Emergency thoughts from PartridgeGP

 

Thoughts on our Emergency Departments

 

Introduction by Croakey: Emergency departments are often thought of as the canary in the coalmine, but what do we do when the canary is clearly in distress?

Dr Simon Judkins, President of the Australasian College for Emergency Medicine (ACEM), started a much-needed conversation about Australia’s overburdened emergency departments back in September with a post to coincide with national RUOK Day.

In response, an anonymous emergency clinician penned this searing, heartfelt account of the very real pressures ED workers face every day. If you haven’t yet read it, we’d very much encourage you to do so.

While only one person’s story, it resonated with and captured the experience of many, reflecting a system underresourced and overwhelmed, according to Judkins, who wrote an open letter in reply — below — calling for courageous reform.


Simon Judkins writes:

Dear Anonymous,

You are not anonymous to me; I know you.

 

Read on…

 

Meet
Treat
Street

 

You don’t need to meet them if they are being dealt with in primary care and have better access to non GP specialist outpatients

 

You treat them better with specialist oversight and so FACEMS 24/7 should be funded to provide that

 

You can’t street them unless you have access to inpatient beds (better use of inpatient beds – yes, care awaiting placement and inappropriate admissions are still things) and better clinical handover to primary care GPs will reduce bounce back and improve patient care

 

The funding model needs to reflect this
Because hospital EDs are a volume model at the moment for funding so there really isn’t the institutional drive to reduce demand

 

A recurring thought at GP19 was the embedding of GPwSI in non GP specialist hospital areas to improve these areas – works in Queensland but I think SA have spent all the $ on bricks and mortar.

 

GPs can help!

 

For patients – book in here to see Your GP at PartridgeGP

 

 

 

 

And for other doctors – including our great colleagues in hospitals and their Emergency Departments…we can help too! Clinical Handover is awesome – we can all do better!

 

gpdu clinical handover

 

GPDU Clinical Handover infographic – final for dissemination

 

 

Secrets Healthy Men know with PartridgeGP and Coles

Tim Ferriss asked a question in his book Tribe of Mentors.

 

 

‘If you could put a message on a billboard, to be seen by millions (or billions) of people, what would you say?’

 

 

I was lucky enough to have an opportunity to answer this in real life when a journalist from Coles contacted me. They wanted to know a GPs views on Men’s Health. The article we produced is here (and reproduced below). This is in the Coles Health and Beauty magazine – they have printed 500,000 copies of this! What was that one message I wanted to get across?

 

 

dr nick tellis coles health and beauty the money quote
The Message!

 

 

 

 

Our practice, PartridgeGP, our GPs, and the rest of our team are here for you. No billboards needed – just book in for an appointment 😎

 

 

 

 

 

 

 

 

 

 

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The Road to being a GP with PartridgeGP

Just check out this picture of what someone goes through to become a GP. Wow!

(thanks to Dr Jared Dart for finding this)

 

 

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PartridgeGP is an accredited General Practice and is further accredited by our Regional General Practice Training Provider GPEx.

 

 

 

This means that the GPs at PartridgeGP 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.

 

 

 

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Teaching Practice of the Year

 

 

All of our doctors here at PartridgeGP are fully qualified ‘Fellows’ (or are studying towards this) 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). 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 PartridgeGP with our excellent Practice Nurses. We all uphold the highest standards of privacy, confidentiality, professionalism, and clinical practice.

 

 

 

Some of our recent GP registrars

Dr Katherine Astill

Dr Clare Mackillop

 

 

 

 

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Dr Gareth Boucher

 

Dr Nici Williams

 

Dr David Hooper

 

Dr Penny Massy-Westropp

 

Dr Monika Moy

 

Dr Clare Mackillop

 

Dr Katherine Astill

 

Dr Jen Becker

 

Dr Nick Mouktaroudis

 

Dr Nick Tellis

 

Welcoming Dr Katherine Astill back to PartridgeGP

Dr Katherine Astill Partridge Street General Practice new female registrar

 

 

Dr Katherine Astill commenced her specialist General Practice training with PartridgeGP in August 2017 and has returned to work with us at our new site in August 2019! She graduated with a Bachelor of Physiotherapy from the University of South Australia in 2009 and furthered her education with a Bachelor of Medicine and Surgery from Deakin University in 2013. After holding positions with the Muscular Dystrophy Association and the Women’s and Children’s Hospital, she decided to specialise in General Practice, with a special interest in Women’s and Children’s Health completing her Diploma of Child Health in 2016.

Dr Katherine has a passion for holistic care and preventative health.

 

 

 

She loves the local Glenelg area and is keen to hit the ground running with the rest of our Great Team here at PartridgeGP!

 

 

 

 

 

 

 

 

PartridgeGP is an accredited General Practice and is further accredited by our Regional General Practice Training Provider GPEx.

 

 

 

This means that the GPs at PartridgeGP 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.

 

 

 

img_1954
Teaching Practice of the Year

 

 

All of our doctors here at PartridgeGP are fully qualified ‘Fellows’ (or are studying towards this) 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). 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 PartridgeGP with our excellent Practice Nurses. We all uphold the highest standards of privacy, confidentiality, professionalism, and clinical practice.

 

 

 

Dr Katherine Astill is a valuable member of our growing Clinical Team!

 

 

 

 

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Dr Gareth Boucher

 

Dr Nici Williams

 

Dr David Hooper

 

Dr Penny Massy-Westropp

 

Dr Monika Moy

 

Dr Clare Mackillop

 

Dr Katherine Astill

 

Dr Jen Becker

 

Dr Nick Mouktaroudis

 

Dr Nick Tellis

 

Welcoming Dr Nici Williams to PartridgeGP

PartridgeGP is proud to welcome Dr Nici Williams to our team!

 

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Born in South Africa, Dr Nici graduated from the University of New South Wales in 2010. She has worked in Indigenous Communities in Cairns, and spent two years on Thursday Island in the Torres Straits where she obtained her Fellowship of the RACGP as well as Fellowship in Advanced Rural General Practice. Following a further year practicing medicine in rural NSW, she and her family relocated permanently to Adelaide in 2018.

Dr Nici also works at the Refugee Health Service, and other interests include dermatology, contraception (including Implanon) and optimising health. She is accredited for Obstetric Shared Care in SA.

 

 

We welcome Dr Nici to Our Team here at PartridgeGP to be Your GP!

 

 

She is available to help you with all of your General Practice needs from mid April 2019 and you can book your appointment with her conveniently online right here – or call our friendly reception team on 0882953200.

 

 

Dr Nici Williams - your gp

 

All of our doctors here at PartridgeGP are fully qualified ‘Fellows’ (or are studying towards this) 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). 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 PartridgeGP with our excellent Practice Nurses. We all uphold the highest standards of privacy, confidentiality, professionalism, and clinical practice.

 

 

IMG_20190321_202633

 

DR PENNY MASSY-WESTROPP

dr penny massy westropp - your gp

DR MONIKA MOY

dr monika moy- your gp

DR JEN BECKER

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DR DAVID HOOPER

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Men’s Health Week 2019 at PartridgeGP 

June is Men’s Health Month and June 10-16, 2019 is Men’s Health Week at PartridgeGP. Men are important and Health is important so let’s look at some issues in Men’s Health.

 

 

 

Do you look after yourself like you do your car?

 

 

From the Men’s Health Week website:

 

A boy born in Australia in 2010 has a life expectancy of 78.0 years while a baby girl born at the same time could expect to live to 82.3 years old. Right from the start, boys suffer more illness, more accidents and die earlier than their female counterparts.
Men take their own lives at four times the rate of women (that’s five men a day, on average). Accidents, cancer and heart disease all account for the majority of male deaths.
Seven leading causes are common to both males and females, although only Ischaemic heart disease shares the same ranking in both sexes (1st). Malignant neoplasms of prostate (6th), Malignant neoplasms of lymphoid, haematopoietic and related tissue (7th) and Intentional self-harm (10th) are only represented within the male top 10 causes.

 

 

Smoking, Skin Cancer, Suicide, and So Much Alcohol

 

 

The above figures are taken from the Australian Bureau of Statistics. Furthermore, there are specific populations of marginalised men with far worse health statistics. These marginalised groups include Aboriginal and Torres Strait Islander men, refugees, men in prison or newly released from prison and men of low socioeconomic standing.

 

Men’s Health Week has a direct focus on the health impacts of men’s and boys’ environments. It serves to ask two questions:

 

What factors in men’s and boy’s environments contribute to the status of male health as indicated in the table above?

How can we turn that around and create positive environments in men’s and boy’s lives?

 

 

We’re going to ask and answer those questions this week. Stay with us online and in person – we’ve got your back!

 

 

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GET A GREAT GP!

(Here’s some we made earlier)

 

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The flu shot, explained – NPS MedicineWise and PartridgeGP

It’s a big flu season in Australia and especially in South Australia.

There are five groups where the evidence is clear that Immunisation against influenza is a good idea:

Pregnant women

Children aged 6 months to 5 years

People with complex and chronic disease

Aboriginal and Torres Strait Islanders

People over 65 years old

See Your GP – the flu shot is one good idea, having a regular GP that You feel comfortable with and see as regularly as you need to is another.

PartridgeGP is here to help – book here!

Read more below:

https://www.nps.org.au/consumers/the-flu-shot-explained

Melanoma May – and Uveal (Ocular) Melanoma at PartridgeGP

Marissa Wreford writes (thank you!), and Dr Ian Kamerman from Northwest Health passes on:

 

May is Uveal Melanoma month.

 

Each year approximately 7 out of one million individuals are diagnosed with some form of Uveal (Ocular) Melanoma. Around half of those people will develop metastatic disease (Stage IV). Whilst average survival time has increased from 6 months to three years since my diagnosis in 2017, metastatic uveal melanoma still has a 5 year survival rate of just 15%.

 

 

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The best chance of survival is early detection. This May do something for your health, and the health of your eyes – a very underrated, yet essential, sensory organ.

 

 

So remember to go and get a dilated eye exam. A standard eye checkup with your optometrist may not show small changes, which when found early can make a big difference. Don’t take your eyes for granted. Don’t think that wearing sunglasses or eating “organic foods” and general healthy choices will spare you or someone you love from this disease. Research regarding lifestyle risks are still to this day inconclusive. Your best chance is, and likely always will be, early detection.

 

So this May ask specifically for a DILATED eye exam. Then continue to do this every May.

 

Use Ocular Melanoma Month as a reminder to give your eyes some love.

 

And for the rest of your skin:

 

Dr Nick Mouktaroudis is a GP and co-owner at PartridgeGP. He’s passionate about health education, has a special interest in Skin, and a lot of expertise to share when it comes to helping people cope with and improve Skin Conditions. With our recent move we thought back to how we started Skin Cancer Surgery and Medicine at PartridgeGP and the story is below.

 

 

Imagine a perfect day in a perfect General Practice. Focus on a busy yet unrushed GP, consulting with another valued patient. The flow of the consult is perfect, the communication great, everything is as it should be. 
 
We have to imagine days like this because they very rarely occur. Flow is fleeting and perfection is often aimed for and seldom reached. 
 
Going back to that consult, we can see that the GP is busy – but is definitely not unrushed. You can feel the pressure in the room as the patient seeks answers and closure and the GP senses the minutes ticking by. The consult comes to a close and both stand, the patient heading towards the door, the GP wishing them well, the patient’s hand is on the door and then. It happens. 
 
‘By the way Doc, what do you think of this?’
 
The GP turns away from the flashing screen and sees, across the room, a spot on the patients leg. 
 
Should we get the patient back at a later date? Offer reassurance we don’t feel confident giving?
 
Or, as the GP in this story does, do you reach for the dermatoscope, call the patient back, and look. There’s no such thing as a quick look and so the light comes out, the gel is applied, and a good thorough look is had. 
 
It’s an ugly duckling, a chaotic little mishmash of colours and globules. 
 
It would turn out to be a nasty – a nasty better appreciated in the pathologist’s dish than in the patients bloodstream.
 
A good result.
 
At the end of the day, the GP sat and wondered how this could be avoided in the future – how could we improve and be better. These challenges see us but we do not always see them.
 
This was our practice and so we had to change. 
 
Plan
Do 
Study
Act
 
Patient safety is paramount. We decided to solve for quality improvement and patient safety at the same time and made the decision to upskill one of our GPs, Dr Nick Mouktaroudis. He undertook multiple courses and extensive study in Primary Care Skin Cancer Medicine, Surgery, Therapeutics, and Dermatology. Following this we spent time and money upgrading our procedure facilities, equipment, and systems to support Dr Nick. We then allocated time for dedicated skin checks and adjusted our online booking and reception protocols. 
 
These were the first steps and in conjunction with our most recent AGPAL accreditation we have repeatedly run through this cycle, improving every time. We now have dedicated times for skin checks and skin cancer surgery, as well as protocols, systems, and education supporting Dr Nick and the other GPs in the practice. Patients enjoy seeing a GP they know and trust who can deliver appropriate care at a Primary Care level and price point. We receive great feedback from patients and local sub-specialists. It’s a clear win for patients, GPs, and our practice – and the mindset of continual quality improvement that we share with AGPAL was the way to get there. 
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What is a Skin Check?

 

 

A Skin Check is a Comprehensive Skin History and Examination which is done at PartridgeGP.

 

Your GP will ask you questions to assess the extent of Your risk/exposure to UV radiation and Your risk of solar related cancers.

 

They will examine you head to toe, examining the skin surface, focusing on any areas of concern (including the eyes, mouth, and anywhere else you may have noticed any spots, lumps, or bumps).

 

 

 

Are there any tools used for the Skin Check?

 

 

A proper examination needs proper equipment and we use handheld LED illumination with magnification as well as polarised light and clinical photography.

 

skin check dr nick mouktaroudis light

 

A dermatoscope is used to examine specific skin lesions. This is a particular type of handheld magnifying device designed to allow the experienced examiner to further assess skin lesions and determine whether they are suspicious or not.

 

 

 

Who should have a Skin Check?

 

 

We encourage all Australians over the age of 40 to have a Skin Check annually. Australians have one of the highest rates of skin cancers in the world.

 

 

Australians who have above average risks should be having Skin Checks before the age of 40 and sometimes more than annually.

 

 

You should have a Skin Check at any age if You are concerned about Your skin or particular skin lesions/areas.

 

 

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We ask You to identify any lesions of concern prior to the Skin Check wherever possible.

 

 

These may include new lesions that You have noticed or longstanding lesions that may be changing in some way or that You are concerned about. If You are worried – Ask!

 

Skin cancer check risk dr Nick Mouktaroudis

Risk factors for skin cancer

 

 

 

People at higher risk of skin cancer are those who:

 

have previously had a skin cancer and/or have a family history of skin cancer

have a large number of moles on their skin

have a skin type that is sensitive to ultraviolet (UV) radiation and burns easily

have a history of severe/blistering sunburns

spend lots of time outdoors, unprotected, during their lifetime

actively tan or use solariums or sunlamps

work outdoors

 

 

 

 

Does My GP take photos of My Skin?

 

 

 

During a skin check at PartridgeGP Your GP will ask Your Specific Consent to take photos if they are concerned or want to make note of a particular skin lesion.

 

Photographs are useful as an adjunct to description of the lesion and act as a reference to position and comparison if required.

 

The photos will be uploaded onto Your Private Medical Record at PartridgeGP.

 

 

 

What if My GP finds something?

 

 

 

This will depend on what Your GP has found.

 

If they are concerned about a particular skin lesion they may suggest a biopsy to clarify the diagnosis.

 

A biopsy is a surgical procedure during which they take an appropriate sample of tissue from the lesion of concern and send it to a pathologist for review.

 

Generally pigmented lesions (coloured spots), will be biopsied in their entirety whereas non pigmented skin lesions may be sampled partially if the lesion is too large to sample in its entirety.

 

The results of the pathology report will guide further treatment.

 

Your GP may elect to treat without a biopsy if they are confident of the diagnosis.

 

This may include freezing/cauterising a lesion, cutting it out (excising), or offering topical treatments such as creams.

 

Biopsies are scheduled in the PartridgeGP theatre and our Practice Nurse will assist Your GP.

 

 

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What do I wear for a Skin Check?

 

 

 

Comfortable clothing.

 

Your GP will ask to examine you down to your underwear.

 

A sheet or towel will be provided for you to preserve your comfort and dignity.

 

A chaperone (Our Practice Nurse) is always offered.

 

Please avoid makeup or nail polish as the Skin Check involves the face and skin under the nails.

 

 

 

 

How long is a Skin Check?

 

 

Allow half an hour for Your GP to perform a thorough history and examination.

 

 

 

 

Do I need to see My GP or should I see a dermatologist?

 

 

GPs are Primary Care Physicians on the front line of Skin Cancer detection.

 

All GPs can check your skin, though not all GPs have formal training or a specific interest in skin cancer medicine and dermatoscopy.

 

Dr Nick Mouktaroudis has trained extensively in General Practice, Skin Cancer Medicine and Surgery, and has formal qualifications in Skin Cancer Medicine.

 

Dermatologists are non-GP specialists in all skin conditions including Skin Cancer Medicine and Surgery although some will focus on other skin conditions.

 

 

 

 

 

Can I do more than a Skin Check?

 

 

 

You can Reduce Your risk by:

Avoid unnecessary exposure to the sun

Wearing sunscreen regularly and on all sun exposed areas.

Wear Hats and Sunglasses when appropriate.

Be aware of Your skin – both You and Your partner can check at Home.

Having a yearly DILATED eye exam with Your Optometrist (anywhere that sells glasses!)

 

 

 

 

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Book Your Skin Check Right Here.

 

 

 

Need more information? Leave a comment or see us in person. We’re Here to Help!

 

 

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You can see any of our Great GPs right here:

 

 

Dr Gareth Boucher

Dr David Hooper

Dr Clare MacKillop

Dr Jen Becker

Dr Penny Massy-Westropp

Dr Monika Moy

Dr Abby Mudford

Dr Katherine Astill

Dr Nick Mouktaroudis

Dr Nick Tellis

 

 

 

Welcoming Dr Jen Becker to PartridgeGP

PartridgeGP is proud to welcome Dr Jen Becker to our team!

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Dr Jen completed her medical degree at Flinders University in 2012 and since then has worked in hospitals across Adelaide and beyond. She most recently completed a 6 month term in public health in Darwin.

Her medical interests include sexual health, women’s health, and adolescent health. Outside medicine, her energies go into cooking, travel, and spending time with family.

We welcome Dr Jen to Our Team here at PartridgeGP to be Your GP!

She is available to help you with all of your General Practice needs from mid April 2019 and you can book your appointment with her conveniently online right here – or call our friendly reception team on 0882953200.

All of our doctors here at PartridgeGP are fully qualified ‘Fellows’ (or are studying towards this) 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). 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 PartridgeGP with our excellent Practice Nurses. We all uphold the highest standards of privacy, confidentiality, professionalism, and clinical practice.

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DR NICK TELLIS

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Your Specialist In Life

DR NICK MOUKTAROUDIS

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DR GARETH BOUCHER

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DR PENNY MASSY-WESTROPP

dr penny massy westropp - your gp

DR MONIKA MOY

dr monika moy- your gp

DR ABBY MUDFORD

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DR JEN BECKER

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DR DAVID HOOPER

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