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					                                    Thoracic Society News
                                    The Thoracic Society of Australia and New Zealand Inc Newsletter
                                                                             145 Macquarie Street, Sydney NSW 2000
                                                                      Telephone: 61 2 9256 5457 Fax: 61 2 9241 4162
                                                     Email: admin@thoracic.org.au Internet: http://www.thoracic.org.au


Volume 15, Issue 2                                                                                       June 2005


                                                                the local organizing committee and Paul Reynolds for a
                                                                job well done. The many overseas guests added to the
                                                                high scientific content and general quality of the
                                                                meeting. In particular, the presence of the President of
                                                                the APSR, Professor Yoshinosuke Fukuchi, who
                                                                participated actively in the meeting, opened up new
                                                                opportunities for TSANZ members within our Region.
                                                                He strongly encouraged the TSANZ to bid for an APSR
                                                                meeting within Australia. This proposal is currently
                                                                being considered by the Executive.

Message from the President                                      Following consultation with Society members the
                                                                Tobacco draft Policy was endorsed as TSANZ policy by
Dr Rima Staugas                                                 the Executive at its most recent meeting. There has
Let me begin with a vote of thanks to Dick Ruffin for the       been lively debate throughout the Society regarding
enormous amount he has contributed to the Society over          this policy and also our policy in relation to funding and
the last two years. Dick has carefully steered the Society      sponsorship. Some have highlighted that they believe
through many sensitive issues and has been                      differential views regarding tobacco sponsorship versus
instrumental in forging positive relationships with the         pharmaceutical sponsorship are somewhat hypocritical.
APSR and enabling a change in the nature of our                 From an ethical perspective it could be argued that
relationship with the Royal Australasian College of             tobacco is supplied with intent to addict and harm.
Physicians. Dick will continue, in particular, to be our        While pharmaceutical companies are pursuing profit, as
representative to the Specialties Board of the College as       all business requires, they are not seeking to harm,
we work towards better partnerships and methods of              even though unintended harm may sometimes occur
interaction. Identifying a clear governance structure for       from the use of their products. Nonetheless, there have
Special Societies within the College will be a significant      been some notable ethical breeches in the
challenge.                                                      pharmaceutical industry as in other profit making
                                                                companies of late, and we have a duty of care to
At the Annual General Meeting the Thoracic Society              identify and notify adverse outcomes. This ensures that
Membership endorsed the MOU with the APSR.                      they are appropriately investigated and action taken if
Respirology will now have an Australian edition which will      required.     Drugs are regularly removed from the
be sent to all TSANZ members. The significant potential         formulary and alerts issued on this evidence.
benefit of the TSANZ becoming part of the ASPR will be
best realized through our active participation in the           The Society’s policy in relation to funding and
Region’s activities.                                            sponsorship has been developed to ensure that the
                                                                objects of the Society are not breached. It also seeks to
The Annual Scientific Meeting in Perth was an                   put sponsorship issues at arm’s length from officers of
unqualified success. I wish to thank all the members of         the Society. This will ensure that they can continue to
                                                                act ethically and in the best interests of patients should
                                                                adverse events from devices or drugs require their
                                                                positive action.
INSIDE THIS ISSUE
                                                                Sponsorship is required to maintain the many strands
 17   On Our Selection                                          of activity where external funds are hard to source. As
                                                                a Society we would have to charge much higher fees if
 23   President’s Award                                         all activities were to be achieved without any
 25   Wunderly Oration                                          sponsorship. We will continue to advocate, with the
                                                                RACP, for increased Government funding of
 31   2005 ASM Awards & Prizes                                  educational activities to reduce reliance on sponsorship
 32   Obituary: Dr Anthony Proust                               and fundraising. It is the Council’s and Executive’s
                                                                belief that the Tobacco Policy and the policy in relation
 33   TSANZ Membership Categories & Fee Structure


                                                                                                                 13
                                                        Please Support
to funding and sponsorship offer an ethical perspective    AstraZeneca Young Investigator Grant -
and also a protective mechanism in this environment.       in – Aid
This appears to be supported by the majority of the        Dr Peter Wark -- John Hunter Hospital:
membership.                                                Project Title: “The interaction between airway epithelial
I draw to your attention to the proposed changes in        cells infected with rhinovirus and lymphocytes from
membership fees on page 33. We encourage your              subjects with COPD”
input via the Forum page of our website on what has
always been a contentious issue.                           Ludwig     Engel     Grant-in-Aid                    for
                                                           Physiological Research
June is approaching and so is the Advanced Course          Miss Jyotishna Narayan – Westmead Hospital
on the Physiology of Exercise in Health and Disease.       Project Title: “Mechanisms linking snoring           and
The program committee has sourced many world               baroreflex sensitivity depression”
experts to update us and hopefully you can attend. In
closing, please let me know of any issues you believe      Boehringer Ingelheim COPD Research
the Society should address.                                Fellowship
                                                           Dr Carol Lang -- University of Adelaide
Until next time.                                           Project Title: “Role of Zinc in the respiratory system
                                                           and COPD”
                                                           Slater & Gordon Asbestos Research
                                                           Grant- in-Aid
                                                           Prof Bruce Robinson -- Western Australia
                                                           Project Title: “How the body recognises Mesothelioma
Rima                                                       antigens and how to modify them to produce new
President                                                  therapies”
                                                           Corporate 7s Touch Rugby Tournaments
                                                           Following the success of the 2004 touch football
                                                           competition in Brisbane, the tournament will be re-
                                                           established in New South Wales in 2005. The ALF is
                                                           planning to hold a tournament at St Joseph's College,
                                                           Hunters Hill on 8th July. The Brisbane competition will
            The Australian Lung                            be held at Ballymore on 10th June.

            Foundation Update                              COPD Research Network
                                                           The COPD Special Interest Group met during the
New Staff Appointments                                     TSANZ Annual Scientific Meeting in Perth. The
                                                           meeting was well attended with much discussion in
We are delighted to welcome three new staff members
                                                           relation to the possible options for developing a COPD
to the ALF:
                                                           Research or Trials Network. At the conclusion of the
Glenn Lawless, Executive Director, Community Relations     meeting it was resolved to establish a steering
Juliet Gale, Lungnet Program Administrator                 committee:
Heather Allan, Executive Director, Clinical Relations.
                                                                    Christine McDonald
Donalee O'Brien, Operations Manager for the                         Peter Black
Australasian Lung Trials Group finishes her contract in             Peter Frith
July and we wish her all the very best of fortune with              Norbert Berend
her new career At The Prince Charles Hospital in                    Dick Ruffin
Brisbane.                                                           Richard Wood-Baker
ALF Multi-Centre Trials Network                                     Ian Yang
The Uniting HealthCare Human Research Ethics                        Mike Epton
Committee (UHC HREC) has agreed to take over                        Phil Thompson
responsibility for all trials originally approved by the            Peter Gibson
TSANZ REC. All new trials will also be submitted to        An initial task will be to identify people interested in
UHC HREC for consideration.                                becoming involved with a research network and to
ALF is looking for a suitable person to build the ALF      solicit ideas for studies.
MCT and explore other trial administration                 An inaugural meeting of the above committee will be
opportunities. Please contact William Darbishire at the    funded by the ALF. It is hoped to hold this in Sydney at
ALF if you have any ideas or suggestions.                  the time of the TSANZ Advanced Course at the end of
Awards at the TSANZ Annual Scientific                      June.
Meeting                                                    Lungnet State Coordinators’ Conference
The ALF National Council was pleased to see a 100%         Glenn Lawless and Juliet Gale organised the 2005
increase in the number of awards available through the     Lungnet State Coordinators’ Conference in Brisbane. A
ALF programs this year.                                    very positive meeting was held over a couple of days
This year’s winners included the following;                at the ALF offices in Brisbane. The group resolved to


                                                                      Thoracic Society News Volume 15, No.2
 14
increase the number of Lungnet self help patient            panel of respiratory physicians and GPs, and will be
support groups in Australia and New Zealand to 200. A       presented by GPs.
new coordinator for Western Australia has been
appointed and Graham Shaw is the new coordinator            The ALF will also be presenting a new COPD vs
for New Zealand.                                            Asthma diagnostic algorithm for GPs at its display
                                                            stand at the conference.
COPD Industry Panel Strengthened
The ALF COPD National Programme Executive met               Spirometer Users’ And Buyers’ Guide
with Industry Panel members in February and agreed          Published Online
project funding for 2005. The new initiatives include the   The National Asthma Council, with funding from the
COPD versus Asthma diagnostic algorithm developed           Australian Government Department of Health and
by the ALF in association with the University of            Ageing, has published a guide to spirometry use and
Adelaide and development of an Alpha 1 antitrypsin          purchase on its website. The authors are Australian
deficiency project. Plans are also in hand for a greater    and New Zealand Society of Respiratory Scientists
involvement of the Lungnet groups around Australia to       (ANZSRS) members Dr Debbie Burton, Assoc. Prof.
raise awareness on World COPD Day on 16th                   David P. Johns and Ms Maureen Swanney. It aims to
November.                                                   give GPs and others performing lung function testing
                                                            all the essentials on fundamental aspects of lung
                                                            function testing: what a spirometer does, why lung
                                                            function should be measured, how to perform, assess
                                                            and interpret spirometry, and how to fit this into a
                                                            standard consultation.
                                                            Infection control, quality assurance and criteria for
                                                            spirometer performance are also covered. The second
National Asthma Council Update                              half of the guide covers the selection of a spirometer:
                                                            All those in the list of currently available spirometers
Vaccination For People With A Chronic                       meet the ANZSRS and American Thoracic Society
Disease                                                     criteria.
The National Asthma Council has published an
evidence-based information paper on the roles of
influenza and pneumococcal vaccinations in
                                                            2005   Deadline   for                 Respiratory
subgroups with asthma, COPD, diabetes or heart              Function   and  Sleep                  Laboratory
disease. The paper, aimed mainly at GPs, was
produced and developed in conjunction with Diabetes         Accreditation
Australia, the National Heart Foundation and the            Members are reminded that Respiratory Function and
Australian Lung Foundation. Vaccination of people at        Sleep Laboratories will need to have applied for
risk of developing complications from influenza and         TSANZ accreditation by 31 December 2005 if they are
pneumococcal disease is a key public health strategy        part of a Training Site for Advanced Training in
for preventing associated morbidity and mortality. The      Respiratory and/or Sleep Medicine. The recently
paper stresses that those most at risk include people       approved “Accreditation of Training Sites in
aged 65 and over, and those with medical conditions         Respiratory Medicine” document has been approved
that increase the likelihood of complications from          and its sister “Sleep” document is soon to be finally
infections: chronic respiratory diseases, diabetes, and     approved. Both specify that laboratories need to meet
cardiovascular disease.                                     the TSANZ accreditation specifications to satisfy the
                                                            RACP requirements as a training site.
The information paper and the accompanying
consumer brochure will be distributed to respiratory        There will be considerable pressure on the resources
physicians, GPs and other health professionals and          of the Professional Standards Subcommittee to
will also be published on the NAC website:                  complete the processes for each laboratory in this time
www.nationalasthma.org.au                                   frame and directors are encouraged to make
                                                            applications as soon as possible. It is anticipated that
                                                            provisional accreditation will be granted to each
COPD and Asthma: GP Workshops With                          application made before 31 December 2005, pending
The Australian Lung Foundation                              completion of the procedure for each laboratory.
The National Asthma Council and the Australian Lung         Details of the process can be obtained from the
Foundation (ALF) are collaborating on a series of           Guidelines      on      the      TSANZ        Website
practical update workshops for GPs at the annual            (www.thoracic.org.au) or by contacting the TSANZ
General Practitioners’ Conference and Exhibition in
Sydney in May. The workshops, entitled ‘COPD and
Asthma - the Chronic Respiratory Crossover’, focus on
the differential diagnosis of asthma and COPD, and
management of COPD based on the COPD-X
guidelines. The content was developed by an expert
                                                            Printing of this issue of the Thoracic Society News has
                                                            been kindly sponsored by Boehringer Ingelheim

                                                                       Thoracic Society News Volume 15, No.2
 15
                                                                                  Medical Research
              Sleep disorders                                                          Funding The
In 2002, a child was killed by a car that left the
roadway. The driver of the car was being investigated                                    Challenge
for sleep apnoea at the time of the accident. A              We need your help during 2005, to ensure that
Coroner’s inquiry found it probable that the driver had      medical research in our country remains
fallen asleep at the wheel of his car prior to the           competitive and translates to better health
accident. The subsequent report makes three                  outcomes for all Australians.
recommendations of particular importance for doctors.
These are listed below together with information to          The much welcomed doubling of the NHMRC budget
assist doctors:                                              ($613.7 million over five years) instigated by the
                                                             Howard Government in response to the 1999 Health
1.     Doctors should consider adopting a more               and Medical Strategic (Wills) Review, is now complete.
       structured approach when treating a patient who       The Investment (Grant) Review of Health and Medical
       is being investigated for sleep apnoea, and           Research released in December of last year is the first
       highlight the grave danger of driving in such a       report card on performance flowing from this
       condition.                                            investment and has been extremely positive. The
                                                             Government’s decision to invest in this sector has
The Australasian Sleep Association has developed a           been validated by both health and economic returns to
patient information sheet on Sleep Apnoea, Sleep             the Australian community and they should be
Disorders and Driving to assist patients with sleep          congratulated.
disorder understand the potential risks associated with
driving. This sheet is available from the National           The Investment Review recommended a number of
Transport        Commission           website       at:      reforms to the medical research sector and further
http://www.ntc.gov.au/ViewPage.aspx?page=A024113             strategic investment to develop better health
02500100020                                                  outcomes. Currently neither the Government nor the
                                                             opposition have committed support for these
2.     That where more than one doctor is involved in        recommendations. It is now the responsibility of the
       the care of a patient, procedures for sharing         Australian community to present a coherent case to
                                                             both Government and the private sector (industry and
       important information pertaining to that patient      philanthropic), pin-pointing the precise details of how
       should be considered.                                 further medical research investment will make a
While confidentiality is of primary importance, sharing      difference.
of patient information is permissible under a range of       While Australia performs highly in medical research,
circumstances, including:                                    there is insufficient funding to translate very many
                                                             exciting discoveries into health practice or products
-     without specific patient consent if it is in           which could deliver both health and economic gains to
      connection with further treatment (for clinicians      Australia. Further investment would allow:
      working in public, private or denominational                   Translation of discoveries into health policy
      hospitals, day procedure centres or community                  and practice
      health centres) – Health Services Act, section 141
      (3)(e)(i)                                                      Targeting of important health issues including.
                                                                     Development of our scientific workforce to
-     with specific patient consent for clinicians working           cover ALL areas of health and ensure that we
      in private practice, or without consent where the
      doctor believes disclosure is necessary to lessen              retain our medical researchers in Australia
      or prevent a serious threat to public health safety    This investment is crucial to ensure that Australians
      or welfare [Health Records Act, Health Privacy         continue to reap the benefits of medical research.
      Principle 2.2(h)]                                      It is up to all of us to impress the critical importance of
                                                             this issue on our politicians. The medical research
3.     To remind doctors of the importance of the            community and patient groups are collectively involved
       Guidelines for Assessing Fitness to Drive             in a campaign to influence the federal 2006 budget
       produced by the Austroads Council when                process. The agenda for the budget is set in October
       consulting a patient who is being investigated for    2005. We have until then to make our case. I strongly
       sleep apnoea                                          urge you all to discuss these issues in relation to your
                                                             own research area with your local member through
The      2003      Guidelines     are    available    at     both face-to-face meetings and through letters. In
http://www.austroads.com.au/aftd/index.html, or the          addition you need to write to the Health Minister (Tony
section relating specifically to sleep disorders can be      Abbott), the Treasurer (Peter Costello) and the Prime
                                                             Minister regarding these issues. All the facts, sample
downloaded       from      the    ASA      website   at      letters and relevant contact details are available at:
http://www.sleepaus.on.net/documents.html                    http://www.asmr.org.au/Campaign/campaign.html
It is hoped that attention to these recommendations will     You must ACT NOW! The future of health and
improve outcomes for patients with sleep disorders,          medical research in Australia is at stake!
and reduce the likelihood of such tragic occurrences
happening again.                                             A/Prof Bronwyn Kingwell
Source: Medical Practitioners Board of Victoria Bulletin     President, The Australian Society for Medical
                                                             Research

                                                                         Thoracic Society News Volume 15, No.2
 16
“On Our Selection”, A Tale From The Darling Downs
By Dr Peter Nolan, Former Convenor, Rural & Regional SIG
Nestled on the edge of the eastern highlands at 850m above sea level is the temperate town of Toowoomba
renowned for its spring garden festivals and beautiful parks. Not far from Toowoomba on the southern escarpment,
one can still view the original homestead of Arthur Hoey Davis, author and son of Dad of “Dad and Dave” notoriety. It
would seem that the struggles of this pioneering family continue to be reflected in the health care institution of the
Darling Downs where a small band of physicians continue to strive to provide quality care to a town that seems
somewhat forgotten by the administrators of our State. Like Dad and Dave, our days are full of interesting escapades
with a reasonable degree of joyful camaraderie. Mostly our exposure is one of a constant stream of general medical
patients referred from surrounding districts with a skeleton staff of largely overseas trained medical registrars and
recent graduates of the post-graduate medical course. Unlike Dad, we don’t aspire to a bumper crop or a future career
in Parliament and constantly find ourselves at the call of the “bank manager” to show cause for our inordinate overtime
or burgeoning budget blow-out in chemotherapy or high cost drugs.
The Department of Internal Medicine of the Toowoomba General Hospital services 7,000 outpatients, 1800 occasions
of day chemotherapy and 4,500 inpatients per year. The Department is staffed by four full-time physicians, one .4
Visiting Oncologist and one .3 VMO. Our usual compliment of seven medical registrars and five junior house officers
or interns barely meets our needs for equitable rosters and a reasonable after-hours duty list. In August 2004, we
encountered an unexpected crisis with a sudden fall in our registrar numbers from 7 to 3. This resulted from the
sudden resignation of one mature-aged overseas graduate, the lack of arrival of a seconded registrar from a tertiary
centre, the inability to recruit/replace one registrar moving interstate and the resignation within five days of an
overseas trained registrar who decided that his overseas holiday in Australia was under threat because of the intense
workload with which he was presented. Overnight a number of strategies were required in order to salvage the
Department from apoplexy. Of course, our initial call was to our tertiary support centres to determine that there was no
possibility of short-term relief from their registrar pools.
Not surprisingly, all of our good intent to organize some regular phone links with Rural & Remote Thoracic Physicians
was dropped in the process of salvaging our day to day work issues.
The effective strategies that allowed the Department to continue included:
1. Cancellation of non-urgent public medical outpatients (all Category 2 and 3 patients).
2. Prioritization of outpatient care to high risk patients including unstable diabetics, all oncology and renal patients, all
unstable cardiac patients and all urgent general practitioner referrals.
3. The development of a Consultant supervised discharge clinic. Rather than deploying patients post-discharge to
follow-up clinics run by the various services to Consultant run discharge clinics were initiated each week. The goal of
these clinics was to complete the evaluation and management of the patient’s illness which was recently hospitalised
and to discharge them in toto back to their general practitioner. Contrary to the usual 35% retention rate for revisits in
our general medical clinics in the six months prior to this event, the subsequent retention rate from our Discharge clinic
was less then 5%.
4. Support of the residual registrars. Consultants, who were not further burdened with outpatient care, took up
registrar roles with day-time admission rosters and day-time ward rounds with residents.
5. Careful assessment of all phone referrals requiring aerial retrieval or prolonged travel to ensure that travel to our
centre was necessary.
6. Consultation with the community general practitioners, explaining why Category 2 and 3 patients were not going to
be serviced and soliciting their support in using the telephone to refer urgent cases that would be seen in a timely
fashion.
7. Weekly interdisciplinary meetings with nursing staff, allied health staff, junior staff and consultants detailing the
weekly roster changes, the weekly admission process and the weekly distribution of workload followed by morning
coffee and patisseries. (These meetings seemed reminiscent of Winston Churchill’s war office and his regular
meetings with his military advisors.)

We have moved through this “famine” but have grown in respect for our junior staff and the phenomenal amount of
hard work that they undertake in their daily duties, and our expectations on ward rounds have been significantly
modified by our own personal experiences when trying to scratch together an effective patient summary and written
record at 2.00 o’clock in the morning after many hours of sleep deprivation. Having worked in this same institution as
an intern, resident medical officer, senior medical registrar and now staff consultant, I have certainly witnessed a lot of
the transitions in the hospital structure, the Health District structure and the staff morale. The incredible
transformations that have occurred in medicine over the last 22 years with increasing public accountability, the
increasing actuality of legal retribution and the increasing complexity of diagnostic and management algorithms, we
need to become more tolerant of the difficulty that our junior staff experience as they come to grips with day to day
patient management while trying to deal with their own emotional and life issues.

                                                                              Thoracic Society News Volume 15, No.2
 17
Having attended the recent TSANZ and witnessed the ongoing interest by the Society to practically support patient
care, I am firmly of the belief that a mandatory period of six (6) months rural placement would be a welcome addition
to the advance training program.
In addition, a half day seminar-type session in the annual meeting entitled “How I do…” would allow some highly
skilled colleagues to present practical solutions to resource limited services, eg, Thoracoscopy in non-surgical units.
In standing down from this Interest Group, I thank the Society for its keenness to look internally at how it can be an
increasingly practical facilitator of change in the delivery of Thoracic Care in Australia.




                                           TSANZ Advanced Course 2005
                          The Pre-Reading Material for this course is now available to
                          all TSANZ Members on the Members Only page of our Web
                          Site:

                                    www.thoracic.org.au/advancedcourse2005.html




              Japanese Respiratory Society’s Meeting 2005
                   Report from Dr Kristina Kairaitis,
                      TSANZ Young Investigator
I was recently fortunate to be invited to attend the 45th annual Scientific meeting of the Japanese Respiratory Society
Meeting in Chiba, Japan as a Young Investigator from the TSANZ. I am very grateful to Professor Fukuchi, the
President of the Asia Pacific Society of Respirology for the invitation to attend the meeting, and also to both the APSR
and TSANZ for providing financial assistance. During my time at the meeting, I presented some of my work on the
effect of mandibular advancement on the pressures in the tissues around the upper airway in rabbits. I also had the
opportunity to talk personally with Associate Professor Shiroh Isono, of Chiba University, whose research interests are
closely related to the measurements we have been making in rabbits. The scientific content of the meeting was
exciting and informative, as many sessions were in English, and a number of international leaders were presenting.
Chiba itself is a short train ride from Tokyo, a fascinating and busy place, which I greatly enjoyed exploring. In the
future, attendance at this meeting should provide a fabulous opportunity for an early postdoctoral student to present
their work.



ATSE Clunies Ross Award 2006
Nominations are now invited for the ATSE Clunies Ross Award for 2006, providing an
opportunity to celebrate Australia's outstanding scientific achievers and ensure the
continued vitality of the prestigious Award.
Since 1991 this Award has now recognised and honoured 87 people for their
successful application of science and technology for the economic, social or
environmental benefit of Australia.
The winners will be announced at the Award Ceremony Dinner held in Melboune on
Wednesday, 26th April, 2006.
A nomination form and criteria is available for downloading on the Clunies Ross
website at www.cluniesross.org.au or by contacting the Award Secretary on
(03) 9347 0622. Please note that nominations close on Friday 29th July 2005.



                                                                           Thoracic Society News Volume 15, No.2
 18
                     2004 President’s Report
        tabled at Annual General Meeting, 22nd March 2005
                              2004 – 2005 has been a year in which we have made advances with relationships
                              within Australia and internationally. The amount of work done by many people on
                              behalf of the Society must be acknowledged. The dedication of Beatie Pearlman, Liz
                              Paul and Dayna McGeeney has been outstanding. They have taken on a lot of work for
                              the Committees and provide a rapid service with improved promptness,
                              appropriateness and level of communication. They are the driving force in producing
                              the Newsletter as well as the email communication providing information. The impact of
                              the work ethic and innovation provided by this group has been substantial for the
                              TSANZ, and I am personally grateful to them for their efforts and support over the past
                              two years.
                              I also particularly want to mention the work done by the chairs of the subcommittees.
                              Last March the chairmanship of the Professional Standards, Clinical Care &
                              Resources, Education & Research and Central Program subcommittees changed.
                              These roles have been respectively taken by David Barnes, Belinda Miller, Peter
                              Eastwood and Paul Reynolds. Each has provided leadership and been innovative
                              within their subcommittee and has put in a tremendous amount of work to the benefit of
                              the Society, as well as each being a very effective member of the Executive via prompt
                              input and advice to the Executive.
Peter Bremner has been highly productive in his role as Secretary and brings a broad perspective to the Executive.
Richard Wood-Baker has continued his track record of an outstanding steward for the Society in his role as Treasurer.
The membership needs to be aware of a new era in relationships between the TSANZ and the RACP. The newsletters
have informed you that we are involved in a pilot project to develop a new operational relationship with the RACP. The
College has selected the Cardiologists, Neurologists, Geriatricians and TSANZ/ASA as the groups to be involved in
looking at a new way of doing business. The document of “A Blueprint for Change“ is available from the TSANZ office
for your information. It provides an outline of some of the anticipated changes.
 A key issue for us is that the SAC committee has been seen as an RACP committee. We have it firmly on our agenda
that it should become a conjoint committee, with dual reporting to the RACP and TSANZ, together with a shared
governance arrangement. Most members of the SAC are members of the TSANZ /ASA and I wish to acknowledge
here the outstanding service they have provided for us.
We are contributing to the RACP basic training programme where I freely admit that I have a bias in trying to ensure
that we have a consistent approach to teaching the examination of the respiratory system with an evidence based
common sense approach rather than a historical approach. Other potential areas that are to be examined include:
accreditation of training sites with the TSANZ collaborating with the College; examining Continuing Professional
Development by making use of some of the expertise of our members. The curriculum development for advanced
training is being led by Martin Phillips and will be a focus of discussion at 2005 ASM; we need to consider how we
advance competency assessment.
There are some unsung heroes in the TSANZ. These are the people who have taken on the accreditation role for the
laboratories. We as a Society need to acknowledge the generosity of time and expertise they have given to the task.
All who have featured on accreditation panels are listed in Appendix 1 and I thank them for their endeavours in this
accreditation role. I would also acknowledge the leadership of Michael Pain in the accreditation process. Discussion
points for the Society are how we sustain this process, and to ask is there a different way of managing accreditation?
As members will be aware we have been working towards membership of the APSR as a National Society. The end
result is the MOU which has been circulated and will be presented at the AGM. The Executive believes we have a win-
win situation with TSANZ representation, opportunities in education training and research for individuals and National
Societies, sharing of programs, and being involved via regional representation in the world of Thoracic or Respiratory
Medicine. Our intent is to provide the funding for National Society membership via advertising within an ANZ
production of Respirology. I sincerely hope we will have the support of the membership to go forward.
The Executive also believes in global guideline developments to maximise our effectiveness as individuals and as a
Society. We are engaging in the BTS/SIGN asthma guideline development process from 2005. Interested members
should self nominate to the Asthma and Allergy SIG.
The ethical aspects of the ALF multi centre clinical trials operation has been transferred to a Queensland ethics
committee after consultation. The discontinuation of the TSANZ Research Ethics Committee does not mean a loss of
expertise since many of the members have expressed eagerness to continue an association with the TSANZ. This
may be via discussion of professional or clinical care ethical issues. On behalf of the TSANZ I wish to thank

                                                                          Thoracic Society News Volume 15, No.2
 19
Christopher Clarke for his vision in setting up the committee and succeeding in: providing TSANZ members (without
major hospital affiliation) an access for research approvals; support of the ALF; and facilitating engagement of the
TSANZ with an eminent range of community members and ethicists. The TSANZ acknowledges the major contribution
of David Hart, Paul Seale, Paul Thomas, Alan James, Abe Rubinfeld, , Carolyn Sappideen, Sylvia Kydziak, Russell
Paine and Bill Uren to the Research Ethics Committee.
Respirology, our preferred journal, has grown in standard and reputation under the editorship of Phil Thompson –
congratulations and a job well done. At the end of the term I look at the original business plan and see some gains
with much to still accomplish for our membership. The team of Rima Staugas and the subcommittees will be a great
success and provide strong leadership for the TSANZ into the future. I wish them well, and thank the TSANZ
membership for the opportunity, experience, and satisfaction of serving the Society. Also, I wish to acknowledge the
many hours my co-worker Ermioni has provided to the Thoracic Society of ANZ gratis. I understand this is not unique
for the staff of the membership but it is a commitment and contribution to acknowledge - and say thank you. There will
be activities and contributions I have failed to mention – thank you to all those who make the TSANZ vibrant.

Dick Ruffin
President
February 2005




                 2004 Honorary Secretary’s Report
         tabled at Annual General Meeting, 22nd March 2005
Proposed Operational Procedure for Branch Election
In an attempt to have consistency and transparency at Branch level, some changes to the election process for State
branches have been proposed. These are an attempt to reflect, as closely as possible where relevant, the procedures
followed for Federal Society elections.
A State Branch Executive should comprise a president, secretary/treasurer and up to four committee members. Where
possible, the executive should be broadly representative of the State membership (e.g. paediatric/adult physicians,
teaching/non-teaching hospital representatives, medical versus scientific members etc).
Members shall be nominated and seconded by existing members (Ordinary or Associate) of the State Society. Call for
nominations should be made one month prior to the Branch AGM. Election should occur by ballot. The ballot should
take place during the AGM. Proxy votes should be accepted for members unable to attend.
The Executive of each State Branch shall be elected by members at alternate AGMs and shall take office from the
time of their election for a period of no less than two years. Committee members (including the president) shall be
eligible for re-election. The president should not hold office for more than four consecutive years.
In an attempt to broaden representation it is proposed that Associate Members have voting rights and be eligible for
election to office. One position should be reserved on State executives for Associate Members.

Membership categories
Ordinary Membership: It is proposed that members with a post-graduate degree who are Level B and above should be
considered for full membership.

Objects of the Society
It is proposed to amend the objects of the Society to allow the Society to enter into relationships with other bodies both
at home and abroad. The following statement should be added to the existing statements, which pursue the objects of
the Society and it will become 2(o). The TSANZ should seek to establish links and enter into relationships with
national and international professional societies having similar objects.

Other
The Population Health SIG has been dissolved.
I would like to thank Beatie Pearlman, Dayna McGeeney and Liz Paul in the TSANZ office for their invaluable support
over the year.

Peter Bremner
Honorary Secretary



                                                                            Thoracic Society News Volume 15, No.2
 20
Honorary Treasurer's Financial Report for 2004
tabled at Annual General Meeting, 22nd March 2005
The audited accounts for the financial year 1st January - 31st December 2004 are available to members of the Society
on request from the Treasurer or Executive Officer. Details of the financial activities of the Society over recent years,
together with the 2005 budget, are shown below. The years are not completely comparable as a result of changes to
our accounting practices over time.
Profit & Loss Statement
                                                                   2004     2005 Budget                2003        2002
INCOME
Member subscriptions                                            212,762           200,000               190,619      157,900
Investment Income                                                 6,228
Unrealised Movement in Investments                               16,557                                                  28,700
Interest received                                                40,885                30,000            16,583          48,316
Newsletters                                                      25,140                24,000            24,590          12,840
Funds from branches                                              42,412                91,000            53,214          15,183
Other                                                             2,182
Advanced courses1                                                16,951                75,000
Mail out and email                                               10,722
Special purpose funding2                                         52,450
Sundry Sponsorship                                               43,293                20,000            88,969          18,971
Surplus on Allen and Hanbury Fellowship                         157,602
Surplus on annual scientific meeting3                           294,858           100,000               371,991      205,962

Total Income                                                    922,042           540,000               745,966      487,872

EXPENDITURE
Audit and bookkeeping fees                                        9,348            11,000                16,667           2,422
Advanced courses1                                                   234            90,000                16,383          25,819
State branches                                                   65,807           119,048                71,400          35,223
Bank charges                                                      1,202             5,000                68,556           3,892
Depreciation                                                      3,652             4,000
General expenses                                                 34,806            35,000                 6,582           1,951
Insurance                                                        10,995            11,000                17,150           1,459
Investment Expenses                                              10,744             5,000
Laboratory accreditation                                          4,442            12,000                 3,119           1,446
Newsletter expenses                                              26,918            27,000                13,801          25,461
Office expenses                                                  19,671            25,000                26,243          28,367
Project Sponsorship2                                             47,113
Management fees for staffing costs                              162,643           170,000               150,059      154,374
Subscriptions                                                     3,055
Telephone                                                         2,589                 3,000
Council and executive expenses                                   13,524                20,000            15,857          35,548
Website maintenance4                                              3,514                 5,000            10,516           6,395

Total Expenses                                                  420,257           542,048               416,333      322,357

Notes: All figures are in AUD.
1. In 2004 the costs of the Advanced Trainees & Respiratory Research short courses are included in ASM accounts.
2. In 2004 this includes funding for the ICC Website setup and the Spirometer Buyers Guide.
3. In 2004 this represents the balance of income over expenditure for ASM activities, not profit on the year’s ASM as in previous years.
4. Includes all IT expenditure.

Assets
                                                2004                 2003                       2002              2001
Skills Enhancement1                                    56,350               56,350                     56,350            57,881

Ann Woolcock Fund   2                                                       12,507                     12,507
                                                      13,639
Total Cash                                           582,598              1,469,840               1,084,555          792,412
Investment Portfolio (Market value)                1,212,041
Receivables                                          262,209                  6,707
Property & Equipment                                   8,236                  8,920                    15,813            42,128
Creditors                                            (71,150)               (10,640)
GST Outstanding                                      (15,342)                (8,613)
Current funds                                      1,978,592              1,466,214               1,100,368          834,540

Notes:
1. Represents 2001 APSR profit, held by the Society for further Skills Enhancement Programmes. This capital is included in total cash, with the
    amount representing funds remaining for expenditure on the programme.
2. Currently held by the Australian Lung Foundation, so not included in current assets.


                                                                                                   Thoracic Society News Volume 15, No.2
 21
Branch Finances1
                 Branch                    2005 Projected        2005 Projected           2004 Balance          2003 Balance
                                              Income              Expenditure

  New South Wales                          $       16,000.00     $      15,100.00     $        4,453.71     $        (3,035.25)
  New Zealand 2                            $       40,000.00     $      55,647.50                           $         8,330.23
  Queensland                               $       16,000.00     $      17,000.00     $           275.39    $         5,031.07
  South Australia                          $        2,500.00     $       7,400.00     $        (1,852.92)   $         2,857.71
  Tasmania                                 $        1,000.00     $       2,000.00     $        (2,627.02)   $        (1,800.00)
  Victoria                                 $       13,000.00     $      12,900.00     $         4,040.18    $         7,461.82
  Western Australia                        $        2,500.00     $       9,000.00     $        (2,380.46)   $        (5,313.38)

Notes:
1. Deficits in brackets.
2. Totals in New Zealand dollars. 2003 balance represents 18 months of financial transactions to bring the branch into line with the Society’s
    accounting practices. 2004 accounts are not available at the time of reporting.

The finances of the Society remained healthy during 2004. Income, allowing for variations in accounting procedures,
has been maintained at a similar level in recent years, mainly through subscriptions and profit from the ASM (the 2003
ASM profit is high as a result of transfer of funds from 2002 & 2003 meetings having occurred in the 2003 financial
year). I am grateful for the continued prompt payment of subscriptions by members of the Society. Expenditure has
decreased slightly, mainly as a result of reduced office and executive costs. I am grateful to the branch treasurers for
their efforts in generating sponsorship (and limiting expenditure), resulting in a small net profit on branch activities
overall! The efforts of the office staff and unpaid work by Society members in limiting expenditure are very much
appreciated and contribute substantially to the continued healthy financial state of the Society. At this time, the Society
has approximately three years estimated running costs in reserve, a financially prudent situation. As a balanced
budget is anticipated I do not recommend any change to the membership fees for 2006.
Special Payments
The executive authorised special payments during 2004. The first was $15,000.00 towards production of a website on
intercostal catheter management. The second related to the management of the Spirometer Buyers Guide, the
executive having agreed to the Society acting as the conduit for the funding of work being performed at Charles Sturt
University and the University of Tasmania for production of the guide
Investment Strategy
During the 2004 financial year an investment strategy was implemented, in an attempt to provide long-term growth for
the Society’s assets. The investment at 31/12/04 is approximately $1,200,000. Full details of the investment strategy,
devised by Cornerstone Wealth Advisors, are available from the Treasurer on request.

I would like to conclude by acknowledging the work of Beatie Pearlman and the other office staff in managing the
financial activities of the Society, together with the long suffering indulgence of my fellow members of the Executive.
Richard Wood-Baker
Honorary Treasurer



Please note that the 2004 Annual Report is available on the
Mem     s
Members Only page of the TSANZ website..




                           TSANZ Tie Sale - Only 20 left!
                           $14 each (inc GST and P&P). Contact the TSANZ Office via admin@thoracic.org.au




                                                                                             Thoracic Society News Volume 15, No.2
 22
                          2005 Perth Annual Scientific Meeting

      2005 TSANZ President’s Award winner, Brian McBride
                     Introduction to Mr Brian McBride by Dr William Musk,
                         Chair Tobacco Control Special Interest Group.

                                                               “Mr Chairman, Ladies and Gentlemen, It is my
                                                               understanding that awards such as the President’s Award
                                                               should be for people who have provided outstanding
                                                               service in the chosen area of the award.
                                                                This year’s recipient has done just that and the award is for
                                                                contributions to smoking control. I believe that, no matter
                                                                the size of the contribution, the spirit of this award is not for
                                                                someone whose job it is to work in smoking control, a job
                                                                for which he or she is paid, but for someone who has been
                                                                prepared to go the extra distance beyond his or her duty, to
                                                                further the aim of reducing smoking in the community and
                                                                thereby improving health in the community. It is for
                                                                someone who is prepared to put in extra effort and run the
                                                                risk of unpopularity or worse in the interests and welfare of
                                                               others.
Prof Dick Ruffin (Left) presenting Mr Brian McBride with the
President’s Award plaque.

I don’t think that the award should be for politicians who just pass legislation as a response to public demand but who
have no a real commitment to the health of the public rather a desire to stay in office. I believe that our society should
acknowledge and encourage people like Brian because it is through them that change can be made to happen. I have
personally witnessed how effective voluntary community activism or service can be in achieving change in the areas of
smoking control as well as asbestos regulation. I know from my own experience how difficult it is to achieve change
from within the health system (however much one believes in the system) because of the inertia of the bureaucracy
and the nature of our wonderful democracy.
Western Australia was the first state in the English-speaking world to introduce legislation for tobacco control into
parliament but not the first to pass it. It happened because a group of like-minded people got together, initially in a
somewhat clandestine way, prepared a parliamentary bill and then found an independently-thinking committed
parliamentary backbencher to introduce it into our state parliament (just up the hill from here). Of course it failed but it
excited community debate about smoking like nothing had before and ultimately the government of the day decided
that the community was ready for change if not demanding it. And so it obliged with a bill to reduce tobacco
advertising in the state. But only to the extent that the majority could cope with it.
The same has occurred throughout Australia, bit by bit, state by state. As it has done in the rest of the western world,
incrementally and depending on how much it is possible to contain the influence of the tobacco and entertainment
industries, who are committed to holding it back. In other places like California, progress has been faster than in
Australia. But smoking prevalence rates have fallen, albeit currently stalled, and smoking-related disease rates have
also fallen in Australia. So the effort has been rewarded.
Brian McBride was one of the Australians who determined that he needed to put in the extra effort over 30 years ago.
He never earned a living from the anti-tobacco business which did not really exist at the time. He was an electrical
engineer who graduated from UNSW in 1964 having gained a diploma in electrical engineering from Sydney Technical
College in 1959, retiring from deputy directorship of the Sydney office of the Commonwealth Dept of Industry, Science
and Technology in 1996. He hated being subjected to the passive smoke generated by his 4 brothers and 2 sisters
and started a 1-man campaign to get smoking banned on his local bus service in 1976. The unreasonable objections
and personal attacks on him by smoking bus drivers escalated to the point that he sued one driver for assaulting him
with cigarette smoke and won the case. It made front page news in the Sydney Morning Telegraph and eventually
National TV! As a result of the publicity he was approached by a number of people to keep the fight for non-smokers
rights going in other areas like restaurants. He then organized a public meeting in Parramatta in October 1977 where
the Non-Smokers Movement of Australia was formed. Brian became Hon Pres for the first 10 years. He then stepped
down to become vice-president and was replaced by Dr Arthur Chesterfield-Evans after Arthur entered the NSW
Parliament in 1997 Brian resumed the role of president until 2003 when he retired.


                                                                                 Thoracic Society News Volume 15, No.2
 23
Campaigns were conducted by encouraging workers to rebel against past acceptance of smoking as a “workers’ right.
These workers were then supported by other members of NSMA who conducted street protests, blockaded ministers
offices, collected petitions and marched in front of NSW Parliament House etc. Talk-back radio was used and press
releases were issued to gain media coverage. Next came the fostering of legal cases designed to underpin the
proposition that non-smokers did have enforceable rights. These cases demanded changes to the law to establish and
uphold these rights. NSM supported Ken Bishop and Roy Bishop, two unrelated Canberra public servants in their
claims for a smoke-free workplace in around 1982-5. These were the cases that made the Australian Public Service
(under Peter Wilenski) and the Australian Public Service Union take smoking at work seriously which led to the ban in
1986. NSM took Channel 10 to court for breaching the Broadcasting and Television Act over Winfield Rugby League
Advertising in 1984 and won.
After several years of attempting to get other agencies to join forces in support of this action Brian finally went it alone
by personally signing the summons and bringing the matter to court. He had to present the videotapes of the
broadcasts and give first person evidence of having seen the broadcast as well as having to prove the authenticity of
the tapes by being sworn in as an expert. He did this by utilizing his credentials as an electrical engineer with an
honours degree. The case survived appeals to the High Court and made a huge contribution to the eventual demise of
tobacco sponsorship of sport in Australia.
NSM went where others feared to tread. It supported Liesel Scholem in her passive-smoking case against the NSW
Health Department in 1989-92. These landmark cases forced the introduction of smoke-free workplaces throughout
both state and federal jurisdictions. Brian personally campaigned for smoking bans courtside at his tennis club
(Parramatta) and was publicly criticized by people who should have been supportive. He and others at NSM met the
costs of their efforts personally. Word has it that he may have even been a BUGAUP man but that secretive
organization never disclosed its members.
I have not personally met him before today but he was described to me as a retired engineer who looks like he goes to
church on Sundays! Not image of the radical activist! Today can make your own judgment on that. Brian and NSM are
testament to the power that voluntary organizations can wield and he must be recognized for the impact of his efforts
on smoking control in this country. It is appropriate that our Society recognize him.”


                               President’s Award Acceptance Speech
                                            Mr Brian McBride, NSW
“Thank you Dr Bill Musk. Ladies and Gentlemen, I am indeed honoured to receive this Award because it puts me in
such distinguished company as the earlier recipients, starting with the Prime Minister of New Zealand, who received it
back in 2000, I believe. However, I am particularly pleased to receive it because it recognises the important role of so
many non-smokers rights activists in fighting the tobacco menace in this country.
We were people who never believed it was the sole responsibility of governments and health professionals to solve
the problem of tobacco pollution of public areas like trains, buses taxis & restaurants. Every citizen had a right and a
duty to do something about it. I even feel guilty when I look back and see that I was well into my forties before I made
a stand on the issue.
But when I did it was no easy road. For some strange reason it was considered bad manners to object to other people
smoking. Authorities always viewed you as a troublemaker – you were always the problem never the smokers.
I will give you one classic example of that strange logic. After months of frustration trying to enforce the no smoking
laws in railway waiting rooms I announced to the smoking stationmaster that I would put up my own signs. I gave
plenty of notice and invited the media along to watch me put up those standard Cancer Council signs on the waiting
room walls. As soon as I did about six railway police swooped on me. They arrested me for defacing railway property,
dragged me on to a train and hauled me off to an interview room in the city. There I was interviewed by a senior police
inspector who insisted on his right to smoke while he interrogated me about my right to protest about smoke pollution
in railway waiting rooms. They were interesting days and thank goodness they are behind us now.
We realised that we had to pursue legal actions to get results that would get the politicians off the fence and make
them act on new laws. We provided both moral and financial support to landmark legal cases like Roy Bishop Vs
Commonwealth Govt. and Liesel Scholem Vs NSW State Govt. These victories paved the way for smoke free
workplaces in the public services and it then flowed on to the private sector.
We also did our bit against tobacco advertising and are proud to be the people who got Winfield Rugby League
telecasts off the air due to our successful prosecution of Channel Ten in 1984. It took until 1990 to prove that it was
tobacco advertising but it finally made a big contribution to the legislative bans on tobacco sponsorship of sport in
1993.
Anyway - it is very satisfying to see the progress that has been made from the combined efforts of a great Australian
network of Government and non-government campaigners including the Thoracic Society. It is pleasing to see that
most States have set dates for the bans in that last bastion of smokers, namely Pubs & Clubs. The bans will start with
Tasmania in January 2006 and move through to NSW & Victoria in July 2007.
                                                                              Thoracic Society News Volume 15, No.2
 24
   So I accept this award on behalf of all members of the Non Smokers Movement, past and present. There are many
   unsung heroes out there, too many to name, but there are two names which I must mention. Firstly, Dr Arthur
   Chesterfield-Evans, who took over as President after the first ten years. His new energy and leadership carried the
   momentum forward to bigger and better things. Secondly, the current President, Mrs Margaret Hogge is full of energy
   and dedication to drive smokers into their proper places, which are dedicated outdoor areas only. I hope the Society
   and other organisations will cooperate and support Margaret in every possible way.
   I would like to thank all the various agencies ACOSH, ASH, QUIT VIC, Cancer Councils and Heart Foundations who
   have helped the Non Smokers’ Movement in any small way over the years. I say a special thank you to my family, to
   my wife Angela and our four children. I am pleased that son Greg and his wife Paula are with us today because they
   live here in Perth. As you might imagine my campaigns caused considerable stress to a growing teenage family
   through their school years. Finally, thanks to the Thoracic Society for having the vision to create this Award and the
   courage to award it to people outside the conventional fields of government, science and academia. I assure you that
   it is deeply appreciated. Thank you.”


   Wunderly Oration 2005 – Professor Philip J Thompson, WA
                                                                 “When I was asked to deliver the Wunderly Oration I felt a mixture of
                                                                 delight, and then some anxiety, but most of all I felt humbled being
                                                                 associated with the Wunderly Orators who have preceded me. Who
                                                                 can forget the inspiring lecture by Bob Williamson last year on the
                                                                 world of genetics and where it is taking us and the ethical and moral
                                                                 issues involved; or the presentations from the likes of Paul Torzillo on
                                                                 aboriginal health, Prof Ian Webster on those less fortunate than
                                                                 ourselves in our society and Prof John Sutton on lungs at the limits.
                                                                 All of these speakers were trying to take us out of our comfort zone in
                                                                 the nicest possible way and confront us with the world beyond our day
                                                                 to day clinical and research practice. In doing so they were all
                                                                 showing great leadership, and it is on this topic that I would like to
                                                                 address you today. Not because I am expert but simply because in my
Prof Dick Ruffin (left) congratulates Prof. Philip J Thompson.
                                                                 opinion it is so fundamental to your future, my future and to the future
                                                                 of all Australians.
   Before starting my oration I would like to speak briefly of Harry Wunderly. He was born in 1892. Significantly his father
   had died from tuberculosis while Harry too contracted tuberculosis as a medical student. He obtained his MB BS from
   Melbourne University in 1915 and subsequently he practised as a tuberculosis specialist in Adelaide. Over his
   professional life time he was awarded his MD, FRACP, FRCP and FCCP and ultimately he was knighted for his
   contributions to tuberculosis. After many years of lobbying state and federal governments he obtained agreement to
   establish a national tuberculosis eradication programme and was appointed as the first Director of Tuberculosis
   Australia. He was also the first President of the National Association to Prevent Tuberculosis in 1959 and in
   subsequent years he worked with WHO and championed anti TB programmes in many parts of Asia. He is quoted and
   revered in a number of publications from countries such as India and Malaysia. He and his wife donated £18,000, a
   significant sum in those days to the RACP to assist doctors to study or train in tuberculosis. He died in 1971 and in
   1985 the TSANZ was asked to take over the administration of the fund that Harry Wunderly and his wife had
   established. After consultation and debate the TSANZ decided to establish the Wunderly Orations to honour the work
   and life of Harry Wunderly a great leader and champion of Respiratory Medicine. In my oration I would like to speak on
   ‘What is Leadership’, ‘Australian Society Today’, ‘What about Respiratory Medicine’ and in conclusion discuss ‘The
   Challenge for Us All’.

   What Is Leadership?
   Concepts of leadership
   Leadership is a complex process by which an individual influences others to achieve a goal or a purpose to the best of
   his/her ability. There is an assumption that leaders act for the common good although this is not always the case.
   Leadership should not be confused with power; power makes you the boss; leaders inspire rather than direct.
   It is important to acknowledge that without leadership groups, organisations, countries become dysfunctional. Studies
   by people such as Hugh Mackay have shown that individuals yearn for strong leadership and will respond to it.
   However it is fundamental that leadership is not about responding to the opinion polls or the popularity stakes and
   reflecting the status quo. Rather, leaders should aspire to take their group, their followers to another level, a better
   level, giving people what they do not already have – a sense of vision, an inspiration or a grasp of a complex topic. To
   some extent we want leaders to compensate for what we lack. As such the amount of leadership we desire is
   proportional to our level of insecurity. This is compounded when a leadership vacuum exists or develops as it then
   becomes a self fulfilling cycle.


                                                                                            Thoracic Society News Volume 15, No.2
    25
We also want our leaders to provide the story that gives purpose to our roles in life – where have we come from,
where are we going and why.
You Are a Leader
An important notion that I would like to share with you is that leaders are not necessarily limited to those running
countries, corporations and institutes and that these particular individuals, merely by virtue of their position, are not
necessarily good leaders either.
Every one of you should see yourself in the context of being a leader – whether on your ward rounds, or in the
research group where you head up a team; in social situations or your family life. In the hierarchical nature of social
structure there are leaders and followers at all levels and individuals migrate across levels. It is worth acknowledging
this and then exploring whether you are the leader you would like to be.
Attributes of a Good Leader
How often have you heard the phrase he or she is a born leader (perhaps not often enough I hear you say), or stories
of crises where someone stepped forward and was the leader – and yet these are the minority. Most successful
leaders are individuals who made a decision to lead and then set about doing it the best way they could.
The fundamental qualities of good leadership are integrity (you must be trusted) and a strong vision for the future.
Leaders are assessed by what they do rather than by what they say. Self serving individuals only have people who
obey rather than follow. As a leader you need to:
a) have an understanding of human nature and insight into your own team,
b) have insight into yourself -your strengths and weaknesses,
c) communicate effectively and share your vision – your style will either build or destroy relationships,
d) be able to adapt to different situations and environments and
e) inspire your followers.
Great leaders have clarity about the issues that need addressing. They inspire a common vision, enable others in the
process, shape the direction to success and tug at the emotions to ensure the passion is there. They share the glory
and retain the pain.

Leadership styles
Four key leadership styles exist:
a) Structural Framework leader;
b) Human Resource styled leader;
c) Politically orientated leader and
d) the Symbolic leader.
In the structural approach – the leader is a social architect – looking at teams and roles with constant analysis and
design. They are strategic people who experiment and adapt. They contrast with the petty tyrants or those who simply
dictate.
The Human Resource orientated leader acts as a catalyst to the team and empowers staff; the leader believes in
people, provides support and is an advocate for staff – the alternative is the abdicator and self serving individual.
The Political Framework Leader is a networker, who assesses the distribution of power, builds linkages uses
persuasion and negotiation. He is neither a hustler nor a manipulator for personal gain and usually follows a win-win
philosophy.
Symbolic leaders are inspirational. They discover and communicate a vision without being fanatical nor a user of
smokescreens and mirrors.
The ideal leader displays all of these characteristics but some will be more relevant to different circumstances. When
your house is on fire you do not normally want the chief of the fire brigade to give an inspirational speech. By gaining
insight into yourself you may see which styles you instinctively prefer and see if they need adjustment.
Another model of leadership is to think of two prime outcomes – concern for people and concern for the tasks ahead
of you. This leads to four permutations:
     I.   the Authoritarian (outcome focussed but unfriendly/hostile),
    II.   the Country Club (people friendly but no outcomes);
   III.   the Impoverished with neither and
   IV.    the Team leader – where concern for people and concern for the tasks are both strong.
It may help to look at what style you encourage. Obviously the team leader is the style to aim for but in some
circumstances other styles may be more appropriate – the authoritarian approach may be useful for the lazy or poorly
motivated.



                                                                            Thoracic Society News Volume 15, No.2
 26
Climate and Culture
I want to finish this section on leadership by raising the issue of climate and culture. That is the climate or culture of a
group or organisation.
The climate is the here and now feel that a group or organisation has. Is it warm and friendly? Is it hostile? Is it united
with a common purpose or dysfunctional? Are there ethical standards that permeate the group? The climate is
strongly influenced by the leadership of the day and by virtue of this is a little more short term and changeable than the
organisation’s culture.
Culture is a more deep seated and long term phenomenon and reflects history and tradition. It is the sum of the
history of events, good times, bad times and the impact of cumulative leadership and individuals. It leads to rites and
customs and influences what is broadly acceptable within a group. It is about the shared image and expectations of a
group or organisation.
In summary all of us in one way or another are functioning as leaders and should be asking: Am I doing it well? Can I
do it better? Good team leaders display the characteristics of honesty and trustworthiness. They are able to see the
way ahead and can then communicate and share this with others. Good leadership relies on you understanding
people and those that you lead. It is about taking people to another level and not simply maintaining the status
quo.
Australian Society Today
Social Change
Australia, like most countries, is undergoing change, and unless we reflect on it, react to it and to some degree adapt
to it we will end up in crisis mode or, at best, our energies and endeavours will be operating at cross purposes - and
progress will not occur despite the best intent.
At a demographic level we are undergoing considerable change, such as high employment and skill shortages. Yet
those who are working are generally working harder than ever, have more material wealth but are not necessarily
happy.
We have low birth rates, high divorce rates and ageing populations. One outcome of this has been an increase in
people who live on their own and by next year, 2006, these individuals will make up the majority of all Australians.
Australia used to pride itself on its great middle class. However in 2003 we had more than two million people living in
poverty, and the bottom 50% of the community owned only 10% of the wealth. Religion has tended to become less
relevant in people’s lives and to a large extent the comparable role of the GP in society has also diminished. All of
these inputs are likely to impact on the psyche and culture of our Society.
There has been a steady loss of leadership and an erosion of our trust in the pillars of the society. At the most extreme
we have Governor Generals and churches caught up in sexual abuse scandals; judges who suffer from alcoholism or
who are asleep at the Bench; senior public servants who are found to be corrupt and yet have no remorse; politicians
who appear to manipulate health scenarios to stay in power and the abuse of commercial positions by the managers
of large insurance companies - to name but a few. Our media tend towards only being interested in the sensational.
We have Editors setting the headlines before the story arises and in our city we had a newspaper covertly sending its
reporters in to eavesdrop on clinical meetings, without any remorse. The net effect is we have less trust in our leaders
or in the traditional pillars of Society and so lose our sense of purpose and direction.
There is also a feeling that the Society is losing its ethical and social values. The bottom line rules over social
conscience. Women, children, asylum seekers and schizophrenics end up in Baxter while a crime leader in Melbourne
on a murder charge is allowed out on bail.
A lot of people feel trapped and powerless in a world that is going in the opposite direction to the one they would like
to pursue: more work; less relationship time with family and friends; less sleep and less recreation and fun. The pace
of life is faster not slower; we are constantly exposed to violence rather than to peace.
Outcomes of Social Change
A world of constant change has led to people being wary of making commitments and keeping their options open in
case the world changes around them. The world of work place agreements and short term contracts supports these
views, as does the insecurity generated by increased crime rates and terrorism. The fundamental question of why
these particular social changes are occurring is not openly discussed and in some cases governments promote fear
as a way of securing their own destiny.
This lack of certainty influences our decisions about personal and work related commitment and encourages
conservatism at a societal level and self interest, neither of which are good for the Society at large. Our insecurity is
leading to more right wing behaviour, tougher sentencing, harsher laws, less humanity, less interest in longer term
solutions and more interest in controlling the situation by regulation. Other reactions include seeking a quick fix
resulting in our highest ever levels of personal debt and our use of antidepressants per capita at an all time high. We
have one of the highest youth suicide rates and drug related crime rates in the world, and yet there does not appear to
be community or political introspection that would have us collectively wonder what at a societal level is amiss.
Concern is more for self and less for national or international issues. Personal agendas bring some pleasure, and we
have seen a concomitant rise in the popularity of reality TV providing escapism for viewers. Prior to the election

                                                                              Thoracic Society News Volume 15, No.2
 27
announcement in 2004 and long before the Opposition imploded, all the opinion polls showed that John Howard was
not well liked, couldn’t be trusted, had no soul -but he remained our preferred prime minister because of our insecurity.

Generational Changes
The internet generation (18-30) was recently surveyed by one of our private health insurance companies. Harsh
economic issues and international insecurity were impacting on their thinking. They had to face up to these issues at
an earlier age – how to make money and have quality of life in a changing environment of internationalisation.

Raised on failed ideologies of love, peace, relationships, sexual liberation and no fathers, they have created a world of
reduced responsibility for themselves. Their thought processes are centred on self. They are individualistic rather than
institutionally focussed and increasingly conservative (eg. don’t cut ties with Britain we might need their support). They
see the pursuit of financial security as a counter to job insecurity, tougher welfare systems and an insecure world.
They are materialistic and financially savvy and responsible. Saving for a house beats saving the world.
We should not be depressed or disappointed by this. It is not necessarily bad, just different. The internet generation is
interested in investment portfolios, not fussed by fashion or having a top job. They are happy, optimistic and more
tolerant, with broader acceptance of people who lie outside the norm, and feel that non-working mothers had better
relationships with children. They are wary of increased immigration but say they would marry across racial and
religious groups. They seek socialisation more in groups than in the past.
It is important that there is acceptance of generational shifts in values and attitudes or we may end up with
disappointment, frustration or conflict.
Solutions and Positive Responses
The paradox is that the vast majority of Australians have an inherent belief that this is the best country and yet in most
cases their hypothesis has had only limited personal testing. This translates to our health systems and medications
where we make the assumption that although the systems are crook they must still be better than elsewhere.
The vacuum of no religion, little community and almost no nationalism has people looking for purpose in their lives.
Thus, there is a mood swing to alternative medicines, holistic life approaches and re-finding their relationships or their
sense of community.
There is a desire to restore balance, get life under control and achieve a balance between work and personal life.
Early retirement is on the minds of many with the latest labour market survey showing that 43% of workers in their late
50s have either retired or are working part time as part of a retirement plan and 74% of persons in their early 60s have
done the same. Eighty-one percent of all Australians would like to retire before 65 but whether they will or will be able
to remains untested.
Are we drivers into the future with our eyes on the rear vision mirror? How much do we respect the views of youth on
the future? The proposed solutions in a recent high school survey involved: idealism (which you would hope for) and
included demilitarisation, making peace, greening of science and technology, intergenerational equity and the concept
of each generation having responsibility for the welfare of ensuing generations. Greater access to education and the
learning of proactive skills such as ecological literacy featured strongly.
The Tsunami provides enormous insight. It has acted as a de facto leader in Australian society and has shown that
with the right motivation or sense of purpose Australians prove themselves to be particularly generous and willing to
get behind a cause. It tends to suggest we are not reaching our potential as a nation and that a leadership vacuum
may exist.
In summary: There is no doubt major social change has occurred with resultant changes in attitude and an increase in
social ills. Generations do react and a shift in attitudes is occurring. However I would suggest that as part of our
response we need to champion and promote better leadership across the community as a step in the right direction.
What About Respiratory Medicine?
In our Region
Geographically Asian countries are our nearest neighbours, and to the West and East we have Africa and South
America. This region contains by far the largest population mass in the world and respiratory diseases are a major
health problem. These include Tuberculosis, Multi drug resistant Tuberculosis, the sequelae of Tuberculosis, Chronic
Obstructive Lung Disease, Bronchiectasis, Lung Cancer, Asthma, Air Pollution, Nutrition, Poverty, Tropical Diseases,
and AIDS to name but a few.
Australia is regarded as an affluent country with a strong emphasis on high standards of medical education and
research and is seen as having the capacity to assist other countries. However our historical ties with Europe and
more recently the USA and our political interface with countries in the region have at times inhibited our interaction
with Asia.
Australia can offer expertise in education and research and approaches to health care. However, we also have a lot to
learn from Asia. I accompanied an ex President of the Cardiac Society of Australia to the National Heart Centre of
Malaysia. He fully expected to offer to train Malaysian cardiologists in Australia but within 15 minutes he was asking
whether Australians could train there. The SARS epidemic taught us a lot about bio-surveillance techniques and this
experience has been invaluable. The Medical Research Building in Hong Kong would be the equal of any in the region
                                                                            Thoracic Society News Volume 15, No.2
 28
while Singapore has announced that medical research and biotechnology is the future economy of Singapore and is
investing heavily in this area. The standard of respiratory science coming out of China is improving at an exponential
rate and is already reaching world standards. By far the most modern computerised hospital I have ever seen is in
Taiwan. All the advances in bronchoscopy technology are arising from Japan. It is too easy to be insular and yet we
have a lot to gain from interacting with our neighbours.
The world is shrinking into trading blocks – the European Union, North America (South America), China, Japan and so
it is with Respiratory Societies: ATS, ERS, APSR and ALAT. At the moment Asia is only just starting to organise itself
into trading entities and equally this is the case with Respiratory Medicine but once they have become robust and well
established Australia will find it harder to gain entry.
This is an ideal situation for leadership on our part to prevail.
Nationally
Respiratory Medicine is alive and well in Australia and we provide excellent standards of care, education and research
but there is always room for improvement. In most of the States and Centres that I am familiar with the concept of
having a whole of State or whole of City Respiratory Network is not well developed nor well articulated. We tend to set
up centres of excellence and then wait for patients to come to us. Statistics on rural patients show they have worse
outcomes than their city counterparts for many health outcomes including lung cancer. Should we be having as our
goal that every person in our respective States will have ready access to a fully trained chest physician and set about
trying to achieve this? Although some State Health services have taken steps to improve the standards of respiratory
care state-wide, I am unaware of any State where the respiratory physicians have worked in a coordinated fashion to
ensure a whole of State service, although it has certainly been proposed in South Australia. The need for a respiratory
service for indigenous people would need to be an important part of any comprehensive state service.
At the bedside and in the laboratory there is plenty of scope for leadership in mentoring and supporting the next
generation of respiratory scientists and physicians. Providing the role model for how to diagnose and manage patients,
how to handle the doctor-patient relationship and how to plan and undertake research are fundamental. Assisting our
staff with their careers and ensuring that the planning occurs well ahead of time and that all opportunities are explored,
are not decisions that the average junior staff member can make on his/her own. The Short Courses for research at
this TSANZ meeting are excellent but having a personal mentor and leader is invaluable.
The leadership roles we take in our hospitals and academic departments are critical in terms of the working
environment whether it be equipment, staff resources, staff attitudes or operating standards
Laboratory to Bedside
The majority of advances in medicine have arisen from basic research. It is critical that the membership of this Society
does not lose sight of this as the Society continues to evolve. It is important that we do our utmost to ensure that
scientists want to work with Chest Physicians and to embrace our Society. However it is equally fundamental that the
scientists are tuned into the diseases and the disease processes that we are dealing with, or their research will be
misdirected and not address the real issues.
Practitioner Fellowships from the NH&MRC have been a major advance. However, providing or facilitating career
pathways for senior scientists should be a long term goal of the Society.
Facilitating research networks within the Society is a holy grail that we should not avoid because it is too hard. We
should continue to see meetings of the Society as opportunities to promote interaction and in particular champion our
up and coming researchers. As with many of our Universities we are not good at recognising our good teachers or for
that matter our best clinicians - and this needs serious consideration.
In summary we need to embrace our region, provide leadership and be a major player. We need to look outwardly at
what we can do for the respiratory patients of our regions. Our staff deserve the best leadership we can offer.
Supporting and integrating the triumvirate of Research, Education and Clinical Medicine is fundamental to our long
term wellbeing.
The Challenge for Us All
We are all leaders in our working lives, at home and in the community. Recognising this is important. It is important to
see if our leadership skills are finely tuned and doing the job we would want. A leadership vacuum creates negative
outcomes. Championing and promoting the merit of good leadership across our community and in our professional
lives can only result in a better Australia, for us all.
I encourage you to take up the challenge.”

Australian Radiation Protection and Nuclear Safety Agency
                                      Re: Radiation Protection Series No.8
           Code of Practice for the Exposure of Humans to Ionizing Radiation for Research Purposes

            Electronic copies of the Code can be downloaded free of charge from the ARPANSA website at:
                                            www.arpansa.gov.au/rps8.htm.


                                                                            Thoracic Society News Volume 15, No.2
 29
                         2005 Perth Annual Scientific Meeting




      ALF/CSL Respiratory Infectious Diseases Poster                    Outgoing President, Prof. Dick Ruffin receives The
           Prize Winner Dr Katherine Semple                          Laennec Medal from incoming President, Dr Rima Staugas.




  Ms Kylie Hill (left) winner of the TSANZ/ Mayo Healthcare        Dr Carol Lang (middle) winner of the ALF/Boehringer-Ingelheim
Physiotherapy Prize and the Ann Woolcock Young Investigator                    COPD Research Fellowship 2005/2006
                              2005.




     Dr Robert Hancox (right) winner of the TSANZ/NAC             TSANZ/ALF John Read Prize for Physiological Research winner,
                       Asthma Prize                                               Ms Cindy Thamrin (right).




TSANZ/Merck Sharpe Dohme Paediatric Respiratory Care Prize    TSANZ/Boehringer-Ingelheim Respiratory Advanced Trainee Travel Grant
                winner, Dr Brent Masters.                     Awardees (Left to Right: Dr Simon Frenkel, Dr Mitzi Nisbet, Dr Ben Harris,
                                                                 Dr Megan Rees, Dr Bronwen Rhodes; absent: Dr Jermey Goldin).




                                                                               Thoracic Society News Volume 15, No.2
     30
                            2005 Perth Annual Scientific Meeting
                                Awards & Prizes - ASM 2005
Award / Prize                        Winner                        Oral/Poster Reference & Title
ALF Slater & Gordon Research                                       HOW THE BODY RECOGNISES MESOTHELIOMA ANTIGENS
                                     Prof Bruce Robinson           AND HOW TO MODIFY THEM TO PRODUCE NEW
Trust Fellowship
                                                                   THERAPIES
ALF/Astra Zeneca Young                                             THE INTERACTION BETWEEN AIRWAY EPITHELIAL CELLS
                                     Dr Peter Wark                 INFECTED WITH RHINOVIRUS AND LYMPHOCYTES FROM
Investigator Grant-in-Aid
                                                                   SUBJECTS WITH COPD.
ALF/Bayer Respiratory Infectious                                   TO 055: “GENDER DIFFERENCE IN PREVALENCE OF NON-
                                     Dr Soctt Bell                 CYSTIC FIBORSIS BRONCHIECTASIS (NCFB) DOES NOT
Diseases Prize [Oral]
                                                                   INFLUENCE CLINICAL PHENOTYPE”.
ALF/CSL Respiratory Infectious
                                     Dr Katherine Semple           TP 222: “THE EFFECT OF MUCIODY ON BIOFILM
Diseases Prize [Poster]                                            FORMATION IN CYSTIC FIBROSIS CLINICAL ISOLATES”.
ALF/Ludwig Engel Grant-in-Aid for
                                     Mr Jyotishna Narayan          MECHANISMS LINKING SNORING AND BAROREFLEX
Physiological Research                                             SENSITIVITY DEPRESSION
Ann Woolcock Young Investigator                                    TO 042: “HIGH-INTENSITY INSPIRATORY MUSCLE
                                     Ms Kylie Hill                 TRAINING (HIMT) IMPROVES DYSPNOEA AND HEALTH-
Award:
                                                                   RELATED QUALITY OF LIFE (QOL) IN COPD”.
Astra Zeneca/TSANZ Cell
                                     Anthony Kicic                 TP 076: “ABNORMALITIES IN THE ASTHMATIC BRONCHIAL
Biology/Immunology Prize                                           EPITHELIUM”.
                                                                   TP 011: BRONCHIAL PROVOCATION USING INHALED
Best Poster Prize:                   Mr John Brannan               MANNITOL-A PHASE 3 TRIAL OF ADULT & PAEDIATRIC
                                                                   ASTHMATICS & NON-ASTHMATICS”.
Boehringer-Ingelheim COPD
                                     Dr Carol Lang                 THE ROLE OF ZINC IN THE RESPIRATORY SYSTEM AND
Research Fellowship 2005/2006                                      CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)
Peter Phelan Travelling Fellowship   Dr Laurel Teoh
Research Medal                       Prof Peter Sly
TSANZ & Allen & Hanburys
                                     Dr Sandra Hodge
Respiratory Research Fellowship
                                                                   TP 038:“SEX DIFFERENCES IN THE RELATION BETWEEN
TSANZ / NAC Asthma Prize:            Dr Robert Hancox              BODY MASS INDEX AND ASTHMA AND ATOPY IN A BIRTH
                                                                   COHORT STUDY.”
                                                                   TO 003: “HEALTH PROVIDERS KNOWLEDGE OF PULSE
TSANZ Nurses Prize – Best Oral       Mrs Judy Ross                 OXIMETRY PRE AND POST AN EDUCATION
                                                                   INTERVENTION”.
                                                                   TP 243: “THE INCREMENTAL SHUTTLE WALKING TEST
TSANZ Nurses Prize – Best
                                     Ms Maria Murphy               (ISWT) OBSERVED IN A PULMONARY REHABILITATION
Poster:                                                            PROGRAM (PRP) AT THE NORTHERN HOSPITAL,
                                                                   VICTORIA”.
TSANZ Respiratory Molecular
                                     Ms Kirrily O’Hara             TP 241:”CHARACTERIZATION OF THE HUMAN ONCOSTATIN
Genetics Prize                                                     M (OSM) RECEPTOR SUB-UNIT, OSM R”.
                                      Ms Hannah Culver, QLD
                                      Mr Danny Eckert, SA
                                      Dr Katherine Finan, SA
                                      Dr Kristina Kairaitis, NSW
                                      Ms Maria Clare Murphy,
TSANZ Travel Grants to the 2005
                                      VIC
ASM                                   Dr Rajeev Ratnavadivel,
                                      SA
                                      Ms Jodie Simpson, NSW
                                      Dr Lisa Wood, NSW

TSANZ/ALF John Read Prize of                                       TO 059: “BROADBAND OSCILLATION MECHANICS IN
                                     Ms Cindy Thamrin              HEALTHY AND EMPHYSEMATOUS ADULT HUMAN
Physiological Research
                                                                   SUBJECTS”.
TSANZ/Allen & Hanburys
Paediatric Medicine Career           Dr Julie Marchant
Development Fellowship


                                                                                Thoracic Society News Volume 15, No.2
31
 Award / Prize                       Winner                       Oral/Poster Reference & Title

 TSANZ/Boehringer Ingelheim                                       TO 032: “SENSITIVITY OF PERFUSION HETEROGENEITY
 Chronic Obstructive Pulmonary       Dr Merryn Tawhai.            REVEALED BY CT-BASED MODELS OF THE HUMAN LUNG
                                                                  AND VASCULAR TREES”.
 Disease Prize
                                     Dr Simon Frenkel, VIC
 TSANZ/Boehringer-Ingelheim
                                     Dr Jeremy Goldin, VIC
 Respiratory Advanced Trainee
                                     Dr Benjamin Edward Harris,
 Travel Grants [x 6]
                                     NSW
                                     Dr Mitzi Nisbet, NZ
                                     Dr Megan Anne Rees, VIC
                                     Dr Bronwen Rhodes, NZ
                                                                  TP 196: “THE ADDITIONAL RISK OF MALIGNANT
 TSANZ/DDB Occupational &
                                     Alison Reid                  MESOTHELIOMA IN FORMER WORKERS AND RESIDENTS
 Environmental Diseases Prize                                     OF WITTENOOM WITH BEGNIGN PLEURAL DISEASE OR
                                                                  ASBESTOSIS”.
                                                                  TP 181: “ENDOBRONCHIAL ULTRASOUND (EBUS) IN
 TSANZ/Eli Lilly Lung Cancer                                      BIOPSY OF MALL PERIPHERAL LUNG INFILTRATES
                                     Dr David Fielding            IMPROVES LOCALISATION AND ALLOWS INFILTRATE
 Prize:
                                                                  CHARACTERIZATION”.
 TSANZ/Eli Lilly Nurses’ Travel      Ms Karen Lamb, VIC
 Grants [x2]                         Ms Sheree Smith, QLD
 TSANZ/Mayo Healthcare                                            TO 042: “HIGH-INTENSITY INSPIRATORY MUSCLE
                                     Ms Kylie Hill                TRAINING (HIMT) IMPROVES DYSPNOEA AND HEALTH-
 Physiotherapy Prize
                                                                  RELATED QUALITY OF LIFE (QOL) IN COPD”.
 TSANZ/Merck Sharpe Dohme                                         TO 067: “A NEW METHOD FOR OBJECTIVE IDENTIFICATION
                                     Dr Brent Masters             AND MEASUREMENT OF AIRWAY LUMEN IN PAEDIATRIC
 Paediatric Respiratory Care Prize
                                                                  FLEXIBILE VIDEO-BRONCHOSCOPY”
 TSANZ/Pfizer Best Presentation                                   “QUANTIFICATION OF NICOTINE AND TOXIC COMPONENTS
                                     Amira Wahdan
 on Tobacco Related Issues:                                       FROM CIGARETTE OUTPUT BY HPLC.”

 TSANZ/Roche Cystic Fibrosis
                                     Upasna Pratap                TP 174: “SOLUBLE TRANSFERRIN RECEPTOR AND
 Prize                                                            SYSTEMIC IRON DEFICIENCY IN CYSTIC FIBROSIS”.



Obituary
Dr Anthony J Proust, FRACP, FRCP, FRCPE 1924 - 2005
Anthony J Proust F.R.A.C.P., F.R.C.P., F.R.C.P.E., a long standing member of the Thoracic Society of Australia and
New Zealand, graduated in Medicine from Sydney University in 1948. After residency at Royal Prince Alfred Hospital
he studied and worked overseas; first at Winnipeg, Canada where he married Moya, then at Johns Hopkins Hospital in
Baltimore and finally Edinburgh and London.
As a well trained general physician with expertise in thoracic medicine and diabetes mellitus, Tony moved to
Canberra, where Moya bore him four children. Before entering consultant practice in Canberra, he was in partnership
with the renowned and popular Dr Albert Hart, of Queanbeyan. Tony’s expertise in tuberculosis led to an invitation to
become foundation Director of the Department of Thoracic Medicine at Canberra Hospital, a position he held until his
retirement in 1995.
One of Tony’s major contributions to medical research was as coordinator of the Australian Rifampicin Trial, a trial that
led the drug to become the mainstay of antituberculosis treatment to this day. In 1984 he founded a medical
periodical, the Australian Tuberculosis Newsletter. His reputation extended outside Australia. In 1981, Sr Mary
Aquinas invited him to work with her at the world famous Ruttonjee Hospital for tuberculosis in Hong Kong. In 1991, St
John’s Medical College Bangalore, one of the more prestigious medical schools in India, appointed him visiting
Professor of Thoracic Medicine. Yet Tony’s interest in diabetes continued and his passion for the history of medicine
grew with age. First was the publication of his History of Tuberculosis in Australia, New Zealand and Papua New
Guinea in 1991, then the History of Medicine in Canberra and Queanbeyan in 1994.
Retirement saw no decrease in his output. A Social and Cultural History of Medicine in NSW was published in 1999.
His final work, A Companion of the History of Medicine appeared in 2003. He was contemplating another work on
medical women in Australia when his last illness overtook him on May 16 2005.

                                                                              Thoracic Society News Volume 15, No.2
 32
Membership categories & Fee structure of the TSANZ
The vexed issue of setting appropriate membership fees for members of the Society has produced impassioned pleas
from senior society members, continuous complaint all members and most headaches for successive treasurers over
recent years. Despite the vigorous debate occurring within the Society, a satisfactory solution has yet to be found. This
is illustrated by ongoing complaints to the office by disadvantaged members, whether real or perceived. In order to try
and find an equitable and acceptable solution to the issues of membership and fees, I invite comments from members
of the Society. This, I hope, will guide the executive in whether to submit a motion to change the current status quo at
the 2006 AGM.
The current membership of the Society comprises approximately 600 Ordinary members (who contribute the majority
of the subscription income), 300 Associate members and 100 student members. Besides subscriptions, the other
major source of income is the ASM, where registrants paying full registration fees & sponsorship are the main sources
of income. Any change to the current fee structures, membership or registration, has the potential to affect income and
thus the financial status of the Society. A number of issues surrounding membership categories and the fees structure
have been identified, making a review timely. These include:

1:   A lack of movement of Associate to Full membership.
2:   A lack of clear indicators for moving from Associate to Ordinary membership.
3:   How to attract junior members.
4:   How to retain junior members.
5:   Why do different membership categories carry different rights.
6:   The Society’s good (some say excessive) financial reserve.

While the Society promotes itself as an egalitarian association, for reasons that are unclear (or shrouded in the mists
of time) it does not allow associate members voting rights. This disenfranchises a significant minority of the Society,
potentially diminishing their contribution. Yet as highlighted in a recent message from the previous President, when
given the opportunity associate members are keen and capable contributors to the Society’s activities. The current fee
structure for Associate membership is seen as too high for some with lower income (or part-timers), resulting in them
not joining or not remaining members once having joined. Under the present rules, associate members move to
ordinary membership once they meet specific criteria (holding a specialist respiratory qualification FRACP, PhD, MD
etc). The increased fee for Ordinary membership is seen as an impediment to this, especially to those with a low
income, while some members may never meet this criteria despite long and successful careers in healthcare.
Two different solutions to the current problems have been proposed:
                                                      Proposal 1
Membership categories
Student member:                  persons fulfilling current membership criteria (non-voting)
Full Ordinary member:            persons fulfilling current membership criteria
Discount Ordinary member*:       persons fulfilling current membership criteria earning less than UNSW Academic
                                 Salary Scale, Level B (Lecturer)
Full Associate member:           persons fulfilling current membership criteria (non-voting)
Discount Associate member#:      persons fulfilling current membership criteria (non-voting) and earning less than
                                 UNSW Academic Salary Scale, Level A (Associate Lecturer)
Retired member:                  members now retired from practice
Emeritus member:                 persons fulfilling current criteria
*Current UNSW Academic Salary Scale, Level B (Lecturer), Step 1 = $62,619
#
  Current UNSW Academic Salary Scale, Level A (Associate Lecturer), Step 1 = $44,756
Membership fees
Full Ordinary                    $270 + $27 (GST) = $297.00
Discount Ordinary                $135 + $13.50 (GST) = $148.50        (50% of Full Ordinary membership)
Full Associate                   $135 + $13.50 (GST) = $148.50        (50% of Full Ordinary membership)
Discount Associate               $67.50 + $6.75 (GST) = $74.25        (50% of Full Associate membership)
Student                          $67.50 + $6.75 (GST) = $74.25        (50% of Full Associate membership)
Retired                          $40 = $4 (GST) = $44.00
ASM Registration (Linked to membership status)
Full ordinary                        $675 (2005 ASM rate)
Discount ordinary or Full Associate  $450
Discount associate or Student        $325 (2005 ASM rate)
Non member                           $775 (2005 ASM rate)


                                                                                                         continued overleaf

                                                                            Thoracic Society News Volume 15, No.2
 33
                                                          Proposal 2
Membership categories
Student member:                        persons in full-time undergraduate study (non-voting)
Ordinary member:                       persons fulfilling current associate membership criteria
Retired member:                        members now retired from practice
Emeritus member:                       persons fulfilling current criteria

Fee structure
Emeritus:                           Nil
Student & Retired:                  $50.00 + $5 (GST) = $55
Ordinary member on joining:         $75.00 + $7.50 (GST) = $82.50
Ordinary member + 5 years:          $150.00 + $15 (GST) = $165
Ordinary member +10 years:          $225.00 + $22.50(GST) = $247.50
Ordinary member + 15 years:         $300.00 + $30 (GST) = $330
The new fee structure would become applicable in 2007, with current ordinary members entering the top fee category
and associate members entering levels according to their period of membership. The option of requesting a reduced
fee on the basis of hardship would remain.

ASM fee structure would remain unchanged, with a reduced fee for those below a set income level (currently less than
$40K) verified by HOD.


      Comments on the two proposals or other models are welcome from members of the Society.

The current membership structure, corresponding fees and conference registration costs for 2005 are outlined below
for comparison:
Membership category            Annual Subscription
Full Ordinary                  $270 + $27 (GST) = $297.00
Associate                      $135 + $13.50 (GST) = $148.50
Student                        $67.50 + $6.75 (GST) = $74.25
Retired                        $40 + $4 (GST) = $44.00

2005 Annual Scientific Meeting Registration Fees
Full Registration (Member/Associate Member/ANZSRS Member)                 $725 (Early Bird $675)
Full Registration (Researcher/Student)                                    $375 (Early Bird $325)
Joint ANZSRS/TSANZ (must be TSANZ or ANZSRS member)                       $850 (Early Bird $850)


The Dr H M (Bill) Foreman Memorial Fund
The Trustees of the above fund invite applications for grants relating to study in Respiratory Disease, and allied fields
(eg microbiology, histopathology, radiology, biochemistry, and molecular biology).
Limited funds are available for registered medical practitioners to assist in traveling to countries other than their own to
study Respiratory Disease, and also for support for clinical research abroad.
Intending applicants should write for further details to: Dr Brian H Davies, Llandough Hospital, Penarth, Vale of
Glamorgan, CF64 2XX, United Kingdom.



Third New Zealand/Australian LAM Science Symposium
              The third New Zealand/Australia LAM Science Symposium will be held on 30 April – 2 May 2006. This
              meeting (The Virginia Northwood Memorial LAM Science Symposium) honours Virginia Northwood who
              was the Founder and first President of LAM Australia. This third symposium follows two very successful
              meetings held in New Zealand; on Waiheke Island in 2002 and at the Hotel Du Vin 2004. On this
              occasion the meeting moves to the “Western” Island – to the Fairmont Resort in the Blue Mountains.
Once again this promises to be an exciting meeting with the sharing of data and ideas between basic scientists,
clinical scientists and clinical researchers in an informal workshop atmosphere at a fantastic location. Already a
number of prestigious overseas speakers have confirmed their attendance.
                    Registrations for this meeting will open in September 2005. All enquiries to:
Prof Allan Glanville, Dept Thoracic Medicine, St Vincents Hospital, Sydney, Australia E-mail: aglanville@stvincents.com.au, or
Prof Judith Black, Dept of Pharmacology, University of Sydney, Sydney, Australia      E-mail:judblack@pharmacol.usyd.edu.au

                                                                                 Thoracic Society News Volume 15, No.2
 34
   ……………TSANZ Updates…….TSANZ Updates……TSANZ Updates……



Pfizer Advanced Trainee Award for 2005
Our congratulations to Dr Tonia Douglas (WA) on winning this award for her work on bronchial allergen challenge to
define atopic asthma in 5 year-olds.

Condolences
It is with sadness that we note the sudden passing of long-standing TSANZ member, Dr Vettivetpillai Ketharanathan,
on 3 March 2005.



                                                             TSANZ ASM
CALENDAR                                                     CANBERRA, ACT
                                                              24 – 29 MARCH 2006
2005
THE 11TH WORLD CONFERENCE ON LUNG CANCER –
IASLC                                                        2006 LAM MEETING
BARCELONA, SPAIN                                             THE FAIRMONT RESORT, BLUE MOUNTAINS, SYDNEY
3 -6 JULY 2005                                               1 MAY – 2 MAY 2006
Contact: www.imedex.com/calendars/oncology.htm               Contact: director@lam.org.nz

11TH WORLD CONGRESS ON PAIN                                  16TH WORLD CONGRESS OF THE WORLD SOCIETY OF
CAIRNS, QLD                                                  CARDIO-THORACIC SURGEONS (WSCTS 2006)
                                                             OTTAWA CONGRESS CENTRE, OTTAWA, ONTARIO, CANADA
18– 19 AUGUST, 2005                                          17-20 AUGUST
On-line Registration: www.tourhosts.com.au/cancerpain2005
                                                             E-mail: info@wscts2006.com
                                                             Congress Home Page: http://www.wscts2006.com
4TH WORLD ASSEMBLY ON TOBACCO COUNTER HEALTH
KYOTO, JAPAN                                                 EUROPEAN RESPIRATORY SOCIETY CONGRESS
21 – 24 AUGUST, 2005                                         MUNICH, GERMANY
                                                             2 – 6 SEPTEMBER 2006
EUROPEAN RESPIRATORY SOCIETY
COPENHAGEN, DENMARK                                          CHEST
17 – 21 SEPTEMBER 2005                                       SALT LAKE CITY, NEVADA
                                                             22 – 26 OCTOBER 2006
AUSTRALIAN SLEEP ASSOCIATION
GOLD COAST, QLD
                                                             2007
7 – 9 OCTOBER 2005                                           TSANZ ASM
                                                             AUCKLAND, NEW ZEALAND
CHEST                                                        23-28 MARCH 2007
MONTREAL
30 OCTOBER – 3 NOVEMBER 2005                                 WORLD FEDERATION OF SLEEP RESEARCH SOCIETIES
                                                             WORLD CONGRESS
10TH CONGRESS OF THE APSR                                    CAIRNS, AUSTRALIA
1ST JOINT CONGRESS OF THE APSR/ACCP                          1 – 8 SEPTEMBER 2007
GUANGZHOU, CHINA                                             Contact: WWW.ICMSAUST.CON.AU/WFSRS
11-14 NOVEMBER, 2005:
Contact: apsr2005@asia.cmpmedica.com                         CHEST
Web Site: http://www.apsr2005.com
                                                             CHICAGO, ILLINOIS
                                                             21 – 25 OCTOBER 2007
2006
2ND ADVANCES AGAINST ASPERGILLOSIS                           2008
ATHENS, GREECE
                                                             TSANZ ASM
22 – 26 FEBRUARY 2006                                        MELBOURNE, VIC
Contact: www.aaa2006.org                                     28 MARCH – 2 APRIL 2008
Email: info@congresscare.com


        Please note: Publication of material in the Newsletter does not mean it has TSANZ endorsement.
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                                                                         Thoracic Society News Volume 15, No.2
 35

				
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