By-Laws of the Association

BY-LAWS
of the
TASMANIAN BRANCH OF THE
AUSTRALIAN MEDICAL ASSOCIATION

INTERPRETATION
l. Where not repugnant to the context, words, occurring in these By-Laws and also occurring in the Articles of Association shall bear the same respective meaning in these By-Laws as they bear in the Articles of Association. These By-Laws shall be construed so as not to conflict with the Articles of Association.
DIVISIONS
2. (a) The Branch subject to the approval of the Council under By-Law (16(a) shall consist of three Divisions, Southern, Northern and North Western. The area of the Southern Division shall be that area of Tasmania south of a line running east and west through Antill Ponds. The area of the Northern Division shall be that portion of the north eastern area of Tasmania contained by a line running east and west through Antill Ponds and a line running north and south immediately east of Latrobe. The area of the North Western Division shall be that portion of the North Western area of Tasmania contained by a line running east and west through through Antill Ponds and a line running north and south immediately east of Latrobe.
(b) A grant of three dollars ($3.00) in respect of each member of the Division on the Divisional Roll on the first day of January of that year may be paid by the Honorary Treasurer annually to each Division in the Association.
(c) The management of Divisions shall be in accordance with By-Law l6 thereof.
MEMBERSHIP
EXTRAORDINARY MEMBERS (see Article 5 (b)).
3A. (a) Any person whose name it is proposed to submit for election as an extraordinary Member shall be nominated by at least two Members of the Council in writing signed by such two Members with the consent of the person to be so nominated endorsed thereon.
(b) The Council may confer on any person elected as an Extraordinary Member such particular or special privileges other than that of voting as it may deem desirable in respect of such membership.
(c) Extraordinary Members shall be either Visiting or Complimentary Members.
(d) Any Member of the Australian Medical Association not resident in the area of the Branch may be elected at a meeting of the branch or of the Council, as a visiting Member of the Branch for a period not exceeding three months, and shall have all the privileges of membership except that of voting.
(e) Any qualified medical practitioner, or person distinguished in science, resident within the area of the Branch but not eligible for ordinary membership of the Australian Medical Association, may, on the recommendation of the Council, be elected as a Complimentary Member of the Branch, and shall have all the privileges of membership except that of voting.
HONORARY MEMBERS (Article 5 (c)).
3B (a) The election of Honorary Members shall by by the Branch in General meeting on the recommendation of the Council.
(b) Honorary Members shall have none of the liabilities of ordinary members as regards subscriptions and shall not be entitled to receive notices of General Meetings or to have any vote.
(c) Every Honorary Member shall cease to be such a member upon resolution of the Council to that effect passed by a majority of not less than two thirds of those present and voting.
AFFILIATED MEMBERS
3C. (a) Any ordinary Member of the British Medical Association who has been admitted by the Australian Medical Association as an affiliated Member of that Association shall so long as he remains an affiliated Member of that Association be an affiliated Member of the Branch.
(b) An affiliated Member of the Branch shall not as such be or be deemed to be a Member of the Branch for any purpose whatever and shall not be required to pay any subscription to the Branch.
(c) An affiliated Member shall enjoy the like privileges as are enjoyed by Members of the Branch except that:
(l) he shall not be entitled to receive notice of or to be present or to vote at any general meeting of the Branch.
(2) he shall not be entitled to act as a representative or officer of the Branch except that he may be co-opted as a member of a committee.
(d) An affiliated Member shall be entitled to use any facilities provided by the Branch for the benefit of its Members and may attend any scientific meeting or conference of the Branch and to speak thereat.
(e) An affiliated Member of the Branch shall ipso facto cease to be an affiliated Member if heceases to be an affiliated member of the Australian Medical Association.
ASSOCIATE MEMBERS
3D.(a) Undergraduates in Medicine of the University of Tasmania in the fourth, fifth and sixth year of their course shall be eligible to be elected by the Council on behalf of the Association as Honorary Student associates of the branch.
(b) Student associates shall not have the right to speak or vote at meetings of the Branch or Divisions.
(c) Persons wishing to be elected as Student Associates shall submit their application on the prescribed form (Schedule AA) endorsed by one member of the Association.
(d) There shall be no subscription for Student Associates.
(e) Student Associates may apply to receive the Australian Medical Journal and the British MedicalJournal at concessional rates.
(f) Student Associates in the sixth year of their course may be invited to attend all Branch and Divisional meetings.
(g) Student Associates in the fourth and fifth year of their course may be invited to attend any particular meeting of a division by the Executive of that Division.
(h) the associateship of a Student Associate may be withdrawn by the Council at any timewithout assigning any reason.
SPECIAL GROUPS OF MEMBERS
3E. (i) The formation of Special Groups of Members shall rest with the Branch Council.
(ii) An application by any such group for formal recognition by the Association shall be made to the Branch Council and in connection with any application the Branch Council may require such information concerning the group and the membership thereof as it thinks fit. If any such group shall have adopted a formal constitution the same shall be submitted to the Association with the application for recognition and if after recognition any such group shall adopt a formal constitution or shall make any alterations to its constitution the same shall be submitted to the Association.
(iii) The mode of application for the formation of any such Special Group and the means of ascertaining the views of Members thereof on matters affecting their distinctive professional interests shall be such as the Branch Council may from time to time determine.
(iv) It shall rest in the absolute discretion of the Branch Council as to whether the Association shall recognise the existence of any such group and it may in its absolute discretion withdraw the formal recognition of any such group granted by the Association.
(v) Any such group may make representations to the Association for consideration in respect of any matter having particular reference to the group or the area within which the members thereof reside and the Branch Council may take such action on any such representations as it shall determine or may decline to entertain any such representations or to take any action in respect of them.
SUBSCRIPTION (See Article 12).
4. Save as is otherwise provided by the Articles of Association or these by-Laws every ordinary member shall pay to the Branch -
(i) An annual subscription rounded to the nearest dollar in respect of his Branch membership as determined by Council under Article l2(a) in the following proportions dependant on the Member's Category of practice:

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A member who shall have been an ordinary member of the British Medical Association and/or the Australian Medical Association for an aggregate period of fifty years shall not be required to pay an annual subscription as from the first day of January next succeeding the expiration of such period.
(ii) An annual subscription in respect of the Australian Medical Association membership as provided in the Articles and By-Laws of the Australian Medical Association.
5. The Newsletter of the Branch shall be published at least quarterly or as determined by Branch Council and posted to each member at his address.
NECESSITOUS MEMBERS
6. Any Member whose financial position is such that he is unable to pay the full annual subscription may apply to the Honorary Treasurer for a reduction in the rate of subscription, and each case will be considered on its merits subject to the following conditions:
(a) Satisfactory proof of the said Member's liability to pay the full subscription must be brought before the Honorary Treasurer, who will bring the matter before the Council, and any information given for this purpose shall be regarded as confidential.
(b) The Council, if satisfied of the said Member's inability to pay the full subscription, shall thereupon recommend that a reduction in the rate of subscription be granted to the said Member, and shall also recommend the amount of the reduction which the said Member should be granted.
(c) Any reduction in the rate of subscription to any Member under this rule shall be for a period of one year. If the said Member wishes to be granted a reduction in the rate of subscription in any subsequent year he must re-apply to the Honorary Treasurer for such reduction, and such re-application shall be considered by the Council as in (a) and (b) above.
TERMINATION OF MEMBERSHIP
7. (a) Membership of the Branch shall be terminated in accordance with the Articles of Association and By-Laws to that end in force (vide Article l4).
(b) Every Member who shall cease to be aMember of the Australian Medical Association shall thereupon immediately cease to be a Member of the Branch.
EXPULSION
8. (a) The Council may expel a Member in accordance with the articles of Association (vide Article l5).
(b) No irregularity in the making of any complaint or in the appointment of the Council or any Member thereof or in any meeting of the Council or otherwise or in any proceeding act matter or thing done or omitted during the course of the investigation or inquiry shall prejudice or invalidate the final decision of the Council convened in Special Meeting in accordance with Article l5.
(c) No Member or Expelled Member shall be entitled to take any action or legal proceedings for defamation against the Association or against the Council or against any individual member of the Branch or against any person who made a complaint or who gave evidence thereon (verbally or in writing) it being expressly agreed that all complaints, notices, letters, evidence and other matters arising under or incidental to any complaint and the hearing and determination thereof and all proceedings and utterances at Council meetings held in connection therewith shall be absolutely privileged and protected accordingly and should any action or legal proceedings be taken as aforesaid this sub-clause may be pleaded as an absolute bar.
(d) Any Member who is actuated by personal malice or dishonourable motives in making or by evidence supporting any unfounded complaint against another Member shall be guilty of conduct making him liable to expulsion by the Council under this By-Law.
9. (a) If a Member be expelled from the Association it shall be the duty of the Honorary Medical Secretary, unless countermanded by the Council, to inform all Members of the Association of such action by a notice in writing over his signature forwarded in sealed envelopes. Similar notices will also be forwarded to the Secretary of the Australian Medical Association, the Secretary of each Branch of the Australian Medical Association and to the Editor of the Medical Journal of Australia.
(b) The Honorary Medical Secretary shall if so instructed by the Council notify such expulsion (with or without stating the grounds thereof) to the Medical Council of Tasmania and to any other Medical Board or similar body in Australia. Every Member who is so expelled shall be deemed to have authorised every such notification. (By-Law 47 also refers).
GENERAL MEETINGS (Articles 17-37)
ANNUAL MEETING
10. (a) An Annual General meeting shall be held in the month of May of each year on a date to be fixed (b) Not less than twenty-eight days' notice of an Annual General Meeting shall be given to each Member.
PROXY VOTING (Article 36)
11. Every Member present at a meeting and qualified to vote thereat may vote in person and, except at an election of officers, as proxy for other Members when duly appointed to do so. The instrument appointing a Member a proxy shall be signed by the Member so appointing, whose signature shall be attested by one witness. It shall be valid only for the voting on the particular motion or motions named in it, with any amendments thereto, or for formal motions arising in the debate thereon.It shall be deposited with the Honorary Medical Secretary before the Chairman opens the proceedings at the meeting for which it is given.
ORDER OF BUSINESS AT GENERAL MEETINGS (Article 25).
12. (a) The order of business at meetings of the Branch or Council shall be as laid down in Standing Orders.(See Appendix B).
(b) The discussion at meetings of the Branch or Council shall be in accordance with the Rules of Debate in the Standing Orders. (See Appendix B.)
VISITORS
13. Meetings of the Branch shall ordinarily be open to Members only, but visitors may be present by invitation of the Council.
COUNCIL REPRESENTATION OF SALARIED MEDICAL OFFICERS ON COUNCIL (Article 40 (iii))
14. If the Council decided to elect an ordinary Member of the Branch to represent the Salaried Medical Officers of the Branch on the Council, nominations will be called for by advertisement in the Newsletter or otherwise as resolved by the Council. the advertisement will state the date by which nominations must reach the Honorary Medical Secretary. Nominations shall be submitted in writing, signed by two other Members who are Salaried Medical Officers, and accompanied by a written acceptance signed by the candidate. The ballot for election will take place at the first meeting of the Council held after the final date set for receipt of nominations.
VOTING FOR OFFICERS AND THE UNIVERSITY AND JUNIOR HOSPITAL
STAFF MEMBERS OF COUNCIL
15. (a) If nominations for Officers or Members of Council exceed the vacancies the Honorary Medical Secretary shall conduct a ballot as laid down in the Articles. Each ballot paper sent to any Member will be accompanied by a small envelope marked "voting paper" and a larger envelope with a declaration as hereafter described printed inside the flap with provision for the Member's signature.
(b) The voter shall write the figure "l" opposite the name of the candidate who stands first in his order of preference, the figure "2" opposite the name of the candidate who stands second in his order of preference and so on. No signature or other mark of identification other than that of the Honorary Medical Secretary as aforesaid shall be written on the voting paper.
(c) Having marked his voting paper the voter shall fold it and seal it in the smaller envelope and insert the smaller envelope in the larger envelope,sign the declaration therein, seal it and address it and transmit it to the Honorary Medical Secretary by post or otherwise.
(d) The declaration to be signed by the voter and referred to in paragraph (a) of this By-Law shall be as follows:
"I declare that I am a Member of the Tasmanian Branch of the Australian Medical Association. Signature .................................."
(e) In the case of ballots for the University Member of Council the declaration shall include the words: "I am a Member of the Full timeClinical Staff of the Faculty of Medicine of the University of Tasmania." and in the case of ballots for the Junior Hospital Staff Members of Council the declaration shall include the words:
"I am a member of the Junior Hospital Medical Staff of ..........................Hospital and the date of my graduation in Medicine was ..................."
DIVISIONS
16. (a) Local Divisions of Members of the Branch formed with the object of promoting the scientific medico-political and medico-ethical interests of their Members may be affiliated to the Branch if approved by Council. When applying for affiliation the proposed Division shall submit to the Council two copies of its Rules which amongst other things shall set out the local boundaries or areas within which its members practice.
(b) The object sought to be obtained by the creation of such Divisions as aforesaid is: To bring the Divisions individually and collectively into closer touch with the Council with a view to developing a more vigorous corporate life in the Association as a whole throughout the State, and with a view to securing:
(i) A common policy throughout the Association in matters of Ethics, Contract Practice, Medico-politics and organisations generally; and
(ii) So far as difference in the conditions of practice in different localities will permit uniform methods of procedure and uniform regulations in regard to professional relations of Members with one another and with other persons.
(iii) Such other objects as may be from time to time approved by the Council.
(c) No Division shall without first obtaining the approval of the President or in his absence the Honorary Medical Secretary do any act or make any written or verbal pronouncement on any medico-political matter or on any matter or question which affects Members of the Association generally.
(d) Every Member of the Association shall be an ordinary member of that Division in which he conducts his practice.
(e)
(i) Each Division shall be free to govern itself in such manner as it shall think fit, and for that purpose to make such Rules as it shall think expedient, and to repeal or alter the same, but no such Rule or repeal or alteration thereof shall come into operation until it has been submitted to and approved by the Council.
(ii) For the purposes of paragraph (e) (i) above the Rules of the Divisions (previously termed Sub-divisions) in force on the day on which the present Articles of Association came into force shall be taken as approved by the Council.
(iii) Notwithstanding anything contained in the Rules of the Division approved according to paragraph (e) (ii) above, such Rules shall be construed in conjunction with the relevant Articles and By-Laws of the Association. In the case ofvariance or conflict between the Rules of the Division and the Articles and By-Laws of the Association the provisions of the Articles and By-Laws of the Association shall prevail.
(f) Every Division shall furnish to the Council in the month of February each year a report of its proceedings during the previous year together with a statement showing the names and addresses of all its Members and such other particulars as the Council may require.
AUSTRALASIAN MEDICAL PUBLISHING COMPANY LIMITED
17. The representatives of the Branch on the Australasian Medical Publishing Limited will be those members of the Branch Council elected to represent the Branch on the Federal Council from time to time.
EXPENSES OF REPRESENTATIVES
18. The Honorary Treasurer of the Branch may pay to any Member representing the Branch on the Council, National Conference,or Federal Council, such travelling and other out-of-pocket expenses necessarily incurred in going to, attending and returning from any meeting of such Council or Conference as the Council may direct.
PRINTING AND DISTRIBUTION OF BY-LAWS
19. (a) These By-Laws shall be printed and a copy sent to each Member. Whenever a resolution to make, alter, or repeal a By-Law is passed and approved by the Branch, if necessary it shall be printed in full and a copy sent to each Member.
(b) Every new Member enrolled shall be supplied with a copy of the By-Laws with all additions and alterations in force.
CONFIDENTIAL COMMUNICATIONS BETWEEN THE ASSOCIATION AND ITS MEMBERS
20. Except with the express authority of the Council in writing no Member shall publish or be a party to publishing in any newspaper or otherwise any communication between him or any other Member and the Association or the Council or a Committee thereof whether such communication be in regard to any matter under consideration by or submitted for the consideration of the Association or the Council or a Committee thereof or any Rule, Minute, decision or proceedings of the Association or the Council or a Committee thereof or any other like matter. Provided that it shall not be necessary to obtain such authority in respect of any such publication in The Medical Journal of Australia or any other newspaper, journal or magazine approved for the purpose by resolution of the Council.
ETHICAL MATTERS
The Branch By-Laws in Ethical Matters are based on the principles elaborated in the "Code of Ethics" approved by the Federal Assembly of the Australian Medical Association in l964.
This code and these Branch By-Laws are designed to provide a standard whereby the doctor may be guided in his dealings with the public, his patients, and his colleagues. If any Member has an Ethical problem not covered by these publications or is in doubt about their interpretation he is urged to seek advice from the Branch Council. In any case of conflict between the "Code of ethics" and these Branch By-Laws, the Australian Medical Association By-Laws shall prevail. (A.M.A. Article 43 (b), see Appendix A) The order in which these By-Laws are set out is similar to the "Code of Ethics" to which the marginal numbers refer.
DOCTOR AND PRACTICE
LOCUM TENENS.
21. No Member shall employ as Locum Tenens Members of the profession who are not eligible for membership of the Australian Medical Association.
22 (a) No Member shall commence any form of private practice in an area where he has acted as a Locum Tenens within five years without a written consent obtained either from the practitioner whose substitute he has been or from the personal representatives of that practitioner or his successor PROVIDED that the Branch Council may at any time by resolution declare that this provision shall not apply in any case where owing to lapse of time or for any other reason the Branch Council shall be of opinion that it should not apply. The period of time during which this restriction shall apply will be related to the period of time spent in practice with principal or partners and this may be considered when a reference is made.
(b) In the event of negotiations for the purchase of a practice, in part or in whole, or another practitioner failing, the proposing purchaser shall not commence practice in the area of the practice proposed to be purchased without the written consent of the practitioner desiring to sell or his personal representatives or his successor PROVIDED that if in any case it shall appear to the Branch Council that the practitioner desiring to sell or his personal representatives have not dealt fairly in the negotiations with the proposing purchaser the Branch Council may by resolution declare that the provisions of this paragraph shall not apply in that case.
23. Any application to the Branch Council for a suspension of By-Law 22 in any particular case may be referred by the Branch Council to the Ethics and Professional Conduct Committee for inquiry and report.
ADVERTISEMENT
24. (a) No Member shall be a party to the appearance of a notice of his professional life in the public press.
(b) No Member shall insert any advertisement relating to his profession or the practice thereof beyond an announcement of change of address or absence from or commencement or resumption of practice.
(i) An announcement of "change of address" shall take the following form:
"Dr (or 'Mr') A.B. has changed his address from ...................to.................
(ii) An announcement of "commencement of practice" shall take the following form: "Dr. (or 'Mr') A.B. has commenced practice at ........................"
(iii) An announcement of "resumption of practice" shall take the following form: "Dr. (or 'Mr') A.B. has resumed practice at ....................................".
(iv) An announcement of "absence from practice" shall take the following form: "Dr. (or 'Mr") A.B. shall be absent from his practice from ....................... until ............." Every such advertisement shall be "run on" without spacing and without display. The type shall be that ordinary used for articles and not larger than that used for the leading articles of the newspaper in which it is inserted. No more space shall be given to the advertisement than that required for printing the same. The name shall be in the same type as the rest of the advertisement. Letters or abbreviations or words indicating medical, surgical or other qualifications shall not be added, nor the name of any qualifying body or university or college. Nor shall any specialty be mentioned except at the commencement of practice and then only if the practitioner confines himself exclusively to the practice of that particular specialty. Hours of consultation shall not be stated, nor telephone numbers if in the telephone directory.
(v) The number of insertions of any such advertisement shall not exceed six, and such insertions shall not extend beyond one week. Advertisements relating to absence from practice, or resumption of practice, shall together not exceed six insertions relating to any one period of absence. Advertisements shall be on consecutive days for each occasion.
(vi) Such advertisements shall only be inserted in papers published at the place of practice, and not in more than two such papers.
(vii) In an announcement of change of address or commencement of practice, the words "in partnership with Dr......................" or "as assistant to Dr..................." may be added where appropriate.
(viii) Change of address shall mean change of place of practice within Tasmania. Where a practitioner changes his address from one place to another int he same town, no more than one such change in any one year shall be advertised unless with the permission of the Council. Commencement of practice shall mean commencement of practice in Tasmania.
Resumption of practice shall mean resumption of practice after an absence therefrom of not less than two weeks.
25. No Member shall permit or be a party to the publication of his name in any "Return Thanks" notice in a newspaper.
26. No Member shall be a party whether on payment of subscription or otherwise, to the appearance of his name in a "Local Hanging-Card Directory" or other similar directory to be displayed for advertisement purposes: nor shall he permit the posting of his name in any workshop or other public place.
27. (a) No Member shall issue or distribute any card or circular or handbill indicating that he has commenced practice or (except to his bona fide patients) that he has resumed practice or changed his address.
(b) No Member shall attach or allow his name to be attached to labels on medicine bottles.
28. No Member shall canvass or employ any agent or canvasser for the purpose of obtaining patients, or shall sanction or be associated with or employed by those who sanction such employment.
29. Except in strict accordance with the terms of an invitation to apply for appointment as member of the Honorary Staff or as Medical Officer, whether honorary or salaried, of a Public Hospital or other Charitable Institution, or as Medical Officer of a Friendly Society or other similar position, or for appointment to any medical office in the Public Service of the Commonwealth of Australia or a State thereof, no Member shall issue or distribute any testimonials, cards, circulars or handbills indicating that he is an applicant for appointment to such position, provided that testimonials may be sent to the members of any board with whom the appointment actually rests.
CONSULTING ROOMS AT CHEMISTS' SHOPS
30. Except with the express sanction of the Branch Council no Member shall have a consulting room with entry common to a chemist's shop or Friendly Society Dispensary. This shall not apply where only one medical practitioner is in practice in the district. In the event of one or more medical practitioners commencing practice in the district he shall not be asked to make any move within six months.
CERTIFICATES
3l. No Member shall sign or give under his name or authority any certificate notification or report or document of a similar character knowing it to be untrue misleading or improper in any respect.
32. No Member shall knowingly enable an unqualified or unregistered person whether described as an assistant or otherwise to attend treat or perform any operation upon a patient in respect of any matter requiring professional discretion or skill or to issue or procure the issue of any certificate notification report or other document of a kindred character, or otherwise to engage in professional practice as if the said person were a duly qualified and registered practitioner.
33. Notwithstanding anything contained in any of thse By-Laws a practitioner who is employed in a professional capacity by any public authority or by any hospital or charitable institution (and whether in an honorary capacity or not) shall be at liberty to furnish to any person authorised by such authority hospital or institution any pathological or other report for the proper performance of his duties that it may be necessary for him to furnish
MEDICAL APPOINTMENTS
34. No Member shall accept or hold an appointment as medical officer to:
(i) Any medical aid association or institution or hospital which touts or canvasses for patients, except as a medical referee.
(ii) Any such association or institution or hospital carried on by laymen for their own profit except as a medical referee.
(iii) Any society or institution or hospital in a State if such society or institution or hospital has been declared by the Branch of the Australian Medical Association in the State to be inimical to the interests of the profession.
(iv) Any Friendly Society or Friendly Society Institute or similar body that offers per capita payment or rates less than those set out in an agreement approved by the Branch Council.
35. (a) No members shall be associated with or participate in the conduct of an Incorporated Medical Practice, either as a shareholder or a director or an employee or a consultant, unless there is for the time being in force a current Certificate of Approval in respect of that Incorporated Medical Practice issued by the Medical Council of Tasmania and unless such Incorporated Medical Practice is conducted in conformity with the provisions of these By-Laws.
35. (b) Each and every member who is a member shareholder or director of a company carrying on an Incorporated Medical Practice shall for the purpose of these By-Laws be deemed to have personally committed or done or omitted to do all acts matters and things which the company shall commit do or omit to do and which the commission or doing or omitting to do by a member is regulated controlled or prohibited by these By-Laws or by the ethical rulings of the Association or the Code of Ethics of the Australian Medical Association and for the purpose of these By-Laws each and every such member shall be personally responsible and answerable for any such act matter or thing committed or done or omitted to be done by such company to the same extent as if he has personally committed done or omitted to do such act matter or thing.
35. (c) Every Incorporated Medical Practice shall conduct its affairs in conformity with the Memorandum and Articles of Association By-Laws and ethical rulings of the Association and the Code of Ethics of the Australian Medical Association as if it were an individual member of the Association.
CONTRACT ATTENDANCE - FRIENDLY SOCIETY LODGES
36. (a) No Member shall become a medical officer under any Agreement expressed or implied of any Friendly Society Lodge unless such Lodge be formally recognised by the Branch Council as one to which Members should be medical officers.
(b) No Member shall accept appointment as Medical Officer of any Association of Friendly Societies, or of any combination of any Friendly Society Lodges or of any other body or organisation whether incorporated or unincorporated, or make any contract for medical attendance with any such Association or combination body or organisation except with the sanction of the Branch Council.
(c) The remuneration for attendance on members of Friendly Society Lodges shall be determined on a fee-for-service basis, and shall not be by any other method without consent of the Branch Council.
THE DOCTOR AND HIS COLLEAGUES.
CONSULTATION
37. The following rules are to be observed in relation to consultations:
(a) In this By-Law a practitioner consulted is the practitioner who, with the acquiescence of the practitioner already in attendance, examines a patient under this practitioner's care, and, either at a meeting of the two practitioners or by correspondence, co-operates in the diagnosis, prognosis and treatment of the case. The term "consultation" means such a co-operation between practitioners.
(b) It is the duty of an attending practitioner to accept the opportunity of consultation in obscure and difficult cases, or when consultation is desired by the patient or by persons authorised to act on the patient's behalf.
(c) In the following circumstances it is especially desirable that the attending practitioner, while dealing with an emergency when this exists, should endeavour to secure consultation with a colleague:
(i) When the propriety of performing an operation or of adopting some course of treatment which may involve considerable risk to the life of the patient or may permanently prejudice his activities or capacities has to be considered, and particularly when the condition which it is sought to relieve by his treatment is not itself dangerous to life.
(ii) When operative procedures involving the death of the foetus or of an unborn child are contemplated; especially if labour has not commenced.
(iii) When continued administration of any drug scheduled under the Dangerous Drugs Acts is deemed desirable in the case of a person who does not need it otherwise than for the relief of symptoms of addiction.
(iv) When there is reason to suspect that the patient
(l) has been subject to an illegal operation, or
(2) is the victim of criminal poisoning.
(d) The attending practitioner should nominate the practitioner to be consulted and advise accordingly,but he ought not to refuse to meet a practitioner selected by the patient or the patient's representative, although he is entitled, if such is his opinion, to urge that the practitioner selected has not the qualifications or the experience which the particular demands of the case require.
(e) The arrangements for the consultation should be made by the attending practitioner.
(f) In all communications between the two parties written or verbal the medical practitioner should be quite clear and definite as to what he wishes the specialist to do: (a) whether to give an opinion only or (b) to take over the case absolutely, but the responsibility of the choice of an anaesthetist and an assistant must lie solely with the specialist and this applies also to the immediate post-operative treatment. In the event of the case being handed over absolutely the specialist is at liberty to carry out the whole treatment. As a matter of courtesy the specialist should notify the practitioner of his proposed treatment operative or otherwise and should in most cases request the co-operation of the practitioner.
(g) When a patient is sent for an opinion only the specialist should notify the practitioner and this completes the specialist's connection with the case. Should the patient return to the specialist without the knowledge of the practitioner the specialist should inform the latter and receive his approval to the transfer of the patient if the latter so desires. (By-Law 40 (b) also applies).
(h) The following procedure in consultations conducted at the patient's residence is generally adopted and should be observed, unless in any particular instance there is substantial reason for departing from it.
(l) The attending practitioner should consider the advisability of ascertaining in advance the amount of the fee to be paid to the practitioner consulted and should inform the patient or his representatives.
(2) All parties to a consultation should be punctual, and if attending practitioner fails to keep the appointment, the practitioner consulted, after a reasonable time, may examine the patient and should communicate his conclusion in writing and in a sealed envelope to the attending practitioner.
(3) On entering the room of the patient theattending practitioner should precede the practitioner consulted, and after the examination the attending practitioner should be the last to leave the room.
(4) The diagnosis, prognosis and treatment should be discussed by the practitioner consulted and the attending practitioner in private.
(5) The opinion on the case and the treatment as agreed should be communicated to the patient or the patient's friends by the practitioner consulted in the presence of the attending practitioner.
(6) Should the practitioner consulted and the attending practitioner hold divergent views, either on the diagnosis or on the tratment of the case, and the attending practitioner be unwilling to pursue the course of action advised by the practitioner consulted, this difference of opinion should be communicated to the patient or his representatives by the practitioner consulted and the attending practitioner jointly and the patient or his representatives shall then be advised either to choose one or other of the suggested alternatives or to obtain further professional advice.
(i) If for any reason the practitioner consulted and the attending practitioner cannot examine the patient together, the attending practitioner should send to the practitioner consulted a brief history of the case. After examining the patient the practitioner consulted shall forward his opinion, together with any advice as to treatment, to the attending practitioner, and he may give to the patient or to the patient's friends such information as he judges appropriate to the position.
(j) The arrangements for any further consultation (if required) shall be left to the initiative of the attending practitioner.
(k) The practitioner consulted shall not attempt to secure for himself the care of a patient seen in consultation. It is his duty to avoid any word or action which might disturb the confidence of the patient in the attending practitioner. The practitioner consulted shall not communicate with the patient or the patient's friends subsequent to the consultation except through the attending practitioner. (By-Law 42 (a) also refers)
(l) It is the duty of the attending practitioner loyally to carry out the measures agreed at or subsequent to the consultation; he should refrain from making any radical alteration in these measures, except upon urgent grounds or after adequate trial, and should carefully avoid any remarks or suggestion which would seem to disparage the skill or judgement of the practitioner consulted.
POSITION OF PRACTITIONER (MEDICAL EXAMINER) EXAMINING ON BEHALF OF INTERESTED PERSONS A PATIENT UNDER THE CARE OF ANOTHER PRACTITIONER (MEDICAL ATTENDANT)
38. (a) Except as hereinafter mentioned the medical examiner should give the medical attendant such notice of the date, time and purpose of his examination as will afford reasonable opportunity for the medical attendant to be present should he or the patient so desire. The exceptions are:
(i) When circumstances justify a surprise visit.
(ii) When circumstances necessitate a visit within a period which does not afford time for notification.
(iii) When the medical examiner, after due enquiry made, has no information as to whether the patient is under medical care.
(b) Where the medical examiner has availed himself of any of the above exceptions, it shall be his duty to inform the medical attendant, if any, as soon as possible of the fact of his visit and the reason for his action.
(c) The medical attendant must not put any unnecessary difficulties in the way of fixing a time convenient to both practitioners.
(d) If the medical attendant fails to appear at the time agreed upon, the medical examiner may proceed with his examination forthwith.
(e) The medical examiner must not without the consent of the medical attendant do anything in the course of his examination which involves active interference with the treatment of the case.
(f) Where the medical attendant fails to communicate with the medical examiner the medical examiner shall at his discretion and subject to the consent of the patient make any examination he may consider necessary.
(g) The medical examiner must not make any comments to the patient which are of the nature of criticisms of or reflections upon the treatment nor must he express without the concurrence of the medical attendant any opinion to the patient as to the aetiology diagnosis or prognosis of the case. His duty is strictly confined to examining in such matters as are necessary for the purpose of his report and reporting to his employer, and to his employer only, his conclusions from such examination.
(h) If the medical examiner finds it necessary to report to his employer that any modification in the treatment which is being carried out is in his opinion necessary to the more rapid recovery of the case he shall in the first instance so inform the medical attendant.
(i) Any report supplied at the request of a patient or his Solicitor shall be considered as the exclusive property of the person who made the request and the contents of such report shall be treated as a professional secret and shall not be disclosed to any other party.
(j) Where a separate report on a patient is required provision should be made for a consultation with thepatient's previous medical attendant, but the report must be treated in manner provided in paragraph (i) of this By-Law.
(k) Patients with compensable injury or illness must be accorded the same degree of professional confidence as any privately presenting patient:
(i) No report or certificate should be given to any employer, insurer or legal practitioner or other third party without the informed consent of the compensable patient at the time of treatment or thereafter;
(ii) In the case of a deceased compensable patient the informed consent of the executor/executrix or next of kin must be obtained for any such professional disclosure.
(l) A specialist to whom a compensable patient has been referred by the attending doctor has an obligation to respect the confidences of such patient. He must not furnish information to an employer, insurer, legal practitioner or third party without receiving the patient's consent to do so preferably through the doctor of first attendance.
CHANGE OF MEDICAL ATTENDANT: SUPERCESSION
One of the basic principles of these rules of behaviour towards one's colleagues is that a Member shall behave towards another Member as he would like to himself be treated. The application of this principle particularly applies when a patient who has been, or is being, treated by a Member wishes to change his medical attendant. The patient's right to choose or dismiss his medical attendant must be recognised, as also the Doctor's right to accept or reject a patient (except in an emergency) is recognised.
The following rules have been formulated as guide to the correct procedure in commonly arising circumstances, and should be observed by Members as closely as possible.
39. When a Member is asked for advice or treatment by a patient and has reason to believe that the patient is already under medical care and that the request is made without the knowledge of the attending practitioner, it is the duty of the practitioner so approached to urge the patient to permit him to communicate with the attending practitioner. Should the patient refuse the proposal, the practitioner is at liberty to examine the patient and to tell the patient his findings and conclusions but he should not accept the patient for treatment, except in consultation, or as a substitute in cases of emergency or other special circumstances or when the attending practitioner has relinquished the case, or has been dismissed in due form.
40. (a) A medical practitioner, before superseding another in the care of a patient whom he believes to be receiving treatment from that practitioner, shall satisfy himself that the other practitioner has been duly informed by those responsible for the patient that his services are no longer required.
(b) No Member shall continue in attendance on or subsequently attend a patient for that particular illness after seeing him in consultation with the regular attending practitioner, or as a substitute for the latter, unless with the permission of such practitioner.
(c) No Member who has attended patients for another medical man during the latter's temporary absence or incapacity shall continue attending such patients for that particular illness after the return of the absent medical man unless with the latter's consent either given to the patient or to the medical man who has temporarily attended such patient.
4l. Death Vacancies: Members shall protect as far as lies in their power the practice of a deceased Member for a period of six months after the date of re-sale of the practice and shall discourage as far as possible patients endeavouring to transfer from the deceased's practice.
Note: The principle underlying this By-Law is that the deceased estate should have the right to sell the goodwill of the practice and the purchaser should be protected as he cannot secure a personal introduction.
42. (a) When a practitioner, in whatever form of practice, has reason to believe that a patient who requests him to give advice or treatment is not under the care of another practitioner, he is at liberty to accede to his request, unless he has previously seen the patient in consultation with a colleague or when acting as deputy for a colleague.In either of these events he should urge the patient to seek the advice of the previous medical attendant, but if the patient declines to do so the practitioner may accept the patient and communicate with the previous medical attendant at his discretion.
(b) When a practitioner in whatever form of practice is requested by a patient or patient's representatives to visit him for the purpose of giving advice or treatment, and has reason to believe that another practitioner is in attendance, he shall inform the patient that he cannot attend without the presence or consent of the practitioner actually in charge of the case. If the attending practitioner, after being duly informed, declines to meet the practitioner who has been invited, and the patient or his representatives persist in the request in full knowledge of this fact, or if the attending practitioner retires from the case the other practitioner may provide the medical care required.
HOLIDAY PRACTICE
43. (a) A Member while visiting a district on holidays is not debarred from attending an emergency case provided he hands it over to the resident practitioner at the earliest opportunity.
(b) Where no resident practitioner is available, the visiting Member is entitled to attend patients if requested, and should charge such fees as he would charge if he were treating the case in his own district.
(c) Where there is a reputable medical practitioner established in, or within a reasonable distance of the holiday resort the visiting Member shall not attend a patient except as acting for the resident practitioner. If, after this, his opinion is further desired, he should only act as consultant, and charge consultant fees.
(d) A reputable medical practitioner, established outside a ten-mile radius, who makes regular visits at short intervals to a holiday resort for professional purposes, shall be regarded as being a resident practitioner.
(e) Where the visiting Member and the patient already stand in the relation of doctor and patient in the Member's own district the above provisions shall not apply. If, however, attendance is given under such conditions, the Member shall charge such fee as he would if attending the case in his own district. If the local practitioner is already in attendance the visiting Member shall only act as consultant.
(f) Where the visiting Member is compelled to undertake a case which appears likely to require prolonged attention, arrangements shall be made for the transfer of the patient to the usual medical attendant, if there be one, at the earliest opportunity.
(g) Where a Member is summoned from his own district to attend a patient at a holiday resort, full mileage rates should be added to the fee. (
h) No Member shall give gratuitous advice at holiday resorts except under such circumstances as he would give it in his own district.
BY-LAWS GOVERNING THE CONDUCT OF MEMBERS IN REGARD TO FEES IN PRIVATE PRACTICE
44. No Member shall divide fees with or give commissions to or receive commissions from any other medical practitioner or any chemist optician insurance agent or other lay man except that a Member who is a director, shareholder or employee of a company which carries on an Incorporated Medical Practice - the business of providing medical or surgical services to the members of the public - may be paid and receive fees or salary from such company for his services as such director employee or dividends or interest in respect of his interest in the company as a shareholder thereof or on account of money owing to him by the company.
45. (a) It is unethical for a surgeon to tender or for a practitioner to accept from a surgeon an assistant's or an anaesthetist's fee which is in excess of the usual fee for such services.
(b) It is unethical for a surgeon to tender or for a practitioner to accept from the surgeon a fee for the after-treatment of a surgical operation case which is in excess of the usual fee for the services rendered and in any case without the patient being aware of such fee being received. (See 46 (e).)
46. (a) No Member, except in the case of emergency, shall perform a surgical operation on any patient unless the patient, or the person legally responsible for him, has consented in the choice made of the Member to perform the operation.
(b) Having been selected by the patient, or the person legally responsible to him for the operation the Member is also responsible for, and shall conduct the post-operative treatment, except by special arrangement with the patient or the person legally responsible for him.
(c) The Member shall tender his account for such surgical operation and post-operative treatment direct to the patient or to the person legally responsible for him.
(d) The Member must not accept his fee for surgical operation from the practitioner in charge of the patient, unless the Member forwards a receipt for the fee received direct to the patient, or to the person legally responsible for him.
(e) If circumstances compel the Member operating to delegate the post-operative treatment of a patient to the referring practitioner, the latter must collect the fee for so doing direct from the patient, or from the person legally responsible for him. The Member operating must not pay the practitioner in charge of the patient a fee for conducting the post-operative treatment.
(f) Separate accounts for the assistant, anaesthetist, or for other necessary services, e.g., the pathologist, must be sent to the patient, or to the person legally responsible for him, or the Member operating must state on his account form the exact amounts due for these services.
INTRAPROFESSIONAL RESTRICTION
47. (a) Where any member shall have been expelled he shall not be called in consultation or accorded professional recognition in any other form by any Member until it shall have been otherwise decided by the Branch Council, except as laid down in By-Law 49.
(b) Notification of the fact of such expulsion shall be given to Members. (By-Law 9 also refers).
(c)
(i) Where any medical practitioner shall have accepted and/or shall have continued to hold any appointment contrary to the declared views of the Branch or on terms or conditions opposed to those approved by the branch or shall have accepted the position of Medical Officer to any Society declared by the Branch Council to be inimical to the interests of the medical profession, or shall have continued to hold any lodge at annual fees per member below those approved of by the Council of the branch after one notification by the Branch Council, he shall, unless the circumstances are proved to the satisfaction of the Branch Council to have been exceptional if a Member of the Branch beliable to expulsion and whether a Member of the Branch or not shall be ineligible for membership of the Branch and continue to be so ineligible for a period of five years from the date of his ceasing to hold such appointment, and shall not be met in consultation or accorded professional recognition in any other form by any Member of the Branch during the period of his disqualification for membership. Provided always that where circumstances have arisen since the commencement of the period of ineligibility for membership which shall in the opinion of the Branch Council justify the shortening or the immediate termination of such period by the Branch Council, or where it has since been ascertained by the Branch Council that the original circumstances were exceptional, the Branch Council shall have power at its discretion to shorten or terminate the same.
(ii) Where any medical practitioner shall have accepted and continued to hold any such appointment as aforesaid and by so doing has been expelled or has become ineligible formembership of the Branch, notification thereof shall be given to Members by the issue to them from time to time as the Branch Council shall determine of a list marked "Confidential" of names and addresses (if known considered necessary) of such medical practitioners.
(d) Where any Member whether by inadvertence or otherwise shall contrary to any By-Law or Resolution of the Branch have consulted with or otherwise extended professional recognition to any such medical practitioner, or visited any patient under his care, he shall forthwith in writing furnish the Branch Council with a statement of the facts and circumstances of such consultation, visit or act of professional recognition.
(e) Notwithstanding any By-Law or Resolution of the Branch to the contrary no Member shall be prevented from holding professional intercourse with any other qualified medical practitioner to such limited extent as may be necessary on the ground of humanity or on the ground of public necessity; the term "public necessity" as herein used being deemed to include an occasion when a Member, acting on behalf of and in protection of the interests of the crown, a Government Department, an employer or any other person, medically examines any person in the presence of another practitioner acting in an opposite interest. Provided that, whenever such intercourse involves professional recognition in contravention of any By-Law or Resolution of the Branch the Member holding the same shall forthwith in writing furnish the Branch Council with a statement of the facts and circumstances thereof.
(f) Notwithstanding any By-Law or Resolution of the Branch to the contrary, no Member shall be prevented from holding professional intercourse with any other medical practitioner to such limited extent as may be necessary for the due performance by him of his duty as an officer in the Naval or Military or Civil Service of the Commonwealth of Australia or the Public Service of the State or as a medical officer of a Government Department or a medical officer of the Government Railways or medical officer of health and in any such case there shall be no obligation for such Member to furnish the Branch Council with a statement of the facts and circumstances thereof.
(g) No Member shall meet professionally in consultation, as assistant, or in any other way any practitioner who shall have been declared by resolution of the Branch Council to have violatedany of the By-Laws or Resolutions of the Branch relating to professional conduct or the generally accepted principles of professional conduct or to have been guilty of conduct in contravention of any By-Law or Resolution of the Branch relating to professional conduct or of conduct which is detrimental to the honour and interests of the Branch or the Association or of the medical profession and for which he shall have been censured by the Branch Council PROVIDED that if the Branch Council shall after adoption of a Resolution as hereinbefore mentioned subsequently resolve that in the opinion of the Branch Council the conduct of the practitioner is no longer deserving of censure notice of such subsequent Resolution shall forthwith be sent to every member of the Branch and thereupon the provisions of this paragraph shall cease to apply to such practitioner.
48. No Member shall refuse to meet another Member of the Australian Medical Association in consultation without adequate reason which he is prepared to substantiate to the Branch Council if so required.
49. Notwithstanding anything contained in By-Law 17 it shall not be construed to conflict with Section 30(3) and (4) of the Tasmania Medical Act of 1959 as amended which states:
(3) "No registered medical practitioner in active practice without reasonable excuse, the proof of which shall be upon him, shall fail or refuse to consult with, or render professional assistance, in consultation to, any other registered medical practitioner seeking his advice or assistance." Penalty $500.
(4) "For the purpose of sub-section (3) of this Section, a resolution or bylaw, or any company, association, or body of persons, whether verbal or written, does not constitute a reasonable excuse."
(Note "The operative word in the above is "seeking" so that unless the expelled member seeks medical co-operation the provision of the Branch By-Laws apply).
THE DOCTOR AND OTHER PROFESSIONS
50. A member shall not refer a patient to any person other than a legally qualified registered medical practitioner unless the treatment for which the reference is made is carried out under his guidance and/or supervision, and he is assured of that person's professional competence.
51. No Member shall administer an anaesthetic for any person other than a legally qualified medical practitioner or a dentist registered under the Dentists Act.
THE DOCTOR AND COMMERCIAL UNDERTAKINGS
52. No Member shall be financially interested in or hold patients for any surgical appliance or medicine.
53. No Member shall use any cypher prescription or secret formula in prescribing or make it a condition that any medicine or appliance prescribed by him shall be dispensed or supplied by any particular firm company or individual, but nothing herein contained shall be deemed to prohibit the use of special formulae in Hospital or Contract prescribing.
54. (a) No Member shall accept financial aid or material sponsorship from any drug company to attend an interstate or overseas medical meeting except in the following circumstances :
(i) provided the appointment of the Member is made with the approval of a recognised body interested in postgraduate education which negotiates with the drug company on behalf of its Member.
(ii) provided that in the case of Members in fulltime employment, offers of financial assistance should be made through the employing authority who would then determine the desirability (or not) of accepting the assistance offered.
(b) No Member shall solicit financial and/or material sponsorship from a commercial medical under-taking in a private capacity for his own benefit.
TRADE ADVERTISEMENTS
55. (a) No Member engaged in medical practice shall give any testimonial or laudatory certificate, whether for publication or not, of any medical or surgical appliance or apparatus, or dressing, or any drug or medicinal preparation, or any cosmetic, or any trade article.
(b) No Member engaged in medical practice shall give any report for publication upon any medical or surgical appliance or any drug or medicinal preparation or any substance capable of being advertised as possessing therapeutic properties to any proprietor or distributor or vendor thereof.
(c) No Member engaged in medical practice shall sanction the quotation of any extract from any publication by him dealing with any medical or surgical subject for the purposes of trade advertisement.
(d) Clinical trials of new pharmaceutical agents are an exception to this By-Law and Members' conduct will confirm to the conditions laid down in paragraph ll.2.2. of the 'Code of Ethics'.
THE DOCTOR AND THE GENERAL PUBLIC PAPERS READ AT MEETINGS OF THE BRANCH.
56. Papers read at meetings of the Branch shall be the property of the branch. The Branch Council shall have the right to publish such papers with or without an account of the discussion thereupon.The author also shall have the right to submit his paper for publication to any recognised medical journal. No paper read before the Branch may be published in the lay press without the direct sanction of the Branch Council. Authors of papers shall have the right of revising proofs of the papers before publication.
PRESS REPORTS
57. Medical Press: Reports of proceedings may be sent to any medical paper for publication but shall not be so dealt with except through the Branch Council.
Public Press: Reports of proceedings may be sent to the public press for publication but shall not be so dealt with except by special direction of the Branch Council.
INTERVIEWS WITH NEWSPAPER REPORTERS
58. No interview with a newspaper reporter on subjects relating to diseases and their treatment shall be given by any Member engaged in active medical or surgical practice, except with the following express stipulation, viz:
(a) That the name of the medical practitioner interviewed shall not be published, nor his identity revealed in any report published of the interview, except with the approval of the Association or of an authorised organisation.
(b) That, if possible, a printed proof of the report proposed to be published shall be submitted to the medical practitioner interviewed for approval,
(c) That the person interviewed should not imply that he has superior ability in the diagnosis or treatment of disease.
PUBLIC LECTURES,BROADCASTING AND TELEVISION
59. (a) No public broadcast or television appearance or address or lecture delivered to a lay audience shall be given on any professional subject by any member engaged in private medical or surgical practice except:
(i) On the occasion of a public gathering organised by the medical profession, or
(ii) Under the auspices of the Australian Medical Association or of this Branch, the Department of Public health, the Australasian Trained Nurses' Association, The Royal Society or any other Scientific Society recognised as such by the Council of the Branch of which the lecturer is a member, or
(iii) Express sanction from the delivery of the same shall have been received from the Branch Council who may delegate such authority, or from an authorised Organisation approved by the Association. No correspondence should be entered into by a Doctor with the Lay Public on clinical matters arising out of a Broadcast by him.
Provided always that this By-Law shall not apply to the regular prescribed course of instruction given to Ambulance Classes of the St John Ambulance Brigade or other kindred bodies or to instruction given by medical officers of the Navy, Army, or Air Force in the course of their duty.
(b) Provided permission has been obtained from the Council and the script approved by that Council there is no objection to the name of the speaker being announced at any public address delivered on television or radio or at any public lecture.
Note: Members who give such public addresses or lectures must take all care to avoid creating any impression of exclusive personal skill because of the possibility of such matters being reported in the lay press. Authorised organisations referred to above are any College, Society or Medical Organisation which successfully applies to the Australian Medical Association, through the Ethics Committee, to be so designate within the meaning of the Regulations. The latter will be laid down by the Association who will thus maintain control of the Standards of Ethical Behaviour.
60. No Member shall write or contribute to or be in any way associated with any column in any newspaper or other lay publication in whichanswers to correspondents on medical questions are print.
61. (a) Books, monographs, pamphlets or literary articles on medical subjects shall not be advertised in the lay press or exhibited for sale or other purposes in shops other than booksellers' sho