Dude, where’s my Outpatients?

Hi from South Australia! Summer has come! Our flagship hospital and one of the most expensive buildings in the Southern Hemisphere, the New Royal Adelaide Hospital (nRAH), came online in September 2017 after a 2 year wait.

 

 

nRAH New Royal Adelaide Hospital

 

 

 

Another big change to the South Australian Hospital System is that the Repatriation General Hospital is gone. Where did the subspeciality clinics go? See below!

 

 

Right Here!

 

arrow down

 

 

 

RGH Clinics – Quick Reference Guide as at November 2017

 

 

 

SALHN Outpatient Clinics Locations and Details

 

 

 

4th Generation Rehab Clinics

 

 

 

 

Bernie Cummins (see below) previously spoke to the Southern Regional GP Council about Outpatients Services in SA and she generously spoke to us again about how things will proceed over the coming months and years.

 

 

 

Here is some information she prepared.

 

 

 

 

royal adelaide hospital and nRAH and outpatients and health pathways

 

 

 

You can find further information right here.

 

 

gpdu.jpg

 

 

The good GP has a stewardship role in the Australian medical system and part of this is referring to subspecialist and hospital care. This is an important role and we don’t take it lightly. We want to do our best for our patients and help them get the care they deserve. One of the challenges is referring to public hospitals, where our referrals sometimes get ‘bounced’ back to us. In private practice, for the patient to receive a (Federal) Medicare Benefit (like when you see Your GP), the GP referral must be to a named provider (Dr Smith, Dr Jones, for example). When referring to a public hospital, there has historically been no Medicare rebate for the patient – public hospitals are funded by the State Governments and Medicare is funded by the Federal Government, and care is free at the point of service. This is changed recently, and public hospitals are now using Medicare funds to run their services. Therefore they now seek named referrals. But to who? It’s very hard to find out exactly which doctor will be seeing you, and so it’s hard to do a named referral, which may delay you being seen.

 

 

 

So, as a public service, we’re Here to Help! Bernie Cummins (Director of Nursing Statewide Outpatient Reform) has provided the following documents to help GPs and patients navigate this system and avoid the ‘named referral bounce’.

 

 

 

 

 

 

 

directive+medicare+billing+outpatients

 

 

 

medicare+directive+and+outpatient+private+practice

 

 

 

 

Good luck, and may the odds be ever in your favour!

 

 

 

img_8445-2

 

 

 

You can see any of our Great GPs right here:

 

 

Dr Gareth Boucher

 

 

Dr Penny Massy-Westropp

 

 

Dr Monika Moy

 

 

Dr Katherine Astill

 

 

Dr Nick Mouktaroudis

 

 

Dr Nick Tellis

 

 

The New Royal Adelaide, Ramping Up and Down, and Health Pathways PS: Where did the Repat go?

Hi from South Australia! Winter is here but change is coming. Our flagship hospital and one of the most expensive buildings in the Southern Hemisphere, the New Royal Adelaide Hospital (nRAH), is about to come online in September after a 2 year wait.

 

 

 

Another big change to the South Australian Hospital System is that the Repatriation General Hospital is gone. Where did the subspeciality clinics go? See below!

 

 

Right Here!

 

arrow down

 

RGH Clinics – Quick Reference Guide as at November 2017

 

 

 

Bernie Cummins (see below) previously spoke to the Southern Regional GP Council about Outpatients Services in SA and she generously spoke to us again about how things will proceed over the coming months and years.

 

 

 

Here is some information she prepared.

 

 

 

royal adelaide hospital and nRAH and outpatients and health pathways

 

 

 

You can find further information right here.

 

 

 

 

 

The good GP has a stewardship role in the Australian medical system and part of this is referring to subspecialist and hospital care. This is an important role and we don’t take it lightly. We want to do our best for our patients and help them get the care they deserve. One of the challenges is referring to public hospitals, where our referrals sometimes get ‘bounced’ back to us. In private practice, for the patient to receive a (Federal) Medicare Benefit (like when you see Your GP), the GP referral must be to a named provider (Dr Smith, Dr Jones, for example). When referring to a public hospital, there has historically been no Medicare rebate for the patient – public hospitals are funded by the State Governments and Medicare is funded by the Federal Government, and care is free at the point of service. This is changed recently, and public hospitals are now using Medicare funds to run their services. Therefore they now seek named referrals. But to who? It’s very hard to find out exactly which doctor will be seeing you, and so it’s hard to do a named referral, which may delay you being seen.

 

 

 

So, as a public service, we’re Here to Help! Bernie Cummins (Director of Nursing Statewide Outpatient Reform) has provided the following documents to help GPs and patients navigate this system and avoid the ‘named referral bounce’.

 

 

 

 

 

 

 

directive+medicare+billing+outpatients

 

 

 

medicare+directive+and+outpatient+private+practice

 

 

 

 

Good luck, and may the odds be ever in your favour!

 

 

 

img_8445-2

 

 

You can see any of our Great GPs right here:

 

 

Dr Gareth Boucher

 

 

Dr Penny Massy-Westropp

 

 

Dr Monika Moy

 

 

Dr Katherine Astill

 

 

Dr Nick Mouktaroudis

 

 

Dr Nick Tellis

 

 

Budget 2017 in Pictures

Politicians are going to politic.

What do GPs have to say about it?

Dr Ewen McPhee on behalf of the RDAA

Dr Bastian Seidel on behalf of the RACGP

 

 

 

 

So, in summary, it’s not great but we’re still Here to Help.

If you have ANY questions – See Your GP!

Our Team can Help You.

 

 

You can see any of our Great GPs right here:

Dr Nick Tellis

Dr Nick Mouktaroudis

Dr Ali Waddell

Dr Gareth Boucher

Dr Emmy Bauer

Named Outpatient Referrals in South Australia

The good GP has a stewardship role in the Australian medical system and part of this is referring to subspecialist and hospital care. This is an important role and we don’t take it lightly. We want to do our best for our patients and help them get the care they deserve. One of the challenges is referring to public hospitals, where our referrals sometimes get ‘bounced’ back to us. In private practice, for the patient to receive a (Federal) Medicare Benefit (like when you see Your GP), the GP referral must be to a named provider (Dr Smith, Dr Jones, for example). When referring to a public hospital, there has historically been no Medicare rebate for the patient – public hospitals are funded by the State Governments and Medicare is funded by the Federal Government, and care is free at the point of service. This is changed recently, and public hospitals are now using Medicare funds to run their services. Therefore they now seek named referrals. But to who? It’s very hard to find out exactly which doctor will be seeing you, and so it’s hard to do a named referral, which may delay you being seen.

 

 

So, as a public service, we’re Here to Help! Bernie Cummins (Director of Nursing Statewide Outpatient Reform) has provided the following documents to help GPs and patients navigate this system and avoid the ‘named referral bounce’.

 

 


 

directive+medicare+billing+outpatients

 

 

 

medicare+directive+and+outpatient+private+practice

 

 

 

Good luck, and may the odds be ever in your favour!

 

 

Feel free to email the Southern Regional GP Council for issues with named referrals – we will be happy to relay you concerns to the people and areas where the decisions are made

enquiries@srgpc.com.au

 

 

img_8445-2

 

You can see any of our Great GPs right here:

 

 

Dr Gareth Boucher

Dr Penny Massy-Westropp

Dr Monika Moy

 

Dr Katherine Astill

Dr Nick Mouktaroudis

Dr Nick Tellis

 

 

(Or BE one of our Great GPs right here!)

Happy Birthday Partridge Street General Practice!

Three years ago, Dr Nick Mouktaroudis and Dr Nick Tellis opened the doors of Partridge Street General Practice at Glenelg! 

In the Beginning

We’ve gone from strength to strength since then and we’re now well established in our own Health Precinct with Aspire Physiotherapy and Pilates next door. 

General Practice and So Much More

The future is bright as we continue to grow! Our Principal GPs are still here:

Your Specialist In Life
Dr Nick Mouktaroudis – for All Your General Practice Skin Needs

We are joined by:

Dr Gareth’s Cycle of Care
Dr Ali – for All Your Women’s, Kids, and Babies Health Needs
Dr Emmy Bauer – Part of the Team at Partridge Street General Practice

We’re providing great General Practice care including:

We’re providing great General Practice care including:

Team Care Needs A Great Team
Here to Help!

We’re Here to Help You – in 2017 and beyond. 

We look forward to seeing you soon!

Welcoming Dr Ali Waddell to Partridge Street General Practice!

Partridge Street General Practice is very happy to welcome Dr Ali Waddell to Our Team!

Dr Ali is one of our two Senior GP Registrars. She completed her undergraduate study at the University of Adelaide and went on to work in rural Victoria completing terms in Obstetrics, Gynaecology, and Emergency. Her experience even includes time in East Arnhem Land in the Northern Territory!

Dr Ali enjoys discussing General and Preventative Health, with a particular focus on Family Medicine, Women’s Health, and Paediatrics. Outside of this, she enjoys relaxing with family and friends and enjoying our beautiful beaches.

 

Partridge Street General Practice is an accredited General Practice and is further accredited by our Regional General Practice Training Provider GPEx and our local Medical School at Flinders University.

 

 

This means that the GPs at Partridge Street General Practice are teaching the Doctors and Medical Students who will be the future of medicine in Australia. It’s a big responsibility and a privilege we take very seriously.

 

 

Award Winning Responsibility!

 
All of our doctors here at Partridge Street General Practice are fully qualified ‘Fellows’ holding a specialist qualification with either the Royal Australian College of General Practitioners (FRACGP) or the Australian College of Rural and Remote Medicine (FACRRM) or both (3-4 years of full time study and 3 exams on top of an undergraduate university medical degree and supervised trainee ‘intern’ year in a hospital) or are studying towards these qualifications. This is our minimum specialist standard and we may have other qualifications and skills.

Our Fellows provide supervision and advice to our Registrars and you may find that they are called in to consult with the Registrar on your case. ‘Registrars’ are qualified doctors who have completed their hospital training and are now embarking on their General Practice training. Some may already have other qualifications in medical or other fields.

 

 

We also supervise and teach Medical Students from Flinders University. They are still studying to become doctors. All of us – Fellows, Registrars, and Medical Students – make up the Clinical Team here at Partridge Street General Practice with our excellent Practice Nurses. We all uphold the highest standards of privacy, confidentiality, professionalism, and clinical practice.

We look forward to having Dr Ali Waddell as part of our growing Clinical Team and sharing her General Practice training journey with us.

Welcoming Dr Gareth Boucher to Partridge Street General Practice

 

Partridge Street General Practice is very happy to have Dr Gareth Boucher with us long term.

 

img_0766-3

 

 

Dr Gareth completed his undergraduate medical studies in Auckland and all of his post-graduate training has been in Adelaide. His medical areas of interest include:

 

  • babies and kids (neonates and paediatrics)
  • emergency medicine,
  • chronic disease management
  • palliative care

 

Outside of work Dr Gareth enjoys cycling, skiing, and photography.

 

 

dr-gareth-boucher-cycling

 

He is a GP Palliative Shared Care Provider, as are Dr Tellis and Dr Mouktaroudis. We’ll let Dr Gareth explain this:

 

 

What is palliative care?

Palliative care is holistic care of people with life-limiting illnesses.  Holistic care means we focus on them, not their illness!

Their goals and ambitions

Their mental, physical, and spiritual well-being

Their symptoms

Their dignity

 

We provide care in the community and co-ordinate service providers. We support patients and their families to maintain quality of life and achieve the outcomes important to them.

The Team at Partridge Street General Practice is able to help you and your family with any Palliative Care needs.

 

 

Partridge Street General Practice is an accredited General Practice and is further accredited by our Regional General Practice Training Provider GPEx and our local Medical School at Flinders University.

 


This means that the GPs at Partridge Street General Practice are teaching the Doctors and Medical Students who will be the future of medicine in Australia. It’s a big responsibility and a privilege we take very seriously.

 

 

Award Winning Responsibility!

 

 

All of our doctors here at Partridge Street General Practice are fully qualified ‘Fellows’ holding a specialist qualification with either the Royal Australian College of General Practitioners (FRACGP) or the Australian College of Rural and Remote Medicine (FACRRM) or both (3-4 years of full time study and 3 exams on top of an undergraduate university medical degree and supervised trainee ‘intern’ year in a hospital) or are studying towards these qualifications. This is our minimum specialist standard and we may have other qualifications and skills.

 

 

Our Fellows provide supervision and advice to our Registrars and you may find that they are called in to consult with the Registrar on your case. ‘Registrars’ are qualified doctors who have completed their hospital training and are now embarking on their General Practice training. Some may already have other qualifications in medical or other fields.
We also supervise and teach Medical Students from Flinders University. They are still studying to become doctors. All of us – Fellows, Registrars, and Medical Students – make up the Clinical Team here at Partridge Street General Practice with our excellent Practice Nurses. We all uphold the highest standards of privacy, confidentiality, professionalism, and clinical practice.

 

 

Dr Gareth Boucher is a key part of our growing Clinical Team.

 

Dr Gareth Boucher

Dr Penny Massy-Westropp

Dr Monika Moy

Dr Katherine Astill

Dr Nick Mouktaroudis

Dr Nick Tellis

Driving. Dementia. Decisions. 

General Practice is the greatest vocation there is. Every day GPs are proud to use their skills and training to help their patients have better health and better lives. It’s incredibly rewarding for us and our patients (and the statistics!) show that it’s rewarding full stop.  

Recently, Dr Tim Senior answered the question ‘Do we even need Doctors?‘. He concluded that GPs ‘know what to do when we don’t know what to do. And I can’t think of any other profession we can say that about’. So let’s have a look at a topic where GPs have to make hard decisions when we don’t know what we have to do. 

Big Australia!

Australia has an aging population and Australia is big. Really big! Driving and Australia go together like Vegemite and Toast! What do we do when aging drivers see their GP and we make a diagnosis of Mild Cognitive Impairment or Dementia?

What are the GP’s responsibilities?

Here is the excellent Dr Genevieve Yates with a very personal and professional view on the matter. 

Here is another excellent video from Professor Joe Ibrahim. 

In South Australia we have clear(er) guidelines on Fitness to Drive, with Mandatory Reporting and the associated safeguards for GPs who report patients they believe to be impaired. It’s still a hard decision. For example, just look at Kate Swaffer who has been diagnosed with dementia. What would you do?

Tough Decisions

What would I do? I’m not sure. Every patient is different and that’s one of the reasons why General Practice is, as I said above, the best vocation in the world. GPs will keep learning every day of their professional lives to serve their patients better. My advice to patients is to See Your GP, your best source of information, advice, and support for all of those hard decisions, when you don’t know what to do. 

We’re Here to Help. 

Here to Help

NEW: We can now refer for sub-specialist driving assessments!

Superpowers and The new Advance Care Directives Act 2013 (SA)

photo

 

Just revisiting an old post after listening to a great podcast – ‘The Good GP‘. It got me thinking. We know that General Practice is a good thing and reduces hospitalization rates (and hence healthcare costs) – but how can we measure this in our own practices?

 

 

Professor Barbara Starfield’s work clearly demonstrates that countries with a strong GP-centred system have much better health outcomes than countries that don’t.

 

 

Maybe utilization of Advance Care Directives could be part of this?

 

 

Read on!

 

 

We have all wished for superpowers – I know I have! Flying, changing the past, and predicting the future would all be fantastic abilities to have. I can’t promise the ability to fly, nor can I give you last weeks winning Lotto numbers prior to last weeks draw. However, I can predict the future for you. At some point in the future, all of us will be unable to make decisions for ourselves. We may be unlucky enough to be in an accident, have a severe illness, or we may just be facing the final stages of a long life well lived, but the time will come. I was lucky enough to hear Dr Chris Moy speak eloquently on some changes to the law here in South Australia that will give all of us the power to have decisions made for us, according to our wishes, if we cannot express them at the time.

 

 

Why is this important?

 

 

This is why.

 

 

 

 

From SA Health:

 

From 1 July there will be a clear decision-making framework and new protections for health practitioners when they find themselves in the difficult position of trying to determine what someone in their care might want, at a time when their patient’s ability to make decisions is impaired.

 

 

Plan Ahead

The new Advance Care Directive Form replaces the existing Medical Power of Attorney, Anticipatory Direction and Enduring Power of Guardianship with a single Advance Care Directive Form (however any of these existing forms will continue to have legal effect post 1 July 2014).

The Advance Care Directive Form allows individuals to appoint substitute decision-makers and/or to clearly document their values, wishes and instructions with respect to their future health care, living arrangements and other personal matters.

 

 

Make the Decisions They would want!

 

 

You can find the form here:

 

 

And you can find some further information here:

Or you can complete it online here:

 

Use your new power wisely!

 

 

Remember, if you have any questions, ask Your GP!

 

 

 

Dr Gareth Boucher

Dr Penny Massy-Westropp

Dr Monika Moy

Dr Katherine Astill

Dr Nick Mouktaroudis

Dr Nick Tellis

 

 

We can Help

 

UPDATE:

From David Coluccio of Senexus Aged Care Solutions!

Hi there,
http://www.linkedin.com/pulse/two-small-pieces-paper-guaranteed-save-your-family-time-coluccio 
Kind regards, David

UPDATE 2:

What are the costs of aged care?

Read here and any questions? Partridge Street General Practice are Here.

UPDATE 3:

Some further reading on end of life care!

 

 

 

And there’s more…

 

 

Most nursing home residents want CPR if their heart stops in the belief they’ll have a good outcome, a national survey reveals.

While survival rates after cardiac arrest are as low as 5% for older people receiving CPR, a survey of more than 2000 nursing home residents found 44% believed they had a good chance of recovering.

“This view is perhaps not surprising given that opinions about the likely outcomes from CPR are often informed by television medical dramas,” said researchers from Monash University.

The misplaced perceptions likely explained why 53% of residents expressed a desire to receive CPR in the event of cardiac arrest, they added.

“These findings highlight the need for older people to be better informed about cardiopulmonary resuscitation, including a clear understanding of what is involved … and a realistic perception of outcomes,” they suggested.

The researchers said the wide gap between expectations and reality also showed the need for novel approaches to end-of life planning in nursing homes.

A new ‘Goals of Care’ model had been developed to replace the old ‘Not For Resuscitation’ orders, they noted.

Under this system, the doctor could assign a patient to curative, palliative or terminal phases of care, based on an assessment of their likely treatment outcomes.

“This transfers the technical medical decision-making responsibility to a physician, who can work with the preferences of the patient or resident, but has an understanding of how likely it is for victim to achieve their previous health state,” the authors explained.

Participatory healthcare has only just begun

Communication has always been central to good General Practice and a good General Practitioner is always learning. We adopt new medications and procedures, we see what we can do better, we engage in reflective practice. Social Media is communication in the 21st century!

 

 

cropped-partridge-street-general-practice-gps.jpeg

 

 

Of course, face to face consultation is what we do most – so here we are!

 

 

You can see any of our Great GPs right here:

Dr Gareth Boucher

Dr Penny Massy-Westropp

Dr Monika Moy

Dr Katherine Astill

Dr Nick Mouktaroudis

Dr Nick Tellis

Doctor's bag

Participatory healthcare has only just begun Image: pixabay.com

Imagine you’re at a friend’s party in you neighbourhood. You recognise a few of your patients. As you join the conversation you continuously blurt out phrases like: “Make sure you vaccinate your kids,” “Our practice has opened a skin clinic; it is important to get an annual skin check,” and “Here’s a copy of our latest newsletter.” When one of your patients tries to start a friendly conversation you say: “Sorry, I don’t befriend patients,” and you walk away to chat with a colleague.

You would make a complete fool of yourself.

Still, that’s how many health practitioners behave online. We often use our professional websites and social media accounts as promotional channels and we’re told not to accept patient friend requests on Facebook. When receiving positive feedback from our patients we have to be careful not to share or re-tweet it as this could be interpreted as…

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