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.

 

 

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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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Casual Receptionist Position at PartridgeGP

Professional

 

Comprehensive

 

Empowering

 

Great General Practice Care

 

Better for our patients, our staff and GPs, and our practice – that’s the PartridgeGP way 👍🏼

 

Find out more here

http://ow.ly/w3uf50uLZ6w

#glenelggp #glenelgsouth #glenelgriver #glenelgnorth #jettyrdglenelg #glenelgbeach #glenelgcountry #glenelgsa #glenelgjetty #glenelgin #glenelg #PartridgeGP #MedicalPractice #Glenelg #AdelaideGP #justagp #generalpractice #medicalcentre #health #wellness #primarycare #better #medical #amazingopportunity #receptionist #joinourteam

Pregabalin and Neuropathic Pain. Beware.

Associations between gabapentinoids and suicidal behaviour, unintentional overdoses, injuries, road traffic incidents, and violent crime: population based cohort study in Sweden | The BMJ

Summarised in the tweet below. Should we treat neuropathic pain differently to other pain and even if we do, does pregabalin have a role?

https://www.bmj.com/content/365/bmj.l2147

Chat to your GP

Book here

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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Winter is coming – What does Croup sound like?

Croup

 

It sounds like this

(click to listen ^)

 

See PartridgeGP here

 

(thanks to the Royal Childrens Hospital, Melbourne)

 

Croup is a condition caused by a viral infection. The virus leads to swelling of the voice box (larynx) and windpipe (trachea). This swelling makes the airway narrower, so it is harder to breathe. Children with croup develop a harsh, barking cough and may make a noisy, high-pitched sound when they breathe in (stridor).

 

Croup mostly affects children between six months and five years old, but it can affect older children. Some children get croup several times.

 

Croup can get worse quickly. If your child is having problems breathing, seek urgent medical attention.

 

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Signs and symptoms of croup

 

  • Croup usually begins like a normal cold, e.g. fever, runny nose and cough.
  • Your child’s cough will change to become harsh and barking, and might sound like a seal.
  • Your child’s voice may be hoarse.
  • When your child breathes in, they may make a squeaky, high pitched noise, which is called stridor.
  • In severe cases of croup, the skin between the child’s ribs or under their neck may suck in when they breathe, and they may struggle to breathe.

 

Croup often begins without warning, in the middle of the night. The symptoms are often worse at night, and are at their worst on the second or third night of the illness. The signs and symptoms of croup may last for three to four days; however, a cough may linger for up to three weeks. The stridor should not persist.

Care at home

A mild attack of croup is when your child has the harsh, barking cough but does not have stridor when they are calm and settled, and they are not struggling to breathe. No medical treatment is necessary for mild croup, or the virus that has caused it. You can usually manage mild croup at home with the following care:

 

  • Keep your child calm, as breathing is often more difficult when upset – the more a child is distressed, the worse their symptoms can become. Try sitting quietly, reading a book, or watching TV.
  • If your child has a fever and is irritable, you may give them paracetamol or ibuprofen. See our fact sheet Pain relief for children.
  • Croup often becomes worse at night. Many children will be more settled if someone stays with them.

 

Steam and humidifiers are no longer recommended as treatment. There is no evidence to suggest they are beneficial.

When to see PartridgeGP

 

You should call an ambulance immediately if:

  • your child is struggling to breathe
  • your child looks very sick and becomes pale and drowsy
  • your child’s lips are blue in colour
  • your child starts to drool or can’t swallow.

You should see Your GP if:

  • your child is under six months old and has signs and symptoms of croup
  • your child’s breastbone or the skin between their ribs sucks when they breathe in
  • your child has stridor when at rest
  • your child is very distressed or their symptoms are getting worse
  • you are worried for any other reason.

 

If your child has mild croup that lasts for more than four days, or if stridor returns after your child has recovered from croup, take them to see a GP.

 

 

 

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Your GP may prescribe steroids (e.g. prednisolone or dexamethasone) to be taken by mouth. The steroids help reduce the swelling in the airway, which will make breathing easier. Antibiotics do not work on viruses and are not given to children with croup.

If your child has severe croup, they will need to stay in hospital, where they will be closely watched.

How is croup spread?

Croup is a reaction to a virus, not a virus in itself, so children cannot ‘catch’ or spread croup. However, the virus that has caused the croup can be spread easily from person to person by coughing and sneezing. If your child has croup, you should keep them away from school and child care while they are unwell so that they don’t spread the virus that is causing the croup. Regularly washing hands thoroughly can help prevent the spread of viruses.

 

Key points to remember

  • No treatment is necessary for mild croup, or the virus that has caused it.
  • Croup usually gets better in three to four days.
  • Try to calm your child, as breathing is often more difficult when your child is upset.
  • Croup can get worse quickly. If your child is having problems breathing, seek urgent medical assistance.
  • In a severe attack of croup, your child needs to be watched closely in a hospital.

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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