Breached as, bro

Once upon a time, as all the oldest stories start, data was kept in peoples brains. This data wasn’t clearly visible and could only be accessed via direct download from the source. The person had to tell you what was in their brain. This is how the oldest stories were passed on, with an oral tradition. There were secrets. Some things were private. There was value in this. Secrets have always been valuable – and many methods have been tried to extract this value, from persuasion, coercion, interrogation, and worse. Lots of secrets equals big value equals a big incentive to try some of these methods. That said, it’s a lot harder to use these methods to find a lot of little secrets in a lot of places, when you don’t really know where to look.

What if someone took a lot of secrets, including your secrets? What if that someone took those secrets and put them all in the same place? Is this sounding familiar? What we have in this situation is motive (lots of valuable secrets – data), opportunity (you know where it is – a big database), and then all you need is the means…

We all know that more mistakes can be attributed to stupidity than malice and I suspect poor systems have led to the situation below. Big health databases are big targets, and data breaches, where your data, your secrets, become public, are becoming more and more common. One big database belongs to Ambulance Tasmania.

The private details of every Tasmanian who has called an ambulance since November last year have been published online by a third party in a list still updating each time paramedics are dispatched.

Key points:

  • Ambulance Tasmania uses a paging system in initial communications between the dispatch team and paramedics on the ground
  • Pager messages dating back to November have been uploaded to a website, which is still live and continually updating
  • The health union has described the data dump as “horrific”

The breach of Ambulance Tasmania’s paging system has been described as “horrific” by the Health and Community Services Union, which has suggested the data dump could leave the Government open to litigation.

The biggest health database in this country is MyHealthRecord. The website states that ‘My Health Record lets you control your health information securely, in one place. This means your important health information is available when and where it’s needed, including in an emergency’. There are some issues with this – many hospitals and health service providers neither use nor access MyHealthRecord and, as I’ve said above, big databases have a big target on them. Hackers and criminals see this target. So do governments and non-criminals.

2018 saw the Federal Government quietly release its long-awaited framework for secondary use of information contained within the my health record. It was controversial. The release of the framework to guide the secondary use of My Health Record (MyHR) system data came just months before the participation rules for the Australian national health record change from opt-in to opt-out. Consent for secondary use is implied if consumers don’t opt out of the MyHR. In other words, people need to take action if they don’t want their health data to be used for purposes other than direct clinical care.

What does this all mean? For patients and individuals it means being mindful about your data. Only give what you need to give, for good reason, and consider time limits and limiting further usage of your data for unconnected reasons.

For doctors, consider clinically appropriate data entry – never forget who you serve and why, and work in and with good practices and practitioners who will take the same care and attention with patients data as you do.

For practices, good policies and solid hardware and software solutions are the key!

For a little bit of further reading:

John Stronner is a guru in this area – a Certified Data Protection Officer, and CEO of Loftus Technology Group. I had the pleasure and privilege of speaking after him on a recent podcast from This Pathological Life! Another podcast I found super useful was the story of the white hat hacker turned protector, Bastien Treptel of the CTRL Group.

Be mindful with your data and your health – we can help with both (with your medical data at least!). Just one little example of how your data can help you is here, where I explain how your GP can upload your immunisation details to MyHealthRecord, allowing you to prove your vaccination status – super important in 2021! You can make your appointment with us conveniently online right here – or call our friendly reception team on 82953200.

Where to now?

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For everyone, we believe that having a usual GP or General Practice is central to each person’s care and recommend that people with any health issues that come to the attention of other health professionals should be advised to attend their usual GP or General Practice rather than a specialised service (ie a place not providing the holistic care a specialist GP would).   If  they say that they don’t have a usual GP or general practice, they should be helped to find one and to actually attend it. Call PartridgeGP on 82953200 or make an appointment online here.

(Hat tip: Dr Oliver Frank)

(TL;DR – Get a regular GP or General Practice and use them!)

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If you’re employed, get a side hustle and get into business. If you’ve already got a business, get a network. Want to get started? Find your tribe here!

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If you are a great GP or a great Allied Health Professional, and you want to serve your clients or patients to the best of your ability, without worrying about all the non clinical things that get in your way, lets talk. Call Mrs Hayley Roberts on 8295 3200 and have a coffee and chat with us as to how PartridgeGP can help you to help others.

Discharge summary versus clinical handover: language matters

PartridgeGP is all about professional, comprehensive, and empowering General Practice care by our GPs. When we refer our valued patients for treatment elsewhere we promote the same high standards, values, and communication  that we provide. A letter, referral, or phone call is just part of the standard PartridgeGP service – it’s good clinical handover. Dr Nick Tellis recently collaborated with some excellent GPs in writing an article for the Medical Journal of Australia’s online Insight Blog on ways to improve communication during these times and stressing the importance of better clinical handover. It’s another one of the ways PartridgeGP provides Better Healthcare for our valued patients. Read on.


This article is part of a monthly series from members of the GPs Down Under (GPDU) Facebook group, a not-for-profit GP community-led group with over 6000 members, that is based on GP-led learning, peer support and GP advocacy, and was originally published at the Medical Journal of Australia (MJA) Insight Blog here


IN our earlier article we described the concept of “passing the baton” when talking about transfers of patient care. All patients come from their communities and to their communities they shall return. In this transition from tertiary hospital to primary care, they benefit from timely, safe, effective clinical handover as defined in the National Safety and Quality Health Service Standards.


In primary care, communication matters, perhaps more so than in tertiary care. Words matter. The language we use matters. It informs thought at conscious and subconscious levels and influences behaviour.


The words “discharge summary” evoke feelings of an administrative process at best, and various unsavoury processes at worst. The accidental discharge, the dishonourable discharge, and the smelly discharge all come to mind. The words “clinical handover” instantly sound more professional. They reflect the sort of interaction between clinicians of which we want to be part. Clinical handover is a term familiar to both clinicians and administrators. It is taught in medical schools around the country and practised between junior and senior doctors within our hospitals.


Transition of care is well known to be a time of maximum risk: “Adverse events are seen to increase particularly during a transition of care, when a patient is transferred between units, physicians and teams.


Clinical handover is a recognised, evidence-based, structured and essential safety mechanism for minimising this risk. Remember, all patients come from their communities and to their communities they shall return. Their community doctor, their primary care physician, is their GP. Patients deserve the best clinical handover we can provide, whether transitioning into or out of our hospitals.


Junior doctors in hospitals presently perform the clear majority of clinical handovers to primary care, labelled as “discharge summaries”. According to the Discharge Summary – Literature Review, published by Queensland Health in May 2017 (not available online):



“Junior doctors perform the clear majority of discharge summaries:

  • Many interns have a flippant attitude to the completion of discharge summaries and have a low perception on the importance of a safe handover of care;

  • Most medical education programs provide minimal education on the completion of discharge summaries;

  • Most interns learn from each other with little input or guidance from registrars and consultants;

  • Interns tend to ‘lump’ discharge summaries together, often completing the summaries on patients they have never met.”



This frequently happens after the transition has occurred. To borrow from our legal friends, you cannot sell what you do not own. How then can you transfer the care of a patient you have never cared for?



Junior doctors report that they have limited supervision and lack templates or guides to help them produce a comprehensive and useful handover for community-based care whereas they receive a considerable amount of training for internal clinical handover.



Medical practitioners frequently use ISBAR (introduction, situation, background, assessment, recommendation) to guide clinical handover. A recent GPDU discussion highlighted that the Gold Coast University Hospital was moving to an ISBAR format for clinical handover to primary care. This was seen by many in GPDU to be a significant step in the right direction. ISBAR for the clinical handover to primary care aligns with hospital handovers and can only improve the transfer of care. Brewster and Waxman recently proposed amending ISBAR slightly to K-ISBAR by adding some kindness into the equation. Taking the opportunity to actively incorporate empathy and understanding into the primary care handover would be a great place to enhance collegiality across community and hospital teams.



When deciding who is tasked with a clinical handover within the hospital, it is unlikely that this would be handed to the most junior member of the team, and exceedingly unlikely that it would be delegated to someone who had never treated or met the patient. Within hospitals, it is expected that a clinical handover occurs at or before the time a patient’s care transitions to another team or provider. Why should this be any different for the clinical handover back to the GP?



In our first InSight+ article, we used the analogy of passing the baton. But what happens when the baton is dropped?



Dr Mandie Villis recently wrote a heartfelt plea for hospital doctors to inform GPs when patients passed away on their watch. Discussions around primary care clinical handover are now occurring around the country and pockets of significant improvement are being made. Momentum is building in regard to formally recognising and changing the language used from “discharge summary” to “clinical handover”. Several hospital and health services have, or are in, the process of implementing “same day” or “24-hour” clinical handover policies, and ultimately the best practice standard will be that this clinical handover occurs at the time of transition of care.



My Health Record (MHR) has been touted as a partial solution to the problems that have traditionally plagued clinical handover. It is important, however, to remember what MHR is and what it was created for. It is a repository of information for patients – a “shoebox” of documents akin to the jumble of receipts we burden accountants with at tax time. It is not, nor was it designed to be, a communication tool for clinicians. The baton transfer cannot occur within the MHR shoebox. It was not designed to replace current clinical record systems or current communication channels between clinicians. These limitations and precautions are outlined in the RACGP My Health Record guide for GPs:



“My Health Record is not designed as a substitute for direct communication between healthcare providers about a patient’s care, and should not be used in this manner. Healthcare providers must continue to communicate directly with other healthcare providers involved in the care of a patient through the usual channels, preferably through secure electronic communication.”



The  Australian Digital Health Agency states:



“The My Health Record system supports the collection of Discharge Summary documents. When a healthcare provider creates a Discharge Summary document, it will be sent directly to the nominated primary healthcare provider, as per current practices. A copy may also be sent to the individual’s digital health record.”



Mission creep of MHR is real, with multiple reports on GPDU of GPs stumbling across clinically relevant information in MHR rather than receiving a timely clinical handover. Important clinical information is “pushed” into MHR and the receiving clinician is not “pulled” to it by any sort of notification. There is no handover without closing the communication loop. Health professionals and organisations must ensure that clinical handover occurs with the intended recipient at the time of care transition. A copy uploaded to MHR for the patient to access, as an archive, may serve as a safety net if all else fails, but should not be relied on as the only source of communication.



Hospital systems must support and value the safety delivered by effective clinical handover to primary care. This will reduce the readmission rates to hospital care and improve the care patients receive. Patient care and practitioner wellbeing should not continue to be compromised due to the hospital culture of a discharge summary being an administrative task undertaken by the most junior team member. The challenges of high administrative burdens, inadequate staffing and unpaid overtime all need addressing. Junior doctors should not be left alone grappling with piles of outstanding discharge summaries to complete on patients they have never met.



The patient journey can be tracked, important milestones bookmarked, and plans documented as they are formed so that when it’s time for a transition, the “baton” is ready. The need for handover cannot come as a surprise when the patient’s trajectory was plotted from the day they were admitted. Adequate clinical staffing levels with protected time for clinicians to prepare clinical handovers should be a key performance indicator in hospital care. Proactive strategies must be put in place to identify and document who will be receiving the clinical handover. The culture that prevails within many of our hospitals needs to change.



Safety and quality bodies, such as the Australian Commission on Safety and Quality in Health Care through its National Safety and Quality Health Service Standards, and the Australian Council on Healthcare Standards through its accreditation regime, can provide effective oversight. All clinicians must lead in continuous improvement in “best practice” for quality and safety in transition of care both into and out of our hospitals.



Let us recognise and applaud our hospitals and health services leading the way in acknowledging discharge summaries as the clinical handovers that they are. May 2019 bring us all closer to high quality, timely, safe and patient-centred clinical handovers.



GPDU dragon head-3


clinical handover


Dr Katrina McLean is a Gold Coast-based GP, Assistant Professor in the School of Medicine and Health Sciences at Bond University, and a GPDU administrator.


Dr Michael Rice is past president of the Rural Doctors Association of Queensland, an educator of students and registrars, a long term resident and rural GP in Beaudesert. He’s a keen user of social media.


Dr Nick Tellis is passionate about great general practice. He’s a proud GP, beachside Adelaide practice owner, and a happy new father. He blogs at when not administrating on GPDU.


Contact Dr Nick Tellis at or 0882953200 if You are a Great GP and want a Better Place to practice great medicine!









My Health Record: Former digital transformation head raises concerns about security of online system – Politics – ABC News (Australian Broadcasting Corporation)

The man appointed by Malcolm Turnbull to transform the Commonwealth’s digital public services has said if he was Australian he would probably opt out of the Government’s controversial online health database.

Learn more here!

GPs want clinical handovers, not discharge summaries

PartridgeGP is all about professional, comprehensive, and empowering General Practice care by our GPs. When we refer our valued patients for treatment elsewhere we promote the same high standards, values, and communication  that we provide. A letter, referral, or phone call is just part of the standard PartridgeGP service – it’s good clinical handover. Dr Nick Tellis recently collaborated with some excellent GPs in writing an article for the Medical Journal of Australia’s online Insight Blog on ways to improve communication during these times and stressing the importance of better clinical handover. It’s another one of the ways PartridgeGP provides Better Healthcare for our valued patients. Read on.


This is the third article in a monthly series from members of the GPs Down Under (GPDU) Facebook group, a not-for-profit GP community-led group that is based on GP-led learning, peer support and GP advocacy and was originally published at the Medical Journal of Australia (MJA) Insight Blog here


“PASSING the baton” describes what health care professionals try to achieve as care of patients is transferred between providers in our complex health care systems. The topic of safe and effective clinical handover comes up repeatedly in discussions on GPDU.


It is apparent that the impacts from delayed or poor clinical handover on patient care across the country are significant, under-reported, and have a profoundly negative effect on the care patients receive.


Dropping the baton


First-hand accounts of treatment delays, duplication of testing, medication errors, and unplanned readmissions are frequently discussed by GPs. Recent clinical case discussions have included a patient in palliative care being transferred to a hospice on a Friday afternoon with no clinical handover, and a 3-month delay in the completion of a discharge summary for a truck driver who was admitted with a myocardial function.


The safety concerns related to poor clinical handover are not new: it’s a problem the health care industry and doctors as a profession have been grappling with for decades. Poor clinical handovers are wasteful of limited resources. How can we improve patient outcomes and “drop the baton” less often?


Rules of the game


The National Safety and Quality Health Service Standards (NSQHS) and the Australian Commission on Safety and Quality in Health Care (ACSQHC) define clinical handover as; “the transfer of professional responsibility and accountability for some or all aspects of care for a patient, or group of patients, to another person or professional group”. Appropriate clinical handover is a requirement of the NSQHS. The ACSQHC notes the importance of “transition of care” that “ends only when the patient is received into the next clinical setting”. The Australian Council on Healthcare Standards EQuIP National Standard 12, in particular, specifies the planned provision of transfer information, including results of investigations.


Breakdown in the transfer of clinical information has been identified as one of the most important contributing factors in serious adverse events, and is a major preventable cause of patient harm.


Why is clinical handover from hospitals to GPs done so inconsistently for patients transitioning from our major private and public institutions? The benefits of passing the baton smoothly are clear. It’s time to coach the team to get it right.


Timing is everything


Health services continue to debate the appropriate timeframe for communicating with the GP who is continuing the patient’s care. Timeliness of clinical handover is a topic that comes up frequently. Hospital targets for transfer of care communications vary widely. A recent discussion on GPDU identified several targets within one small geographical area, ranging from “at the point of discharge”, “48 hours after discharge” and “5 days after discharge”.


GPDU dragon head-3


The reality is that few patients leave hospital with an effective clinical handover. Some will be received within the hospital’s current targets; however, many clinical handovers are not received for weeks, months or, as one post highlighted, years after the patient care is transferred. Some never occur.


Many GPs are asking whether these targets are consistent, appropriate, acceptable or safe. A robust discussion took place after GPs were approached to complete a survey that included a question asking what conditions should warrant a discharge summary on discharge, and what the acceptable timeframe for receiving a discharge summary should be.


The overwhelming consensus was that the gold standard should be clinical handover on discharge for all patients. Many were frustrated that this question even needed to be asked. Some GPDU members wondered whether this was a trick question aimed at moving the goalposts further away from quality patient care.


Services promoting clinical handover to GPs on discharge were highlighted. The Sunshine Coast Hospital and Health Service was identified as a provider that was actively trying to effect positive change. They received plaudits from the wider GP community simply by having a discharge summary management policy specifying complete discharge summaries available at the time of patient discharge.


It is well known in GP circles that starting late ensures that you will run late all day. Timely discharge summaries aren’t late. Timing is everything when you want to be a frontrunner.


Don’t fumble the handover


The consensus among GPs is that well timed, efficient, effective and safe clinical handover, at or before the point of transition of care is essential. Alternative strategies risk adverse outcomes. Clinical handover must be a standardised process between clinicians.


Returning to the athletics track, we can see a clear difference between a handover, a throw, and a drop. Highly trained athletes accept nothing less than a smooth handover – nor should highly trained clinicians. Delegating the handover to non-clinicians, including nurses and medical students, is not good enough. Supervision and ongoing coaching of clinicians is vital.


The baton is passed between people not machines


Imagine the difference electronic systems could make to this smooth handover. Sadly, this smooth electronic handover exists only in the imagination.


In the real world, GPs are grappling with being thrown links to hospital electronic records through systems such as “The Viewer”. Investigations are likely to be uploaded (after a delay) to MyHealthRecord. These are raw data, unfiltered and disorganised, and more of a throw than a handover. Being thrown raw data and being expected to catch them in this way is akin to a hospital doctor being given the login to the GP clinic’s patient management system and being expected to extrapolate a referral.


Personal bests are set; medals are won


The late Sir Roger Bannister ran the 4-minute mile and reset the expectations for all that followed him. GPs and their discussions can highlight outstanding clinical handovers and applaud initiatives and hospitals that are doing it right. Feedback and constructive criticism can be passed back to hospitals that are raising the bar. Medal-winning performances show the possible and provide a model for future improvement. GPs are uniquely placed to spot the talent and report the score widely and rapidly.


Eyes on the prize: what’s the next goal?


If we can normalise the clinical handover to young GPs who are the future of general practice, it will encourage them to demand it of their hospitals.


Hospitals are incredible places, but the aim is for patients to return home to their communities and trusted GPs. They come home. Their GPs are waiting, willing and able. We can do better, and we will. We extend an open hand to our amazing hospitals. Pass us the baton – we won’t drop it.


clinical handover


Dr Katrina McLean is a Gold Coast-based GP, Assistant Professor in the School of Medicine and Health Sciences at Bond University, and a GPDU administrator.


Dr Michael Rice is past-president of the Rural Doctors Association of Queensland, an educator of students and registrars, a long term resident and rural GP in Beaudesert. He’s a keen user of social media.


Dr Nick Tellis is passionate about great general practice. He’s a proud GP, beachside Adelaide practice owner, and a happy new father. He blogs at when not administrating on GPDU.


Contact Dr Nick Tellis at or 0882953200 if You are a Great GP and want a Better Place to practice great medicine!





MyHealthRecord – Opt Out Here

We’ve written about the Patient Controlled Electronic Health Record (PCEHR or MyHealthRecord) before – you can have a look at the links below.


e-health warning

pay for performance

why i will not use the pcehr

the australian pcehr – success or failure

Info for Best Practice using GPs here




Also – see MJA Insight right here!



Today we’re going to talk about how NOT to have a MyHealthRecord. Perhaps you don’t think it’s private, perhaps you’re opposed to it for some reason. Perhaps you just don’t want one. Read on.



The Australian Government is expanding My Health Record for all Australians in 2018.



By the end of 2018, a My Health Record will be created for every Australian unless they choose not to have one.



How can I opt out?


If you decide that you don’t want a My Health Record created on your behalf, you will have the opportunity to tell us during a three-month period.


This period will run from 16 July to 15 October 2018. It’s not possible to opt out of having a My Health Record before this period starts on 16 July 2018.



Opt Out Here!





book online at Partridge Street General Practice

Partridge Street General Practice is all about quality – professional, comprehensive, and empowering General Practice. You can make an appointment with us right here.


join the team


Want to be part of the Partridge Street General Practice team? Contact Dr Nick Tellis at or 0882953200










Qi at Partridge Street General Practice

We’ve just celebrated the Chinese New Year – the Year of the Dog. People born in Dog years display loyalty and honesty amongst many other good qualities. However it is said that they can also be critical – maybe overly so. Segueing to another Chinese concept, we meet Qi, the vital life force that flows through the body. Let’s put these together.




A wise man once told me that the three pillars (the vital life force) of general practice are quality, service, and finance. All three of these come together in the form of the Practice Incentive Payments (PIP) scheme. You can read about this here but in summary Accredited General Practices are paid amounts of money for reaching certain quality measures. These include planning the management of a proportion of patients with diabetes and asthma, and ensuring women are screened for cervical cancer. There are also Incentive Payments for managing aged care and quality in prescribing.





These payments were due for a change on May 1st 2018. Were they promoting the vital life force of General Practice, were they tick box exercises for busy GPs, or were they overly critical of General Practice, not focusing on true quality? Enter QI – Quality Improvement. Rather than Qi, QI may be an altogether different beast.






The Department of Health has confirmed that the Practice Incentive Program Quality Improvement Incentive will now occur from 1 May 2019.



From their press release:



The Practice Incentive Program (PIP) has been a key driver in quality care in the general practice sector and the PIP QI Incentive will continue to build on this important work, further strengthening quality improvement in primary health care. The additional 12 months will enable the Department, with the support and advice from PIPAG, to ensure that any implementation issues are identified and addressed and that general practices have adequate opportunity to prepare. It will also allow the Department to continue to consult with stakeholders on refining the design of the PIP QI Incentive.


The changed time frame will mean that the following five incentives which were to cease on 1 May 2018, will now continue through to 30 April 2019.



The five incentives are:

Asthma Incentive

Quality Prescribing Incentive

Cervical Screening Incentive

Diabetes Incentive

General Practitioner Aged Care Access Incentive


The six PIP Incentives that continue to remain unchanged are:

eHealth Incentive

After Hours Incentive

Rural Loading Incentive

Teaching Payment

Indigenous Health Incentive

Procedural General Practitioner Payment



What next? Will the new QI beast be reflective of quality in General Practice? Will the measures align with what we as General Practitioners believe is high quality Great General Practice care? Or will it aptly be launched in the Chinese Year of the Pig in 2019?


For what it’s worth, here are my measurements of quality, service, and finance in General Practice – the Qi of GP:



Quality – Time and Presence with Our Valued Patients


Service – Charging a private fee to those who can pay, allowing us to be charitable to those who cannot


Finance – Running Practices efficiently and well, with clinicians as owners steering the course of patient centred practices.



I would love to hear other views on this. We are all professionals or patients or both and we can always improve. Let me know here on the blog (or on our website) – or, if you’re a GP, on the fantastic GPDU FB Group – where GPs are invited to a festival of education and collegiality (#FOAMed – #GPDU18) May 30 – June 1! My last quality ltip – for personally better Qi – is below!


Get a Great GP!

(Here’s some we made earlier)

Dr Nick Tellis

Your Specialist In Life

Dr Nick Mouktaroudis

Dr Gareth Boucher

Dr Gareth’s Cycle of Care

Dr Penny Massy-Westropp

Dr Penny Massy-Westropp

Dr Monika Moy

Dr Monika Moy

Dr Katherine Astill

Dr Katherine Astill 1

We look forward to seeing you soon!

Mr Perfect and #socks4docs

Mental health and depression are serious issues. GPs see, treat, and support people with these issues everyday but who looks after the GPs? We can see that doctors are only human and suffer the same stresses as everyone else. Sadly, sometimes, it is too much.







I wrote previously about how to detect depression in patients. ‘Listen to the patient’, ‘How do they feel?’, ‘How do they make you feel?’. Experienced GPs can spot depression a mile off…in other people. How many turn that acumen on themselves? How many have their own GP to care for them?



I also wrote ‘American studies show patients are scared of psychiatric referral. Australian GPs are also scared of psychiatric referral’ and ‘Untreated depression is associated with decreased quality of life and increased mortality. Depression can be successfully treated and treatment is effective. The earlier the better!’. This is as true for GPs and doctors as it is for every other person.

So GPs, doctors, and others – Exercise, diet, psychotherapy, GP counselling, reducing drug and alcohol use, getting more and better sleep are all options. These take time and effort so give yourself permission to spend these on You. Your friends, family, and colleagues are here for you. They will #bekind.






Depression is not just a chemical imbalance. No pill can defeat the entirety of the patient’s life and circumstances pushing them in the wrong direction. Consider the your environment and be aware of the particular pressures of medical work and life. GPs have a fantastic and privileged therapeutic relationship with their patients, and they can use this to capitalise on the essential window of time before delivering medical advice. This “privileged moment for change” prepares people to be receptive to a message before they experience it. Robert Cialdini has coined the term ‘pre-suasion’ to describe this. The therapeutic relationship allows pre-suasion, and therapeutic change can then be addressed, with consideration of motivation, opportunity, and ability.





Dr Eric Levi has literally stepped forward online with the #crazysocks4docs / #socks4docs hashtags. It’s a lighthearted way of getting us to acknowledge a serious topic. I’m in!




#socks4docs (holiday edition)






The equally dapper Terry Cornick has been kind enough to contribute his story to my blog – and I hope it gives some of you hope, a good read, and another option for you and your patients.




Terry is a Healthcare Consultant, Mental Health Advocate and Freelance Writer.

His professional background includes Consulting in Healthcare and he loves creating, research, technology, and communications. Daily he deals and develops relationships with Doctors so knows a little about them too and the unique stresses they are placed under.

Initially as a hobby, Terry created a grassroots men’s mental health support network named “Mr. Perfect” that is growing by the minute. Although it does not pay a cent, it pays handsomely in purpose. You can check it out at

Known sarcastically by his wife as “Dr Terry” he lives on the North Shore of Sydney with his young family and is currently contemplating his next move professionally, navigating the ever challenging and life-threatening dilemma for men of “providing” yet being “Mr. Perfect” personally too.


Trying to summarise and reduce my story to a blog is a challenge to say the least. Although a relatively spritely 33 years old, the increasing grey hairs and wrinkles around my eyes and my “old soul” remind me daily this life is a battle. And the battle is ultimately with yourself (hands up I have paraphrased this from a song I once heard, I just cannot remember which).

I love to compartmentalise and segment so my mind can attempt to process things, ideas, events, thoughts, feelings. Broadly speaking I did this with my life; pre-25 years old, 25 to 30 years old and 30 years old and beyond.

The first stage can sometimes appear as a blur. But perhaps an easier way of me dealing with it. It was a painful period for the majority of it. A challenging upbringing, tragic events, abuse and trauma pushed me so far into a shell that I never thought I would emerge from it.



During the okay times, this was okay with me. My introverted character and lack of self-esteem meant hiding was easier and far less painful. Until the occasional explosions. But life then returned to the blur.

A couple of moments in my early Twenties truly made me question my sanity. So at 21 years old I googled “Depression”. I matched 6 out of 8 symptoms. So clearly I was fine. I closed the laptop and the cycle of darkness continued as did the periodical suicidal meltdowns (behind closed doors of course).

Then the “Great Escape” took me to the other side of the world travelling. Less than two years later I was back in Australia for good, despite this being the deepest, darkest scene of my life. After a night out on the Gold Coast I stood on a balcony peering and leaning over contemplating that this was a good time to jump and end the pain. I felt so weak and thankfully, eventually, stepped back.

Somehow, after a few more substantial blips and obstacles, my life starting to become what others saw as “success”. More money that I knew what to do with, travel, a waterside apartment and a beautiful partner. One of my best mates teased me at work and called me “Mr. Perfect” regularly, not knowing 1% of my history or what was going on in my complex mind.



Look familiar?



Behind the acting and those curtains and backstage was a chaotic scene. Anxiety, PTSD and Depression drove me to the edge. But approaching my 30th year on this earth I made some changes. As I was about to get married, my absent dad passed away in the UK. I was sick of my job and when we started to talk about having a family, I could imagine putting my child through a similar existence.

So I visited my in-law’s family GP. He looked me in the eye and asked “How long have you felt like this?” I paused. “For as long as I can remember.” His usually relaxed face turned serious. “I know a great Psychiatrist I would like you to see”. It took every ounce of energy to do so but once that train was in motion I was getting professional help (lucky enough to have the resources to do this privately) and within six months I felt positive.

I started writing a book and then a blog (I did not show my wife) and Mr. Perfect was born. A chat in the pub with mates, a cursory read of a report about men’s “connectedness” and healthcare professionals I know telling me there was little grassroots support for their male patients, and the Mr. Perfect movement gained momentum.



There have been many blips, I am not “Perfect” after all. From stopping my medication without advice, from stopping my Doctor appointments to then leading back to professional help when the cloudy spells turned into storms and into hurricanes. These weather systems are here for life, and that’s okay, but with the right strategies I can turn this into something impactful for others.

But there is hope. Friends, family and colleagues have all benefited and most importantly my son will arguably be the most loved and supported kid when it comes to talking about his mental health.



Thanks Terry! You can see the themes above of time and a relationship as potent therapy for the management of major depressive disorder in general practice. The initial clinical gestalt and the ongoing therapeutic relationship can be powerful tools for change. Depression is subjective and has been part of the human condition throughout history. This gives us all we need to move forward.




 It therefore seems fitting to end with the words of a doctor from another time:

“The three grand essentials of happiness are: Something to do, someone to love, and something to hope for.”

Alexander Chalmers (29 March 1759 – 29 December 1834)




If you are worried about depression, anxiety, or have any other mental health concerns, reach out:

ACIS 131465 (South Australia – Acute Crisis Intervention Service)






Your GP at PartridgeGP


Beyond Blue & Beyond Blue New Access (free mental health coaching)



Mr Perfect



Doctor’s Health SA



GPs Down Under




Five things Your Practice can do to Reduce Your Cyber and Privacy Security Risk

Are you a Practice Owner? Are You embracing the brave new world of E everything? Paul Fitzgerald, of Cyber Health International offers You some thoughts in this guest post on

Mr Paul Fitzgerald

The Australian Privacy Principles, and the recently passed (by the Australian Parliament) Mandatory Breach Notification bills provide various guidelines, which should be adhered to by anyone who handles any electronic medical data. Basically, the principles stipulate that all medical practices must ensure that all necessary measures are in place while saving, accessing and sharing any electronic medical data to keep patient data secure. Lack of compliance to the security standards could lead to large fines for both companies and individuals. Several steps can be followed by medical practices to ensure compliance to privacy standards. These steps include:

Run a complete risk assessment of the practice

Many medical practices adopted electronic health recording systems before there were clear guidelines on what these systems should contain. This means that a practice could be using electronic systems which are not compliant with current standards. To ensure compliance, a risk assessment should be done on the current systems to highlight areas in which compliance is not enforced, and to expose areas in which changes are needed. Ensure the latest version is being used, including any security patches from the vendor.

Prepare for disaster before it occurs

All data handled by a medical practice should be safe both from loss and corruption. One of the main ways of ensuring that data is not lost in case of any mishaps is backing up of medical data daily. Data should be backed up in an offsite location to ensure that in case of incidents such as natural, or man-made, disasters the data backup is not destroyed, as well. Antivirus programs should also be installed on all computers to ensure that data is not corrupted or destroyed by computer viruses, or held to ransom by cyber criminals.

Implement an ongoing employee training programme

Any system is only as strong as its weakest link, and in some cases poorly trained employees, or temporary staff, are the entry point for hackers into medical practices. It is also these staff who are more likely to have an “oops” moment and accidentally release confidential information. A medical practice could have excellent processes and systems, but if the employees don’t use their passwords to securely access records and files the system security is rendered useless, and anyone can gain access to these records. Medical practices should continually train their staff on how to follow the right security protocols, to ensure data integrity and security.

Purchase medical products with security compliance, and compatibility in mind

New equipment bought for a medical practice should be compatible with existing systems and should offer enough security features. With the advent of connected devices, the Internet of Things, it is critical that devices are secure, and kept up to date. Before making any major purchases enough review of the product should be done to ensure both security and compatibility.

Collaborate with affected parties

Changes which need to be made to bring about cyber security and privacy compliance affect many people in the practice. Affected groups should be offered training and management must ensure that staff understand the importance of compliance to everyone involved in the practice. Also, ensure that key staff are trained on what to do in the event of a breach. A comprehensive disaster plan is essential, and must be practiced regularly.

Thanks Paul! He does add, if you would like to discuss a risk assessment of your practice, please visit Cyber Health International to arrange a time that suits you to receive a call. Remember though, a lot of General Practices are small businesses, and a lot of You are the Key People in those businesses. Look after yourselves, see Your GP, get a great workplace, and Good Luck!

This is why I will not use the PCEHR

I think I can confidently say that I will be following Dr Kruys’ lead on this issue. Very disappointing.



That’s what I wrote 2 years ago. Since then GPs have had multiple pushes and pulls towards the Patient Controlled E-Health Record. What’s happened? See below.



Reach exceeds Grasp


Has this happened with other electronic databases?




Watch this space. Why would such a system exist if doctors, hospitals, and patients are not enthusiastic about it?



Here is the Value for Others in Your Health Record



In the meantime, PartridgeGP will continue to provide You Excellent Care via Your GPs.


Book in here!