grief to come. The RACGP has also claimed the high ground and elected to make some changes in the past with CPD. I think the removal of its claimed tiara of “we’re acting on behalf of our members” is essential. I think that in the long term the members need to define what they think is essential. As someone once said to me: “Not the bosses, Not the state. Let the workers decide their fate”.

We need a coordinator to look at the PSR issues. What we want changed or repealed? Perhaps an issue best addressed by the members of the medical community who have gained memorable experiences in undertaking legal challenges to this issue. Dr Karmakar has publicly stated he wants to see the Medical Legislation rewritten to allow a fair go for doctors.

We need a coordinator for publicity/ email. We need doctors harassing the AMA/ RACGP to achieve an outcome. We need Emails sent to politicians. We need Phone calls and representation made for our issues.
We need a coordinator for stories and information we may receive. What are we going to do about any information we have received. Gathering enough information to be useful and deciding how to use it.

 

Finally a few people to act as a steering committee/action committee. Although we have a campaign mapped out, as every soldier knows no plan survives contact with the enemy. Will need to make changes – on the fly. Anybody can have a good idea. What we really need someone with a good idea and the energy to back it.

 

 

Choosing Covert Action

Most of the people working with us can do a great deal without even coming out of the closet. Your own family, your colleagues, and your friends do not need to even have an inkling of what you are doing.

The basic plan is to cause the government pain and financial burden. But if you are going to do this, pick a definite goal, remind yourself every day that you are doing this, make sure you do this and consider every day how you may be able to extract a little bit more pain for opposition from your actions. Let’s look at some options.

Decide to do three extra ECGs every week and to refer even the slightest abnormality (which the agency does not believe you are qualified to interpret and certainly are not entitled to be paid for) for specialist review. I think those mad ECG machines with their mad interpretations of excellent justification for such an action. How can you as a caring sensible legal practitioner who apparently has little knowledge of ECGs, be expected to make  contradict the judgement of a professional system such as a “ECG computer” indicating ischaemia, fibrillation, QRS changes, ST changes et cetera in its analysis of your patient’s ECG.

Send one extra patient per week to a hospital or specialist.

 

Do an Extra ECG or a few extra pathology tests/ maybe with a few less pathology tests.
In Cons10.com we broach this concept. On the first visit never investigate more than one single test – for example FBC, E&LFTs or perhaps an X-ray, never both. On the next visit, some more tests of one sort as appropriate. And on the next visit more tests as appropriate. Have a look at the pathology schedule, and see if you can work out some new tests to do every so often. There are two paths here. The first one is just doing some extra tests at the usual visit – creating some extra work for you on the next visit checking them. The second one is to break the tests into blocks or bits – generating more tests overall as well as more visits overall.

Just one basic rule – safety first. Never put a human with health problems in danger. If the situation is dangerous or life-threatening: just do what has to be done.

Decide to do three extra x-rays a week.

The Referral:
 Send patients who are not profitable to be cared for to hospital and keep sending them there.
Refer: Patients who come with too many issues and who demand too much time: send to hospital or specialist.

Refer: Complex patients whose conditions are terminal or severely chronic and complex. (It’s the sort of thing you get in trouble for. If something goes wrong, everyone will say you should not have been looking after the issues/problems/patients. It is maybe beyond your pay grade (as GP). This sort of thing is easy for others to say and hard to defend). If you send them to a specialist or a hospital – you can be sure that it will cost the government a whole lot more than anything you would have cost them.  Send to hospital or specialist.

Refer: Patients needing expensive care e.g. dressings: send to hospital or specialist.
 Send one extra patient per week to a hospital or specialist.
Send patients who are not profitable to be cared for to hospital and keep sending them there.

Scripting:
Low or nil repeats especially on potentially risky medications.

 

Work and Leisure:
Bill one afternoon per week.
Take an afternoon off work, maybe similar to other practices nearby.
And here is a favourite. Reward yourself for all the work you have done. All too often doctors work every day without a break. Take a week off every three months and perhaps the occasional extra day as well. This means that you like most members of our society will actually be taking the same quota of holidays that everyone else in the workforce expects.

Go home on time. If patients are late get them to make another appointment. If finances are a problem perhaps this is not for you. But if you are getting long in the tooth in the workforce, perhaps time is a much better reward for you than the money.

Bill - Procedures, MHCP, OPs, dressings

Think Of Options:
Find more expensive ways to do things if the system refuses to do things your way.

 

Clinical examinations:
Examination protocol – full safety. This is a serious issue as many doctors are retreating from doing examinations from the fear of an accusation been levelled against them. A single accusation that you have touched something or acted inappropriately can be a career ender. So maybe the thing to do, is to always book an appointment with a chaperone - next visit. This has the effect of bringing a patient back for an extra visit to perform a medically necessary “procedure”.

Organise this event by asking the patient return to discuss the results/findings as you leave to “write up” your notes. Remember AHPRA believes that the recording of notes is paramount and takes precedence over all other activities. You can be complying with their impositions at the same time as kicking them in the teeth as well for their stupidity.
Summary: Separate appointment with chaperone booked for   examinations.

 

Being Too Helpful:

Stop doing illegal things to help patients. For example, if someone calls wanting medical information, you need signed consent every time. Maybe add that you need accompanying photographic ID and identification / JP witnessed declaration as well. Even better if you use a consultation to help patients do what the system expects them to, to make everything legal.

Do Things Properly
DO THINGS PROPERLY.
E.g. So even a very routine item e.g. repeat for BP pills may be best dealt with as a single item with notes made- to protect the practitioner. There is a cost to doing things properly or improperly. Do everything formally and properly and leisurely. Remember AHPRA wants good notes first, foremost and as the main consideration for all medical work. If you do not document positive and negative indications for doing a medical action, you have breached AHPRA's code of conduct.

 

Information Transmission:  you need signed consent every time. Maybe add that you need accompanying photographic ID and identification / JP witnessed declaration as well.

 

Authority Scripts:
Always send these off by mail rather than ringing the HIC/PBS for an approval. If they are returned asked the patient to come in to clarify the issue – if necessary. Perhaps require these to be done at a dedicated appointment – single issue appointment.

The new PRODA authority script approval system is so secure that it will literally make you use up the entire consultation to get the authorisation. Make patients make an appointment solely for this purpose. If patients insist  on more , more more- the practice policy is that you must attend the front desk and pay for the extension to you consultation in advance. People usually refuse to pay after a consult and create an incredible ruckus in being forced to pay and you can well generate a slew of AHPRA complaints if you refuse to do what patients tell you to do.

Default to safety- the organised process of pay first and do second. If patient insists that a critical issue be dealt with, send a hospital referral telling how the patient kept this critical issue till last, self-prioritising the issue after other minor issues and refusing to pay for consultations.

 

 

 

“The Big Goal “of the Covert Campaign:   CONS10.COM

Become a lot tighter about one consultation- one problem. No one said that political action has to lose you money. This website looks at a number of actions to make your consultation shorter and more financially rewarding. You need to spend some time working through each page of the site. You need to make some notes that are relevant to you – things that you have decided you will be doing. And as someone who has tried to implement these changes in your practice – to be effective at implementing these changes you must remind yourself every day by flicking through your notes – what it is exactly that you have decided to do.

Keep your goals firmly in front of your eyes and make sure you work towards them every day in every way.

Become a lot tighter about one consultation- one problem. No one said that political action has to lose you money.

Logging in Patient Complaints: One Problem One Consultation.
As this is getting hard for you: counting to 1, here’s another suggestion.
Give patients pen, paper and board to write down their "one" problem before seeing the doctor. No book in before they return the board and pen. Keep the paper to give to the doctor. You will decide how much can be done for "one" item in all fairness, at some stage. E.g. scripts plus minor item, if scripts are routine may be ok.

Scripts really should, have a review of the needs of the meds done and notes made. So even a very routine item e.g. repeat for Oxazepam may be best dealt with as a single item with notes made- to protect the practitioner. There is a cost to doing things properly or improperly. A SIMPLE ITEM SUCH AS Oxazepam scripting has regulatory requirements so it may be best to devote a full consultation to making sure that the regulatory requirements are met.

 

Complain to the authorities about doctors in authority. Just accusing them that they are bad eggs will cause an incredible avalanche of misery as AHPRA weighs in to sort this issue out.

I think you can close the hospital system down almost if you complain about all the stupid actions emanating from them. Patients sent home without treatments or diagnoses. Patients sent home with STDs that they can live with. Patient s denied essential, medications. Patients given medication in breach of the regulations.

 

 

The Overt Action Pathway

Quote:

Nobody thunk it, nobody knew
No one imagined the great Doc guru
Docs are one.
He hid in the forest, read books with great zeal
He loved Che Guevera, a revolutionary veal
Doc Tse Tongue.
He spoke about justice, but nobody stirred
He felt like an outcast, alone in the herd
Doc doldrums.
He mooed we must fight, escape or we'll die
Docs gathered around, cause the steaks were so high
Bad Doc pun.

But then he was captured, stuffed into a crate
Loaded onto a truck, where he rode to his fate
Docs are bummed.
He was a scrawny doc, who looked rather woozy
No one suspected he was packing an Uzi
Docs with guns.
They came with a needle to stick in his thigh
He kicked for the groin, he pissed in their eye
Doc well hung.

 

 

Take Legal Action:

Do it in a way with a likely outcome for you. Don't play AHPRA's game. Court for Defamation, Damages, Negligence, False Staements, Illegal Actions. These are the wheelbarows to push. And by pushing your own chosen Agenda, along with others afflicted by AHPRA, these action are more likely to succeed and create change than actions against AHPRA where it almost controls the legal framework. Change the conflict to "we attack and you defend".

If you have been bruised by AHPRA, you have undoubtedly been in contact with AHPRA staff and AHPRA investigators. I personally believe that in this complex world is almost impossible to follow “every” rule. That means that in following one rule you tend to break another.

So in enforcing its justice, AHPRA is going to make some legal breaches.

Consider launching a legal action against the AHPRA staff for the error of their ways.
This tactic is based on the same tactic used to gain special tax consideration for Scientologists from the IRD in the US. The Scientologists considered that they would launch a legal action against every IRD staff member who they were having dealings with. As the staff progressively became more worried that defending the legal action would cost them time and money, a growing tidal wave of staff pressured the IRD to solve their problems for them. Tax concession status for the Scientologists was granted to end the tidal wave of lawsuits.

I believe that many of the AHPRA staff commit errors in the pursuit of their duties. It is a valid negotiating tactic to force them to defend their actions – especially where it appears that they may have committed an offence themselves or potentially caused harm arising from their errors.

The basic overriding principle of undertaking these legal actions is to try to catch the AHPRA staff committing an illegality. In attacking the staff committing an offence, it removes the capacity of their employer (AHPRA) to underwrite their legal defence. The employees are forced to bear their own legal costs. AHPRA is restricted from using your money to defend them, because the issue is criminal, not in defence of their job. And then AHPRA faces exactly the same situation faced by the doctors it acts against. Even if they win the legal action of their defence, they still lose time and money. It becomes not worthwhile to work for an organisation like their employer. In the long run, only the foolish and desperate would work for AHPRA.

 

Offences include:
Changing the patient’s complaint. This is especially probable if the complaint has been taken verbally and written up by the AHPRA employee. The basis of action here is that the AHPRA employee has created the complaint or “optimised” the complaint.
Contacting the patient and initiating a change in the patient’s complaint. AHPRA and its staff are supposedly unbiased investigating bodies. They lose the enshrined protection for this role if they are making up the complaints as well.

Breaches of the privacy act regarding access to electronic files and especially government electronic files such as the electronic health record. The Privacy Act is a “big deal” piece of legislation. It allows access to information for relevant purposes under the Act. It is certainly not to be used for fishing expeditions, especially where there has been no complaint.

Failure to provide information as requested. I would suggest to everyone on the complaint that they always require a summary at every stage of the punishment process from their AHPRA investigator – especially as “only they would be aware of what the medical board has actually decided” (Justification). Any fault arising from the information provided from this request would of course require compensation for the doctor due to the injuries that it may inflict on the doctor, his work, his time or his reputation.

Extending punishments beyond what has actually been ordered. An order is an order. The moment an AHPRA staff member insists on doing it a particular way, it is probable that their actions are breaching the orders as created, making them liable for “damages”. There are time frames for telling a doctor that a complaint exists. There are time frames for AHPRA actions in pursuit of a complaint. Breaching these timelines is a breach of the Act.

Failing to respect prior decisions or judgements: is arguably a “contempt of court”.
Telling lies or fabrications to achieve their aim is defence in some way shape or form. I think damages can be claimed. One particular favourite I have seen come from AHPRA staff is the claim that 10 minutes is not an adequate time for a holistic medical consultation. It decries the obvious observation that 80% of general practice consultations are less than 10 minutes. If the AHPRA investigator’s statements are at odds with the evidence of the case, this is obviously a breach. Compensation from injuries resulting may be forthcoming if pursued.

 

 

Complain to the authorities about doctors in authority. Perhaps put in a complaint to AHPRA about AHPRA. Just accusing them that they are bad eggs will cause an incredible avalanche of misery as AHPRA weighs in to sort this issue out. This is nasty. AHPRA feels it is appropriate to use anonymous complaints as a basis for investigation and that all such complaints must be investigated fully. Follow-up a bevy of such complaints with FOI to assess the timeliness and appropriateness of investigation to cause some real grief.

 

Do an FOI request. Share this with others such as on our Bloodweaver site www.bloodweaver.com

 

Be a nuisance. Keep asking for things and insisting that things be provided. And if you have the slightest hint of a transgression or a fault or a possible breach of legality – complain/ lodge a complaint. Everyone can play this game in a democracy. AHPRA thinks it is entitled to do what it wants – but perhaps you are also entitled to do what you want. Even if timeliness is breached – complaints not dealt with in a timely manner – this can be the basis of a serious complaint.

 

 

 

 

As We Have Already Stated:

Whether you have a story to tell us that you may be willing to share. Whether you have an instant you know about which may be of use to us.

 

We need a coordinator for – organising to lodge complaints against the AHPRA organisation and its employees. If you are willing to bear the cost of legal appeal (likely up to $15,000 with almost no possibility of any success), perhaps you would be willing to invest some money in some action against AHPRA and its employees on your own behalf. More later.

We need a coordinator for – organising to lodge FOI requests to seek information from AHPRA for consideration of lodging legal challenges, legal complaints or legal actions. More later.

We could do with some funding. The campaign will probably need two employees over for retirement after six months to undertake the necessary political and media representation. For instance, every time a claim is released – I can foresee a need to contact multiple organisations and to push them to make a response. (AMA, RAC GP, TV media, print media, magazine media). A job which has to be done again and again and again to make sure the message gets airplay.

We could do with someone to assist us in acquiring more email addresses/fax numbers to enable us to communicate with more doctors.

 

We need a coordinator to pull together doctors who are willing to produce statements for the defence of their colleagues. I.e.
10 minutes is an adequate time for holistic medical assessment in general practice.
The medical records are more than adequate and are typical.

The punishment is meted out would inflict time and financial costs of the member to a substantial extent. AHPRA often insists that judgements only require 10 hours. One colleague has undergone the process said it took 30 hours of his time in personal education plus travel and inconvenience time and time off work. To stand before a judge and say it is not reasonable to revoke a judgement because only 10 hours are involved is a flagrant lie – which an organisation such as AHPRA commonly defaults to due to the lack of opposition.

Yes it is reasonable to examine patients.
Yes it is reasonable to ask people to come back for return or follow-up appointments.
Yes there is a limit to how much work can be done at one consultation time and is appropriate to stop undertaking further work.
Yes the patient’s actions indicate exploitation or harm to a practitioner and are not reasonable.

We need a coordinator to look at the issue of medical education. I am loath to believe that AHPRA is a trustworthy body to allow to manage/enforce or set standards for continuing medical education. I believe there is only grief to come. The RACGP has also claimed the high ground and elected to make some changes in the past with CPD. I think the removal of its claimed tiara of “we’re acting on behalf of our members” is essential. I think the long term the members need to define what they think is essential. As someone once said to me: “not the bosses, not the state, let the workers decide their fate”.

 

We need a coordinator to look at the PSR issues. What we want changed or repealed? Perhaps an issue best addressed by the members of the medical community who have gained memorable experiences in undertaking legal challenges to this issue.

 

We need a coordinator for publicity/ email. We need doctors harassing the AMA/ RACGP to achieve an outcome. WE need Emails sent to politicians. We need Phone calls and representation made for our issues.

We need a coordinator for stories and information we may receive. What are we going to do about any information we have received. Gathering enough information to be useful and deciding how to use it.

Finally a few people to act as a steering committee/action committee. Although we have a campaign mapped out, as every soldier knows no plan survives contact with the enemy. Will need to make changes – on the fly. Anybody can have a good idea. What we really need someone with a good idea as an energy to back it.

 

 

Limits of Medical Indemnity Insurer Support
E.g. Avant

As advised previously, it is Avant’s view that if you do not hold reasonable prospects of successfully appealing the case/ conditions; you will need to pay for any legal action. In short, you are not covered by your insurance policy for Medico-legal expenses.

Limits of Medical Indemnity Insurer Support
E.g. Avant
As advised previously, it is Avant’s view that if you do not hold reasonable prospects of successfully appealing the case/ conditions; you will need to pay for any legal action. In short, you are not covered by your insurance policy for Medico legal expenses.

Please note the following clause of your Practitioner Indemnity Insurance Policy:
Withdrawal of indemnity for Part B

We may decide not to incur any further legal fees and other expenses for pursuing, defending or responding to a request for indemnity under Part B if we believe, in our sole opinion, that there are no reasonable grounds in pursuing, defending or responding to the complaint, matter or prosecution or there are no reasonable prospects of success if we do. We will take account of the lawyer’s advice in making that decision. If we do that, we will tell you in writing. We will pay the legal fees and other expenses incurred prior to the date on which we write to you telling you of our decision.

You may continue pursuing, defending or responding to the complaint, matter or prosecution. After we cease paying the legal fees and other expenses, we will only pay you thereafter for the reasonable legal fees and other expenses (not including the GST component if you are registered for GST) that you have incurred if you are successful in pursuing, defending or responding to a complaint, matter or prosecution.

 

 

 

 

 

The Mission

There are three parts to our strategy for change with AHPRA
1. www.Cons10.com Web Tutorial
2. The Positive Action Guide on www.GUVNOT.com
3. Getting Support for your own Positive Actions through a Group: Group Actions at www.Bloodweaver.com

Quote:
We will fight for DOCine freedom
And hold our large heads high
We will run free with the Buffalo, or die
Docs with guns.

 

Your Fate if you Do Nothing:
The President said "enough is enough
These uppity docs, it’s time to get tough"
Doc dung flung.

The newspapers gloated, folks sighed with relief
Tomorrow at noon, they would all be ground beef
Docs on buns.

The Docs were surrounded, they waited and prayed
They mooed their last moos,
they chewed their last hay
Docs outgunned.

Docs with guns

 

 

 

The "Jurors"-
an art work at Runnymede: an Explanation:

Chair 3
On the front of the chair you'll see an excerpt from the Magna Carta in its original Latin. It's a section from Clause 39 stating that no one is to be imprisoned without "lawful judgement of his peers", the fundamental principle of trial by jury in common-law legal systems across the world.

Chair 9
On the back of the ninth chair we find representations of 'The Golden Rule' that states you should treat others as you would wish to be treated yourself. Versions of this concept are found in all major world religions and philosophies and the phrase is expressed on The Jurors in 14 different languages.

Chair 10
On the back of the tenth chair is Chinese script that describes the Confucian principles of Ren (humaneness), Li (ritual) and Yi (justice). These ideals are at the core of Confucian ideas of how a society should be organised and were developed in the Han Dynasty (from 206 BC). On the front of the chair is the striking hollow boab tree found in Australia, these trees were adapted in the 1890s by police for use as temporary prisons for aboriginal prisoners

Chair 11
On the back of chair eleven Ancient Egyptian scales are topped with the head of Ma'at, the goddess of truth, justice and balance. A dead person's heart is weighed against a feather to see if the owner is worthy to enter paradise. Ma'at's symbolism is still apparent in the western personification of Lady Justice.