It’s the week after the RACGP AKT and KFP exams for some and before a busy week for others. You may be a little flat and the world may seem a bit chaotic at the moment so I thought I’d take a minute to remind us all of how good we have it in Australian General Practice.
What are some of the little things your patients have done for you? (#kickbacks 8-)) These are three that come to mind for me:
Doctors are people too. Is this a controversial statement? I’m going to go further and say doctors are people first. I bring this up because some doctors are amazing but they are still only human. There’s a special respect from me for our rural doctors including rural generalist GPs. To me, they are Superhuman! I look at what I do now, and what I used to do as a rural doctor (within 30km of a major Australian city), and, to quote a popular film it’s not the same game. It may not even be the same sport.
I’ll move to some other popular culture. A guilty secret of mine is that I like comics. One series I really liked (and beware this is a NSFW comic and not for children) is Irredeemable. It’s the story of an alien superman (The Plutonian) who becomes a superhero on Earth. He’s super resilent, can fly, has superhuman endurance…you know, those usual rural generalist abilities. The series opens with a family running for their lives. Heat beams target them. Their house is reduced to rubble. Spoiler Alert – they die. Hovering in midair over their bodies is The Plutonian. What happened?
Prior to the above events, the Plutonian was doing his thing, saving people. It’s what he did. Day in, day out, with never a day of rest. He stops a nuclear bomb going off in a packed sports stadium. The crowd goes wild. He stands there, letting his adrenaline drop down. One voice comes to his ears amongst the adulation of the crowd.
‘What a poser’, or words to that effect. Only a few words, only one person, and buried in a sea of praise. But they were enough. They were too much. Superhumans are human too. Perhaps they are human first too? He snaps and flies off.
I think 14 doctors committed suicide in the last 12 months. I could be wrong about this number. I’m not wrong when I suspect the number that had contemplated suicide was probably much higher. I don’t know the answer but being kind is a good start. Please, be kind. That is all.
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:
Quality Prescribing Incentive
Cervical Screening Incentive
General Practitioner Aged Care Access Incentive
The six PIP Incentives that continue to remain unchanged are:
After Hours Incentive
Rural Loading Incentive
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:
It’s 2018 and many of you will have made your New Year’s resolutions. Many of these resolutions will have been broken by January 15th! We’re past that date, so for those of you who are left, here are some free Fitness Tips to help you carry on and improve your health in 2018.
Number 3 Fitness Tip from Dr Nick Tellis and Partridge Street General Practice
Get to the Gym…or the Run…or the Swim
We’ve all had those days where we don’t really want to exercise. Abs may be made in the kitchen but they’re certainly not made in bed. Remove the obstacles. Have your gear out the night before – clothes, trainers, swimmers, headphones – whatever you need to Get It Done. Leap out of bed as the morning alarm sings, get your gear, and Get Out.
Once you’re at the gym or pool or about to start your run – Start! If you’re not feeling it after 5-10 minutes, stop and head home. That’s cool, it’s not your day. I can assure you following this tip will hugely increase the amount of exercise you do.
Number 2 Fitness Tip from Dr Nick Tellis and Partridge Street General Practice
Don’t be the fittest person
Here’s the easiest tip here – especially for those of you just starting out. It’s often said that if you’re the smartest person in the room, you need to find a new room. Training with people fitter than you will bring you up with them. Generally people fitter than you have been doing it longer than you have and have built up some great habits and great tips of their own. Let them lift you up!
My personal take on this is that I train with people younger and fitter than me. I take the opportunity to train with greatfemale athletes – even though I’m nearly double their weight, I can almost keep up! 😎
Number 1 Fitness Tip from Dr Nick Tellis and Partridge Street General Practice
Rack Your &%*%ing Weights!
You’ve got to the place of exercise and you’ve lifted/run/swam. It’s time. Time to put the little metaphorical cherry on that big beautiful exercise cake. Time for a little ‘accessory exercise’.
Rack your &%*%ing weights! Seriously! This is free exercise! You’ll feel better, your training buddies will love you, and your friendly gym owner will sing your praises (and maybe even put your picture up in the gym!). Routine will give you strength and is that extra 1% for you when motivation fails. Routine gets you to the gym. Routine gets your training partners to the gym. And the Routine of racking your weights is worth it’s weight in gold.
If you’re running or swimming instead of lifting – that’s cool too. Walk more. Walk to and from your run or swim. That incidental movement – briskly, to be truthful – adds up. It adds up to fitness. It adds up to cardiovascular health. It adds up to a little less weight around the middle. It Adds Up!
Working at Partridge Street General Practice, I have all types of tasty foods available to me on Jetty Road Glenelg. The problem is so many choices mean too many opportunities to overeat and too many poor (but delicious) food choices after a busy morning. I had a think and this is what I came up with.
Eggsactly. I will have breakfast at lunch and reduce my poor food choices. It’ll also reduce the running around at lunch wondering what to eat. I should be feeling great with loads of morning energy for when I’m back at work next week.
See you next week with more improvements to come! If you liked this, go back and revisit Week 1, or even say hi here!
See all of our great GPs at Partridge Street General Practice right here!
The sun is hiding for more of the day and our noses are running more than our feet. Does this mean a trip to the GP for antibiotics?
Everyone should have a great family doctor – and that should be a Specialist GP (or a doctor training to be a Specialist GP!). Having a regular specialist GP working with you means fewer trips to hospital, fewer unnecessary medications, and generally better health overall.
The excellent Dr Michael Tam, from the UNSW School of Public Health and Community Medicine, says no.
“The presence of green snot … does not indicate that you need antibiotics,” Dr Tam said. “Green nasal discharge is most commonly due to a viral infection of the nasal mucosa — basically, the common cold.”
So relax, get your sleep, wash your hands, cover your mouth when coughing, eat well, and avoid those little 💊💊💊 whenever possible.