Make Everything an Adventure

Great thoughts Terry 👍🏼

Terry The Tourist

Although we are blessed in Australia with a truly great outdoors, when other factors come into play such as bad weather or lack of means to drive to a beach or similar, children have a wonderful way of being quiet and calm one moment and the next being as animated as a Tasmanian Devil (think the Disney cartoon kind). They also appear to take to, and welcome routine and sometimes practicality.

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What the FACRRM with Dr David Hooper at Partridge Street General Practice

 

David completed his nursing and medical degrees at Flinders in 2010. He subsequently spent 4 years in Darwin, Hervey Bay, and Port Lincoln completing his fellowship in rural and remote general practice. He spends 1 week each month as an emergency physician in Broken Hill. He’s married to Kerri and has 2 boys, Aiden aged 9 and Mason aged 11. In his spare time he enjoys marathon running (very slowly) and silver smithing.

 

Dr David is a Fellow of the Australian College of Rural and Remote Medicine, which is the other qualification that fully qualified General Practitioners in Australia can have. ACRRM defines a General Practitioner as the doctor with core responsibility for providing comprehensive and continuing medical care to individuals, families and the broader community. Competent to provide the greater part of medical care, the general practitioner can deliver services in the ambulatory care setting, the home, hospital, long-term residential care facilities or by electronic means – wherever and however services are needed by the patient.

 

We’re very happy to have Dr David with us as part of the PartridgeGP team and you can book in to see him right here.

 

Our team – here for You!

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Dr David Hooper

Dr Nick Tellis

 

Your Specialist In Life

Dr Nick Mouktaroudis

 

dr nick mouktaroudis at Partridge Street General Practice

Dr Gareth Boucher

 

dr gareth boucher

 

Dr Penny Massy-Westropp

 

 

Dr Penny Massy-Westropp

Dr Monika Moy

 

 

Dr Monika Moy

 

Dr Abby Mudford

 

dr abby mudford at Partridge Street General Practice3

Dr Chrissy Psevdos

 

dr chrissy psevdos at Partridge Street General Practice

 

Dr Katherine Astill

(on Maternity Leave from August 2018)

 

Dr Katherine Astill 1

 

 

join the team

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Our GPs at Partridge Street General Practice

Our team – here for You!

20180920_082754_0001
Dr David Hooper

 

 

Dr Nick Tellis

 

Your Specialist In Life

Dr Nick Mouktaroudis

 

dr nick mouktaroudis at Partridge Street General Practice

Dr Gareth Boucher

 

dr gareth boucher

 

Dr Penny Massy-Westropp

 

 

Dr Penny Massy-Westropp

Dr Monika Moy

 

 

Dr Monika Moy

 

Dr Abby Mudford

 

dr abby mudford at Partridge Street General Practice3

Dr Chrissy Psevdos

 

dr chrissy psevdos at Partridge Street General Practice

 

Dr Katherine Astill

(on Maternity Leave from August 2018)

 

Dr Katherine Astill 1

 

 

join the team

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Why do we charge a gap?

 

There has been a change in Canberra. Is an election coming?

If you suffer from premature election, you may feel the need for better healthcare. Primary care consistently delivers better bang for your buck – whether via the tax system or from your own pocket. Sometimes there is a gap – read on and watch the video.

 

 

Bulk Billing.

 

 

Medicare.

 

 

It’s important to us at Partridge Street General Practice that our valued patients know why we charge a gap fee.

 

 

Here’s a video by the excellent Dr Edwin Kruys that sums it up.

 

 

 

If you still have questions, come and say hi!

 

 

Our team – here for You!

Dr Nick Tellis

Your Specialist In Life

Dr Nick Mouktaroudis

dr nick mouktaroudis at Partridge Street General Practice

Dr Gareth Boucher

dr gareth boucher

Dr Penny Massy-Westropp

Dr Penny Massy-Westropp

Dr Monika Moy

Dr Monika Moy

Dr Abby Mudford

dr abby mudford at Partridge Street General Practice3

Dr Chrissy Psevdos

dr chrissy psevdos at Partridge Street General Practice

Dr Katherine Astill

(on Maternity Leave from August 2018)

Dr Katherine Astill 1

join the team

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Are Medically Prescribed Opioids Killing Australians?

In 1996 Oxycontin a drug more powerful than Heroin hit the medical marketplace. It was touted as the cure for any pain, without addiction and without risk. Drug Companies have made many millions from this drug, at the cost of many deaths.
In 2018 we face an evolving crisis following America down a slippery slope, that will cost us our relatives, parents, sons, and daughters if we don’t change.
Partridge Street General Practice is proud to be a low prescriber of opioids, narcotics, and other medications that have NOT been shown to be effective and safe. We will be happy to discuss better options with you right here.

 

Our team – here for You!

Dr Nick Tellis

 

Your Specialist In Life

Dr Nick Mouktaroudis

 

dr nick mouktaroudis at Partridge Street General Practice

Dr Gareth Boucher

 

dr gareth boucher

 

Dr Penny Massy-Westropp

 

 

Dr Penny Massy-Westropp

Dr Monika Moy

 

 

Dr Monika Moy

 

Dr Abby Mudford

 

dr abby mudford at Partridge Street General Practice3

Dr Chrissy Psevdos

 

dr chrissy psevdos at Partridge Street General Practice

 

Dr Katherine Astill

(on Maternity Leave from August 2018)

 

Dr Katherine Astill 1

 

 

join the team

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Do You Even Aged Care?

Last night on the 730 Report we saw several GPs make the point that fewer GPs are providing care to elderly Australians in Nursing Homes and other Aged Care facilities.

See Here

 

TRACY BOWDEN: Dr Joseph is a strong believer in continuity of care.

DR PETER JOSEPH: For patients, they come in and they don’t have to explain things to you, that happened years ago, because you know it.
You learn what’s going on in the family and how that affects their health.
You can also pick subtle changes.

 

What are the solutions?

Dr Stephen Dick suggests the following:

 

The service is not viable financially and is attached with a burden of being on call 24/7, and having to deal with untrained staff triaging patients who are
quite sick with chronic diseases.

The fix:

1. GPs to operate on a salaried basis to service nursing homes, including a callout fee. The FFS model is broken, utterly, utterly broken, when it comes to aged care.


2. Legislated nurse to patient ratios – both RN to patient and carer to patient ratios.


3. Nursing homes to provide an imprest of basic medications, such as antibiotics and opioids, for after hours issues.


4. Pharmacies to be contracted to provide medications for the residents from a nationally standardised medication chart on a capitated basis – NO MORE OWING SCRIPTS.


5. Get an accreditor with teeth to do spot inspections and severe fines for companies that flout the rules. First offence – $50,000 fine. Second offence – $200,000 fine, resident fees non-payable and the CEO of the responsible corporation placed under house arrest until rectified. Third offence – Home shut down, bonds repaid in full to residents within 30 days, and residents to stay bond-free when and if the facility reopens.I guarantee that if a hospital suddenly had to find 80-odd hospital beds they’d find a solution quick smart.


6. Diets to be individualised and supervised by a dietitian and speech pathologist.


7. Responsibility for the nursing home to provide access to physio, OT, speech, podiatry, optometry in addition to DT.


8. Homes to have a standardised kit out of medical equipment, such as a diagnostic set, ECG machine, local anaesthetic and suture material, biopsy sets, and a room with a printer and wireless access to a network so that we can attend without having to bring every. Little. Piece. of equipment.

 

 

I suggest some simple rules for Aged Care facilities:

 

advice while Dr Nick Tellis is away

 

 

What are your thoughts?

 

Our team – here for You!

Dr Nick Tellis

 

Your Specialist In Life

Dr Nick Mouktaroudis

 

dr nick mouktaroudis at Partridge Street General Practice

Dr Gareth Boucher

 

dr gareth boucher

 

Dr Penny Massy-Westropp

 

 

Dr Penny Massy-Westropp

Dr Monika Moy

 

 

Dr Monika Moy

 

Dr Abby Mudford

 

dr abby mudford at Partridge Street General Practice3

Dr Chrissy Psevdos

 

dr chrissy psevdos at Partridge Street General Practice

 

Dr Katherine Astill

(on Maternity Leave from August 2018)

 

Dr Katherine Astill 1

 

 

join the team

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The Psychology of Money (Social Determinants of Health)

When it comes to what makes us sick, approximately 75% of our health issues happen to our patients and us before they or we engage the health care system. The Social Determinants of Health come into play here:

Social and cultural determinants of health

these are defined by the World Health Organization (WHO) as:

The poor health of the poor, the social gradient in health within countries, and the marked health inequities between countries are caused by the unequal distribution of power, income, goods, and services, globally and nationally, the consequent unfairness in the immediate, visible circumstances of people’s lives – their access to health care, schools, and education, their conditions of work and leisure, their homes, communities, towns, or cities – and their chances of leading a flourishing life. This unequal distribution of health-damaging experiences is not in any sense a ‘natural’ phenomenon. Together, the structural determinants and conditions of daily life constitute the social determinants of health

There is a lot online about combating these – here I’m going to take a different approach. Welcome to Morgan Housel and the Psychology of Money – happy reading!

health and money

Take it away Morgan!

Part 1 (of 20)…

Earned success and deserved failure fallacy: A tendency to underestimate the role of luck and risk, and a failure to recognize that luck and risk are different sides of the same coin.

I like to ask people, “What do you want to know about investing that we can’t know?”

It’s not a practical question. So few people ask it. But it forces anyone you ask to think about what they intuitively think is true but don’t spend much time trying to answer because it’s futile.

Years ago I asked economist Robert Shiller the question. He answered, “The exact role of luck in successful outcomes.”

I love that, because no one thinks luck doesn’t play a role in financial success. But since it’s hard to quantify luck, and rude to suggest people’s success is owed to luck, the default stance is often to implicitly ignore luck as a factor. If I say, “There are a billion investors in the world. By sheer chance, would you expect 100 of them to become billionaires predominately off luck?” You would reply, “Of course.” But then if I ask you to name those investors – to their face – you will back down. That’s the problem.

The same goes for failure. Did failed businesses not try hard enough? Were bad investments not thought through well enough? Are wayward careers the product of laziness?

In some parts, yes. Of course. But how much? It’s so hard to know. And when it’s hard to know we default to the extremes of assuming failures are predominantly caused by mistakes. Which itself is a mistake.

People’s lives are a reflection of the experiences they’ve had and the people they’ve met, a lot of which are driven by luck, accident, and chance. The line between bold and reckless is thinner than people think, and you cannot believe in risk without believing in luck, because they are two sides of the same coin. They are both the simple idea that sometimes things happen that influence outcomes more than effort alone can achieve.

After my son was born I wrote him a letter:

Some people are born into families that encourage education; others are against it. Some are born into flourishing economies encouraging of entrepreneurship; others are born into war and destitution. I want you to be successful, and I want you to earn it. But realize that not all success is due to hard work, and not all poverty is due to laziness. Keep this in mind when judging people, including yourself.

Read on!

Our team – here for You!

Dr Nick Tellis

Your Specialist In Life

Dr Nick Mouktaroudis

dr nick mouktaroudis at Partridge Street General Practice

Dr Gareth Boucher

dr gareth boucher

Dr Penny Massy-Westropp

Dr Penny Massy-Westropp

Dr Monika Moy

Dr Monika Moy

Dr Abby Mudford

dr abby mudford at Partridge Street General Practice3

Dr Chrissy Psevdos

dr chrissy psevdos at Partridge Street General Practice

Dr Katherine Astill

(on Maternity Leave from August 2018)

Dr Katherine Astill 1

join the team

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Little Sick, Big Sick

GPs, Pharmacists, and Nurse Practitioners have roles in primary care – but it’s not either or. It’s both. They shouldn’t be competing against each other. They are not the same.

Professor Claire Jackson has her views and expresses them eloquently below. My views are:

GPs provide excellent care and deliver fantastic value to their patients and to Australia.

Other health practitioners also have the potential to provide excellent care to people at a different level and in different ways. They may very well provide care to many many people that GPs don’t already see. They’re not GPs.

If you want to be a doctor and further go on to specialise in General Practice, becoming the Specialist Urban or Rural Generalist, there is a pathway for this. It’s Medical School, Internship, and Fellowship Training.

Let’s look at some communities and people that aren’t well looked after under the current system like ATSIs, people with an intellectual or physical disability, and the homeless.

These are the groups Nurse Practitioners and Pharmacists should be working with GPs and existing Primary Care networks to get better outcomes happening.

Professor Jackson, Australian Doctor 2009

IT’S as pervasive and globally contagious as swine flu — and potentially as deadly in a susceptible population.

I am talking about the growing conventional wisdom that general practice is a basic combination of lots and lots of ‘little sick’ (so much more easily and less wastefully dealt with by nurses) and the far less frequent ‘BIG SICK’ (which requires the calling forth from the back room of the big gun, highly-trained, clever-dick, scarce-in-supply GP).
Such wisdom has led to the situation in the UK where nurse-led clinics in hypertension, asthma, lipid management, COPD, diabetes, and so on are increasingly the order of the day. In this utopian setting, issues of patient concern are dismembered carefully into presenting ‘body parts’, where nurse-led protocols can be used to define management algorithms. The GPs remain available for those patients who defy the guideline, or where the nurse perceives they require professional referral.

Naturally, there are quite a few problems with this approach, particularly for a country that leads the WHO/OECD league tables for longevity, patient GP satisfaction, and preventable death rates.

 

The first problem is this myth is based on a totally flawed assumption. The ill-defined nature of primary care presentations makes accurate diagnosis and problem definition the most challenging of all medical specialties. GPs and practice nurses are greatly offended by the oft-heard view that general practice is mostly ‘vaccinations, coughs and colds and protocol-driven chronic disease management’. When is ‘diarrhoea’ due to viral infection, and when to coeliac disease, alcoholism or rectal cancer? When is ‘cough’ due to parvovirus rather than oesophageal disease, anxiety, sarcoid or lung cancer? When is ‘nausea’ viral and when secondary to polypharmacy, renal dysfunction, drug abuse, cholecystitis, depression or Barrett’s oesophagitis?

The skill involved in accurately and rapidly diagnosing problems in general practice is profound, requires complex clinical reasoning, and a significant skill base. It is entirely inappropriate to triage most primary care patients into anatomical group assessment clinics based on presenting complaints. To do so is to risk diagnostic delay, confusion and inconvenience for the patient and often significant expense. Patients deserve and expect the best qualified person to work with them in the all-important problem definition and initial management decisions. In our world, that is the GP/practice nurse team in combination.

The second problem with the myth of little sick/big sick is the absence of any pretence at patient-centredness. What patient wants to book appointments at predetermined clinic days/times for between one and four separate comorbidities? How do they fit that easily with competing demands from work, family and carer needs?

Third, the myth ignores the significant and growing prevalence of comorbidity in primary care. Recent data has charted the growing increase in disease co-morbidity in our communities. Such presentations predicate a skilled generalist approach. General practice is trained and skilled for this and is increasing its capacity to deliver.

Fourth, the myth contributes to the decimation of continuity of care.
Stephen Campbell’s paper in the New England Journal of Medicine
in July this year chillingly chronicled the demise of continuity of care in UK general practice since the 2003 reforms. Such data allows Australian communities, governments and health professionals a sneak peek at the consequences if we emulate this model.
The fifth problem in this myth is the complete antithesis of the consultation and reform agenda advanced by the National Health and Hospitals Reform Commission and National Primary Care Strategy. Throughout the reform process, consumer groups overwhelmingly said they wanted comprehensive, co-ordinated, integrated, patient-centred care delivered to themselves and their families — not a fragmented ‘little sick/big sick’ approach.

 

Finally, there is no evidence for enhanced benefit. The Cochrane Collaboration summary on the equivalence of GP-led and nurse-led care has more disclaimers than a set of K-Tel steak knives. Most damning is the statement that these findings “should be viewed with caution given that only one study was powered to assess equivalence of care, and many studies had methodological limitations”.

So, Australian policy-makers, reformers and governments beware — 50 years of general practice hard slog has resulted in international benchmarking for key health outcomes, and unsurpassed general practice patient satisfaction. Over the past five years, the GP/practice nurse/allied health practitioner team has progressed a collaborative general practice team that has taken this even further, with the absolute preservation of continuity of care. This is the model Australian consumers have overwhelmingly endorsed.

Unravel this, without clear benefit and evidence, at your peril.

 

This article is based on a speech Professor Jackson made at the RACGP GP09 conference.

Professor Jackson is head of the discipline of general practice at the University of Queensland.

 

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stick with doctors 😎

 

 

 

Our team – here for You!

Dr Nick Tellis

 

Your Specialist In Life

Dr Nick Mouktaroudis

 

dr nick mouktaroudis at Partridge Street General Practice

Dr Gareth Boucher

 

dr gareth boucher

 

Dr Penny Massy-Westropp

 

 

Dr Penny Massy-Westropp

Dr Monika Moy

 

 

Dr Monika Moy

 

Dr Abby Mudford

 

dr abby mudford at Partridge Street General Practice3

Dr Chrissy Psevdos

 

dr chrissy psevdos at Partridge Street General Practice

 

Dr Katherine Astill

(on Maternity Leave from August 2018)

 

Dr Katherine Astill 1

 

 

join the team

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