6 August 2008

Some answers on the Wanniassa Medical Centre

| johnboy
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Daktari has posted some answers on the Wanniassa issue which I thought needed wider prominence than just sitting in the comments:

    As one of the doctors at the Phillip Medical Centre I think I can answer some of your questions.

    “How do they currently measure the performance of its contracted doctors at the Phillip Centre? Will the ex-WMC doctors be gauged by these same performance measures at any time within the next 2 years?”

    The performance of contracted doctors at Phillip is not measured by PHC, all they need do is fulfill their contractual obligations. Part two of your question is therefore irrelevant.

    “Are GPs at Phillip who engage in regular >5 minute consultations and/or do not maintain their quota of XRay and test referrals considered to be performing below Primary Care prescribed KPIs (Key Performance Indicators)?”

    The quicker amongst us average five patients per hour. There is no quota for Xrays or pathology. We can use any Xray or pathology service we choose. I am unaware of PHC having KPIs. Nice myth though: sorry to bust it.

    “What is the first available appointment for Dr X (previously from from the Wanniassa Medical Centre) that I can make and can they guarantee that I will see THAT doctor within 3 hours of my scheduled appointment?”

    The doctors from Wanniassa will maintain their existing appointment system ie you make an appointment to see a specific doctor at a specific time. Their punctuality or lack thereof will be the same as it was before the move.

    “When was the last time that Primary Care polled its current Phillip patients to see how well the Centre is performing in the eyes of its current customers? If not in the last 12 months, how important are the views of Primary Care customers considered?”

    That was done as part of accreditation just over a year ago.

    “How many of the WCM doctors believe that the move to Phillip is largely a positive one for their respective patients’ health care?”

    Interesting question. The WMC doctors signed contracts with Symbion. Their contracts allowed for a move within five km of WMC. They, like the doctors at Phillip, received upfront payments for agreeing to the contractual conditions.

    “What percentage of patient non-transfer rate from WMC have Primary Care deemed acceptable? i.e. have they calculated that the move is financially sound if up to 10%/20%/30% (or more) patients refuse to follow their doctors to Phillip?”

    There is such a massive shortage of GPs in this region that even if none of the WMC patients transferred to Phillip all the doctors are going to be flat out any way. By the way, a significant number of WMC patients already attend Phillip as we are open until 10.00 pm every day of the year.

    There has been a lot of deliberate misinformation being peddled about the WMC move to Phillip. Contrary to the what Annette Ellis has told you, patients will be able to make appointments to see their own doctor. The WMC practice will be on a separate level, and has its own waiting area.

    Interestingly, the Woden area was not considered an area of need by the federal health bureaucrats. However, we consistently see more that 300 patients a day. We see people who can’t get to see their own doctor in a reasonable time frame (within a few days), we see people who can’t get to a see a GP because none are accepting new patients, and we see out of hours patients when most GPs are having a well earned rest. We also see many patients who previously would have had to attend ED at the Canberra Hospital. As a result, we are extremely busy most of the time. We are unable to get enough doctors because of the shortage that exists. Most patients accept that we are doing the best we can under the circumstances. However,a small minority are rude and aggressive toward the reception staff, and carry on like spoiled children. Can you imagine someone making a scene at the door of a restaurant that was about to close (like mdme workalot)?

    So instead of blaming the doctors at Phillip for the inconvenience of having to wait for medical attention, perhaps have a think about why there is such a massive shortage of GPs (clue: GP numbers are not controlled by the medical profession).

    While it will be inconvenient fore some, the Wanniassa Medical Centre is being moved is being moved lock stock and barrel into new premises less than 5 km up the road.

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barking toad2:03 pm 07 Aug 08

Just on Daktari’s last 3 sentences about wait times and abuse of reception staff.

A close relative attended recently and had the expected two hour wait – expected at a bulk billing clinic given the demand. But was astounded by some skank berating the receptionist because she had been waiting for nearly 20 minutes to see a doctor(there were some 30 patients waiting, most before her).

Is it just my wishful thinking that would have seen the lass on reception slip the papers of the lard-arse skank to the end of the queue as she waddled back to her seat to watch the telly?

daktari said :

peterh

If we could get more doctors we would. We are constantly advertising, approaching doctors, offering substantial sign-on packages. But they just aren’t there.

We do employ RNs, and treatment room assistants. The RNs do immunizations, injections, dressings etc. Those having recurring treatments don’t queue with those waiting to see a doctor.

the problem is that, in order to be identified as requiring recurring treatments, we must first see a doctor at the clinic. If i walked in with my ampoule for my injection – I get it, don’t get it through the doctor, I would be in the queue. Is there a mechanism that ensures that the people coming in for an injection can be passed to the treatment room assistants and treated, then out on their way without having to sit and wait for a doctor first?

peterh

If we could get more doctors we would. We are constantly advertising, approaching doctors, offering substantial sign-on packages. But they just aren’t there.

We do employ RNs, and treatment room assistants. The RNs do immunizations, injections, dressings etc. Those having recurring treatments don’t queue with those waiting to see a doctor.

I don’t know of many practices employing RNs to triage patients (except ED at TCH). Yes it would be good, but RNs don’t grow on trees either. We are lucky to have some experienced ones running the treatment room.

And Madman, despite having a fully equipped dental practice we just can’t get dentists. You may think it a joke, but I can assure you, the dental health of many Canberrans is appalling.

letsallcareabouthealthcare said :

I will be (personally) delighted if all of what the current Phillip Medical Centre doctor says transpires to be true, and remains true.

The Phillip Centre is in fact 10 minutes closer to me than Wanniassa. So my concern is actually not about location (although I am aware that this is a big issue for other WCM patients, particularly the elderly and those who do not drive).

I’m more concerned that Primary Care will alter the way I and others are able to access our family doctors by implementing walk-in booking and other policies which would fly in the face of advice that people should seek to develop a consistent, regular and trusting relationship with one doctor.

I do remain unconvinced however by both the response and others’ comments in this blog that the WCM doctors believe this to be a move made in the best interests of their patients.

if the phillip centre wants to make it easier for patients, increase the numbers of doctors working per day. Don’t have 2 doctors servicing 20 or 30 patients.

This will only lead to bad customer service by the overwhelmed receptionist staff. (who, if they aren’t RN’s, should not be performing triage on incoming patients, particularly little kids)

If you Consider that there are some patients who need regular injections that we are not able to administer ourselves – the needle is HUGE, employ a RN primarily for this function.

As a HR therapy patient, I really just want my 3-monthly jab and on i go. am not fussed as long as they understand that I will have a regular 3-monthly appointment for the rest of my life for this jab.

Tuggeranong square gets my business at the moment, and i pay a bit for a doctor to jab me.

letsallcareabouthealthcare12:13 am 07 Aug 08

I will be (personally) delighted if all of what the current Phillip Medical Centre doctor says transpires to be true, and remains true.

The Phillip Centre is in fact 10 minutes closer to me than Wanniassa. So my concern is actually not about location (although I am aware that this is a big issue for other WCM patients, particularly the elderly and those who do not drive).

I’m more concerned that Primary Care will alter the way I and others are able to access our family doctors by implementing walk-in booking and other policies which would fly in the face of advice that people should seek to develop a consistent, regular and trusting relationship with one doctor.

I do remain unconvinced however by both the response and others’ comments in this blog that the WCM doctors believe this to be a move made in the best interests of their patients.

LOL – the doctors are in there contractual obligations to refuse.

If it is the centre at 33 Colbee Crt then do a search from there to Sangster place in Waniassa and it shows it is 5.3km in distance.
Their contract is being violated!!!

I have a suspicion that 2 of the doctors are going to retire before the move.

Oh yeh and if it is the one at Colbee Court which claims to also be a dental surgery – I called there last week to make a dentist appointment and they appologised as they couldn’t take me as they didn’t have a dentist and haven’t been able to find one in a while!!!! What a joke!

gun street girl10:51 pm 06 Aug 08

sepi said :

Oldies moving into retirement homes need to have a local GP sign on as their treating dr, before they are allowed to move into the retirement home. In some parts of Canberra it is impossible to get Drs to accept these new patients (especially as they know they are elderly and are bound to need a few appointments).

I believe that’s got a lot to do with the miniscule return given via Medicare for nursing home (ie on site) visits. I can’t quote figures (GP isn’t my area), but have been told that the actual cost of the time it takes to go to the facility, see the patient, and get back to the practice is not well represented in Medicare billing – particularly in a population of GPs who are already swamped in work already.

This lack of on-site care likely leads to an increase in ED presentations from nursing homes. This is further compounded by the fact that nurses are being pushed out of the aged care facilities (poor pay compared to hospital colleagues, heavy work, low glamour/glory quotient), so under-qualified staff are left with little choice but to call an ambulance when things go wrong, because they are not equipped, professionally speaking, to deal with emergent medical problems themselves.

Anothe problem with GPs refusing to take on new patients.

Oldies moving into retirement homes need to have a local GP sign on as their treating dr, before they are allowed to move into the retirement home. In some parts of Canberra it is impossible to get Drs to accept these new patients (especially as they know they are elderly and are bound to need a few appointments).

As if finding a spot in a decent retirement home wasn’t hard enough already.

johnboy said :

There’s a clinic in parliament house, couple of nurses and a doctor IIRC.

And if you want a PO with a guaranteed no-wait EVER, use the one in NPH. It’s amazing. A fully kitted-out Post Office, and no one in it. I did my passport renewal there, with no appointment, at lunch time!

Ahh, never saw a doctor but they put one’s name on a form when I got a jab.

Thanks for clearing it up.

Ruby Wednesday10:14 pm 06 Aug 08

johnboy: There’s a couple of nurses but no doctor at the facility (the nurses centre) in APH.

Well a survey of one isn’t all that conclusive, so let’s make it a survey of 2.

I commonly can’t get into my dr, or any other dr at that practice on the same day, or even the next day. I have now resorted to making dr’s appts for a few days into the future, as soon as my toddler starts to get a cold, in case we need to take her in if she gets worse. Then I cancel most of these appts – so it is a waste of time for everyone.

My dr is so busy they won’t take on any more patients, even family members of existing patients (except new children). I have already followed my dr from one practice to her next practice – 3 suburbs away. She is very good, but the prices continually go up, the appointments seem to get shorter, I seem to wait longer, and the delay in getting an appointment has gone from next day, to next week.

Woody Mann-Caruso9:59 pm 06 Aug 08

They probably do what I do: call my local surgery and ask if I can see my doctor that day. Usually I can. Sometimes I can’t, so I see a different doctor at the same surgery instead. I’ve never not been able to get in the same day – not once in 12 years, at four different surgeries.

Bummer – I suspected as much…

There’s a clinic in parliament house, couple of nurses and a doctor IIRC.

You expected anything else?

PS – I wonder what the federal MPs do when they get sick in Canberra. I think we need a few of them to feel really dreadful or get injured and find they can’t get in anywhere that day, and maybe they will get around to declaring Canberra an ‘area of need’ for GPs.

I don’t dispute that this medical business is well within their rights to move.

But I do think healthcare and access to healthcare in the ACT is lacking, and is getting worse all the time. I think this is why people have reacted so strongly to this decision.

We need more GPs AND more medical centres.

And I do realise it isn’t up to the GPs to change the system. But that doesn’t mean noone should complain.

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