By Dr Jared Dart BSc BA (Econ & Govt) MBBS PhD FRACGP
COVID 19 Fiveways Surgery Update 18 March 2020
This week our community was touched by coronavirus – fortunately, there is no risk to our patients or staff. This brought into stark relief the risks posed for our patients and staff.
As a result, we are implementing strategies to protect you, our patients, as well as our staff. We have more than 1100 patients over the age of 70 for whom the risk of COVID 19 is significant. There are also other vulnerable groups within our practice such as those recovering from cancer, those on immunosuppressive therapy, pregnant mothers and people with chronic disease.
We have a responsibility to set up systems to protect our patients from cross infection when attending our clinic. This week we started with dedicated cold and flu clinics where our patients were seen in dedicated consult spaces by staff wearing protective equipment. However, there is a national shortage of protective equipment and we must ration this so that we have enough to safely examine and assess patients who need face-to-face care.
The importance of social distancing
(Courtesy of The Conversation link here)
New clinic procedure
From Monday 23 March 2020 we will shift to delivering mostly Tele-consultations. We will only examine people in person by invitation. This might seem extreme, but it is likely that in the coming weeks to months that more widespread social isolation or home quarantine will be necessary. I do not want to alarm you, but I do want you to be prepared for the changes that we will make to your care at this practice.
A large proportion of routine care can be performed by telehealth. Over the next six months we may well delay some routine preventative health care like skin checks, routine Pap smears, check-ups and routine physical examinations. These things can wait for a time when the risks are lower.
We will, however, increase important services like tele-consultation for mental health issues (including with our psychologist), triage of and advice to people with viral illnesses and remote care for people with chronic disease. We will assess people by phone and advise them on a care plan and the need for further assessment. Physical examinations, if required, will be arranged on the same day.
Remember, even if you have cold or flu symptoms, at the moment it is much more likely that it isn’t COVID19! Testing is also strictly limited to people who fit the criteria set by the Australian Government and the reagent required for testing is in short supply. If you are sick, stay home until you have been well for at least 48 hours. If you need advice call us to arrange a phone consult.
Accessible care, delivered by telemedicine
We will increase our telephone and video call support for isolated and vulnerable people – particularly our more elderly patients who are at an increased risk of serious complications from COVID-19. This might mean twice weekly Tele consultations with a GP or one of our nurses. It might mean managing your diabetes, your blood pressure, your asthma, your emphysema, or your UTI through remote means.
You can be confident that we will use robust and secure means of treating you during this time. There is a truism in medicine that 80% of diagnosis can be obtained from taking a good history. Experienced GPs can often tell the problem as the patient is walking into the room or not long after they start telling their story. We are experienced at dealing with uncertainty, managing people at home, determining who needs more urgent or more intensive care, and providing a safety net and follow-up plan for our patients.
The most important thing for you to understand is that we will be with you throughout these difficult times. It may not be in the manner in which you were accustomed, but it will be delivered with the same warmth, compassion, professionalism and expertise that you are used to. This practice has been operating for more than 75 years, we will continue despite the challenges that face us. You, our loyal patients, are utmost in our minds and hearts during this difficult period.
Social Distancing in Pictures
Courtesy of https://imgur.com/gallery/ljS0CLI
Tele-health services (phone or video)
To provide you with the clinical care and advice that you need we will use either telephone or video consultations. If we decide that video consultation is the most appropriate way to treat you, we will email you instructions on how to prepare for your appointment. Within the next few weeks, I hope to be able to deploy a telemedicine platform I have been working on for the last three years called Welio. This will enable us to provide you with the care that you need in the most secure and appropriate manner.
Tele-medicine consultations are often shorter than face-to-face consultation. Sometimes we may need to have more frequent follow-up consultations to check that you are progressing in the manner in which we expect. As a result, most of our appointments will be 10 minutes or less. For some of you, these consultations can be bulk billed but for others there will be a private fee, with no Medicare rebate.
As per Government advice Telehealth rebates will be available to:
- people isolating themselves at home on the advice of a medical practitioner, in accordance with home isolation guidance issued by the AHPPC,
- people who meet the current national triage protocol criteria for suspected COVID-19 infection
- people aged over 70
- Aboriginal and Torres Strait Islander people aged over 50
- people with chronic health conditions or who are immunocompromised
- parents with new babies and people who are pregnant.
Remember to use effective hand hygiene practices
We hope to keep costs affordable for you (and us) during this difficult financial period for the community. Unfortunately, I predict that many general practices will go out of business during this time. This will unfortunately be true of many other small businesses and many of our patients who are casual staff may also be experiencing financial hardship. If you feel that our care is unaffordable for you please contact us by email (email@example.com) so that we can consider how best to provide care for you.
As a community, we all need to come together to get through this. We are committed to doing our part to support you and the local community.
We recognise that the weeks and months ahead may be very concerning for you and your family. You may have a number of questions and concerns about coronavirus and what it means for you and your family. Do not feel that any question is too small or frivolous. Our nurses and doctors are here to help you and your family AND for the foreseeable future – Fiveways Surgery is only going to be only a phone call away!
Yours sincerely and with my warm regards
Dr Jared Dart
Director iHealth Australia