Who needs doctors anyway?

johnboy 2 April 2009 21

Katy Gallagher has announced that her feedback report into nurse operated walk-in health centres has encouraged her to progress the idea.

    “I am very exited about the potential of the walk-in centres to provide additional health services for a discrete group of patients and to assist our GP and emergency department workforce,” she said.

    The first walk-in centre will be established on The Canberra Hospital site, with the exact model still to be determined.

    “We will then look at rolling out of a further two centres to come on line within the next three to four years,” she said.

    “It’s important to note that the walk-in centre model is not a replacement for GPs or emergency department care, but would provide another type of care for people with one-off, non-serious health concerns,” Ms Gallagher said.


What's Your Opinion?


Please login to post your comments, or connect with
21 Responses to Who needs doctors anyway?
Filter
Order
deezagood deezagood 12:33 pm 03 Apr 09

davesfk said :

Anyone else think that Gun Street Girl sounds like the sort of person who should be working as part of katy’s taskforce?

Rather than opening more beds in the acute sector (which I agree is under resourced) why isn’t the government opening up privately practicing primary care clinics?

There’s nothing stopping them from poaching GPs from Sydney (where there is oversupply) and placing them on salary here. It’s what the corporate mobs do. There’s a bunch of old buildings (schools) that would be perfect to convert to primary care centres. The bulk billing issue wouldn’t apply as services wouldn’t be funded through Medicare.

Yes – and offering other financial/salary incentives (just as they do to lure GPs into country service) to qualified doctors … or offering undergraduate/Graduate medical scheme sponsorship to trainee doctors etc… I know a lot of doctors leapt at the country-service bounties offered in some parts of rural Australia – surely a few years in Canberra would be as palatable as living in woop-woop.

gun street girl gun street girl 12:29 pm 03 Apr 09

davesfk said :

Anyone else think that Gun Street Girl sounds like the sort of person who should be working as part of katy’s taskforce?

!!!!! Gulp.

I don’t qualify to work for Katy’s taskforce, because I actually work on the frontline and care about getting things done properly. Ergo, my opinions are rather inconvenient.

There’s nothing stopping them from poaching GPs from Sydney (where there is oversupply) and placing them on salary here.

…Except a reluctance to put up sufficient incentives. Showing Sydney GPs pretty pictures of balloons aloft and autumnal colours (“Work in Canberra! It rocks!”) isn’t quite enough to bring them here. 😉

davesfk davesfk 12:23 pm 03 Apr 09

Anyone else think that Gun Street Girl sounds like the sort of person who should be working as part of katy’s taskforce?

Rather than opening more beds in the acute sector (which I agree is under resourced) why isn’t the government opening up privately practicing primary care clinics? There’s nothing stopping them from poaching GPs from Sydney (where there is oversupply) and placing them on salary here. It’s what the corporate mobs do. There’s a bunch of old buildings (schools) that would be perfect to convert to primary care centres. The bulk billing issue wouldn’t apply as services wouldn’t be funded through Medicare.

gun street girl gun street girl 11:57 am 03 Apr 09

deezagood said :

I also worry about the liability/consequences/stress for the poor RN who ‘diagnoses’ the slightly feverish baby as having a cold … when the baby actually has meningococcal, or something more serious. What if a patient presents as having a very mild concussion and is treated accordingly – but later dies from brain trauma?

Who will be held responsible if a patient is misdiagnosed and there are serious consequences of this misdiagnoses?

This was another concern raised by “the big bad bullies” of the AMA:

http://www.ama.com.au/node/2098

gun street girl gun street girl 11:55 am 03 Apr 09

peterh said :

for the sake of safety for a nurse in one of these clinics, and to reduce the response time for an emergency patient, wouldn’t it be a good idea to have one GP at each of these sites, to assist when required, for example, at a very busy period, or when a patient presents with something that is far more than a stubbed toe or sniffle? I just feel that the blame shift for this boutique project (thanks gun street girl) would have nurses getting roasted for things beyond their control, or experience. Could the use of an attending GP create a second level of support for the nurses?

Sure. Then again, this already happens – GP clinics employ practice nurses, who attend to basic issues, ranging from the simple (immunisations) to more complex (pap smears, for instance). I don’t see a similar advantage in an _acute care_ hospital catering to non-acute issues, though. TCH can’t properly service critically ill patients. Our emphasis should be on how to ameliorate that situation, not on how we can better deal with a non-acute casemix.

I visit the TCH once every 6-months. I am operated on by a different registrar each time. I would prefer to visit a clinic to get this procedure done, but, as it is classified as basic surgery, i continue to play pot luck with the person performing the surgery, even though i have been informed by friends who are nurses elsewhere in australia that these procedures are performed by nurses in other hospitals.

Another perspective, if you will: those registrars have all learned something from providing you with that basic surgery. They are training to become independent practitioners, and exposure to simple, bread-and-butter cases expands their experience base, knowledge and skills. As a side issue, this is one of the (admittedly many) reasons medicos have reservations about handing these duties across to nurses in teaching hospitals: our younger colleagues will miss out on the easier casemixes, and their training can potentially suffer as a result.

deezagood deezagood 11:47 am 03 Apr 09

I also worry about the liability/consequences/stress for the poor RN who ‘diagnoses’ the slightly feverish baby as having a cold … when the baby actually has meningococcal, or something more serious. What if a patient presents as having a very mild concussion and is treated accordingly – but later dies from brain trauma?

Who will be held responsible if a patient is misdiagnosed and there are serious consequences of this misdiagnoses?

ED Doctors can (and do) make the same mistakes, but at least they have the advanced medical training and/or peer support to inform their decisions. Canberra needs more Doctors AND Nurses – this is a placebo. And while I agree with Sepi’s point that it would be great to be able to quickly get a script for a minor complaint (eg. ear infection) without having to wait four days to see a doctor …. we should be able to get that script from an actual GP just as quickly (like they do in other major cities).

peterh peterh 11:46 am 03 Apr 09

for the sake of safety for a nurse in one of these clinics, and to reduce the response time for an emergency patient, wouldn’t it be a good idea to have one GP at each of these sites, to assist when required, for example, at a very busy period, or when a patient presents with something that is far more than a stubbed toe or sniffle? I just feel that the blame shift for this boutique project (thanks gun street girl) would have nurses getting roasted for things beyond their control, or experience. Could the use of an attending GP create a second level of support for the nurses?

I visit the TCH once every 6-months. I am operated on by a different registrar each time. I would prefer to visit a clinic to get this procedure done, but, as it is classified as basic surgery, i continue to play pot luck with the person performing the surgery, even though i have been informed by friends who are nurses elsewhere in australia that these procedures are performed by nurses in other hospitals.

gun street girl gun street girl 11:32 am 03 Apr 09

Palin s Lovechild said :

Muttsybignuts would appear to be clinically accurate but the big bad bullies at the AMA would argue differently. It would be a turf would that nurses would loose.

Why even bother going to med school if nurses and doctors are interchangeable? Let’s not resort to the old “nurses can do just about everything a doctor can do and the only thing stopping them are evil doctors who just want to keep them down” conspiracy/argument – it over-simplifies what is a far more complex issue, and insults those of us in the industry who know that simply isn’t true. There’s certainly a role for nurse practitioners; but the implementation of them won’t replace a GP workforce shortage (though it would be nice for the pollies if it would – an NP costs less than a GP), nor will it find you any more beds on the wards (indeed, it may well make it harder). Redistributing a workforce that’s already in shortage into boutique projects like this one is a luxury the ACT can’t afford right now.

Palin s Lovechild Palin s Lovechild 11:16 am 03 Apr 09

Muttsybignuts would appear to be clinically accurate but the big bad bullies at the AMA would argue differently. It would be a turf would that nurses would loose.

Hospitals would not be such a bad place to work if Stanhope would drop his lefty tree-hugging human rights agenda and ensure the safety of staff. I feel the human rights of the staff should be more important than the patients esp those who throw stuff. ACT Health have a duty of care to their staff, clinical or otherwise.

Medicine and nursing needs to be more attractive to students when choosing careers. HECS-free courses may be an option. Opening new clinics will just redistribute the statics numbers of GPs and nurses that currently work in the system.

National Registration of health professionals due on 1 July 2010 will be of no assistance with the current shortages.

Muttsybignuts Muttsybignuts 9:53 am 03 Apr 09

Great idea. As a previously registered nurse I know that RNs are more than adequate to handle most medical situations. If they cant accurately diagnose the ailment they will send them on to a Doctor or Casualty ( or whatever they call it nowadays).

gun street girl gun street girl 8:59 am 03 Apr 09

There’s an excess who are disillusioned and burned out from working on the front line. They are already filtering into administrative roles; there will be a few who will be more than happy to move into a 9-5, Monday to Friday cushy clinic designed to look at sniffles and stubbed toes. Nevermind that it leaves their workforce on the ground even more hamstrung than before – am sure admin will think of a new initiative to fix that problem too.

poptop poptop 8:33 am 03 Apr 09

So we have an excess of nurses who can be allocated to this new initiative?

What happened to the nursing shortage?

farnarkler farnarkler 10:17 pm 02 Apr 09

This system works like a dream in the NHS in the UK. The staff are able to prescribe medicinces and deal with the less sick.

barry ottor barry ottor 9:44 pm 02 Apr 09

this is a bloody good idea, most doctor’s time is spent chatting to geriatrics who have nothing better to do than waste their time. Get people in and out in quick time and watch the health crisis rapidly right itself. Why on earth a 10 year trained doctor is required to renew prescriptions for birth control pills is beyond me!?

gun street girl gun street girl 9:23 pm 02 Apr 09

Danman said :

Easy to open the beds up, but you kind of need staff to attend them as well..

Exactly. We’ll also need nurses to staff these new clinics – nurses who could be working the wards, thusly opening beds. Instead, we’re most likely going to see the wards losing nurses to this new clinic, which isn’t a solution to bed block or a GP shortage.

Maybe they need more incentives for hospital staff, it seems that regularly having your life threatened, being swung at, having walking sticks swung at you, kicked in the neck, kicked in the chest and verbally abused isn’t enough.

I would risk that hopitals are the most dangerous place to work.

The threat of physical, verbal and mental abuse is really only the tip of the iceberg. There are heaps of other, equally compelling reasons to leave.

GS girl – what do you think she should be doing?

I actually think this isn’t a bad idea. If the problem is just bronchitis, or baby with a temperature, I’d rather see a nurse today, than my GP in 4 days, which is the current situation.

Succinctly, she shouldn’t be trying to replace a service (critical GP shortage) with a new (potentially outgunned) service that siphons from a workforce that is already in shortage itself. Not enough GPs? Endeavour to employ more. Provide incentives for GPs to locate to the ACT, and for those already here to stay in practice. With regards to a nurse clinic taking the pressure off the ED (which is the real political crux of the issue), it won’t. The pressure on ED comes from access block, and access block is NOT caused by an excess of GP type patients presenting to the ED. It’s caused by a lack of beds. Period.

sepi sepi 9:05 pm 02 Apr 09

GS girl – what do you think she should be doing?

I actually think this isn’t a bad idea. If the problem is just bronchitis, or baby with a temperature, I’d rather see a nurse today, than my GP in 4 days, which is the current situation.

Danman Danman 8:48 pm 02 Apr 09

hospitals as well.

Danman Danman 8:47 pm 02 Apr 09

Easy to open the beds up, but you kind of need staff to attend them as well..

Maybe they need more incentives for hospital staff, it seems that regularly having your life threatened, being swung at, having walking sticks swung at you, kicked in the neck, kicked in the chest and verbally abused isn’t enough.

I would risk that hopitals are the most dangerous place to work.

gun street girl gun street girl 6:54 pm 02 Apr 09

Daresay she’s excited to have found yet another project to deflect attention away from the real problems (and their rather expensive, inconvenient solutions).

Primal Primal 6:50 pm 02 Apr 09

“Very exited”? What, is it a bowel looseningly good policy???

CBR Tweets

Sign up to our newsletter

Top

Search across the site