By Dr Jared Dart BSc BA MBBS PhD FRACGP
COVID 19 Fiveways Surgery Update 4 April 2020
In this email I will discuss:
- how we are dealing with the circumstances to deliver safe, accessible and sustainable care;
- the process for our flu immunisations clinics; and
- our telehealth strategy.
As I reflect on the last two months, I am struggling to appreciate what an extraordinary change has occurred in our practice and our community. Even though some of the events seemed predictable to me, now that we are here, I must admit to feeling somewhat numb. After two months of planning and preparation I am also rather exhausted.
What is clear to me, however, is that what makes our community so wonderful has not changed. The friendly, considerate community members remain the same. We have received gifts and cards and expressions of gratitude and warmth which have made the difficult times seem easier. Our local community of shops at Fiveways is closer than ever and I’ve enjoyed the comraderie with our fellow tenants.
Like all businesses, we have had to make changes to account for the downturn in trade (we have seen a 50% reduction in consultations). We feel for those businesses now unable to trade and for those who have lost their jobs. As always, we will provide compassionate relief to any people who have a lost a job – we do not want price to be a barrier to our care. Please let us know if you are experiencing financial hardship.
We have also seen an increase in calls for advice. As a result, our phone lines are sometimes busy. I would encourage all of you to use our booking App – Automed – or visit our website www.fiveways.online to book a telehealth appointment. In case you haven’t seen it, below is a screenshot of what our booking page looks like. You can only select a telehealth consult – please call if a face to face appointment is required.
Online Booking complementing Phone Booking
We have been working hard to make our care:
We have implemented approaches which prioritise your safety when you come to see us.
- We have implemented a telephone or video first consultation process so we can safely manage patients while reducing the number of patients seen in the practice. I will discuss this further later in the email.
- All our staff observe social distancing at work.
- When we interact with patients, we use personal protective equipment for all face to face consultations (I have implemented a sustainable approach to the use of PPE to allow this).
- We have a dedicated consultation room for examining at risk patients (colds or flus) which we clean after every patient
- Our equipment and clinic are regularly and thoroughly cleaned
- We believe that doctors should only consult patients if they have a practice where they can safely examine patients. We strongly discourage you from using online only clinics – these are not an appropriate means of delivering primary care.
- All our doctors continue to provide face to face services like immunisations, accident and injury care, planned procedures like Implanon insertions and excisions, and necessary examinations identified by telephone consultations
- We recognise this is a difficult time for many patients. As a result, we will be discounting our telephone or video consultations to account for their often shorter duration. Consultations less than 10 minutes will cost $68 ($30 out of pocket; Medicare rebate $38.20 where applicable). Longer consultations will attract a larger fee. Let us know if you are experiencing significant financial hardship.
Government Funded Influenza Immunisation Eligibility
‘Flu’ vaccine clinics
Last year we gave more than 2000 influenza immunisations. Fortunately, it is likely that the social distancing measures implemented for COVID19 will result in a reduced incidence of influenza this year. Demand for influenza immunisations has grown as people have begun to realise the value in preventative immunisations. Even though the Government always starts to raise awareness early to encourage immunisation, given that any influenza peak is likely to occur later in the year (e.g. August), there is no rush to arrange your flu immunisations.
Currently we have only received 200 vaccines from the Government for those aged over 65, 200 for those aged 5-64 with chronic diseases and 40 for those aged under 6 months to under 5years.
We have also received 300 private flu vaccines for those not eligible for the Government immunisation program. We can order more of both – in order to manage this process so that no one misses out, we are taking expressions of interest for the flu clinics by email.
Please reply to this email with the name and date of birth of all family members wanting an immunisation as well as your address so that we can accurately identify you. Please indicate if any of your family has chronic diseases like diabetes, heart failure, COPD which may mean you are eligible for a Government funded vaccine. My staff will call you to arrange a time and take pre-payment for private vaccines so that we can minimise contact during the clinic. For those unable to use email, please call the clinic.
Safe immunisation clinics
We have already run one flu vaccine clinic this week targeting our very old or otherwise vulnerable patients. Our process has been designed to reduce patient contact and observe social distancing. As a result, it will take us longer to provide these immunisations, so please be patient.
We schedule 10 patients every 15 minutes and space these patients 1.5M apart in our waiting room. Patients with cold or flu symptoms or a temperature are not permitted to enter. We ask all patients to wear short sleeved shirts for ease of immunisation. There is a 5-minute period between clinics to allow patients to leave and avoid a crowded foyer. Our staff all wear protective equipment and sterilise our hands between patients.
These visits are only for influenza immunisations so please do not ask for prescriptions or referrals – these can be arranged by a telehealth consult.
Dr Dart’s Telehealth Set Up
The following picture shows our current set up for telehealth consultations:
- Tablet for video or phone calling patients
- Usual computer for accessing and recording notes
- Wireless ear phones and microphone
Every cloud has a silver lining
Even though COVID19 has been a very difficult time for the community, so far we have been spared from large scale infections and the associated deaths and disability. We must not become complacent. I hope that my emails have helped you to prepare for the current circumstances.
At times like these, we all need to have a smaller life, focusing on our family, friends and community. Even though we are physically distanced, I encourage you all to maintain close social connections using telephone or video communication platforms. We are actively reaching out to our isolated, vulnerable or very elderly patients during this time and our GPs remain available for mental health support. Our psychologist Dr Jayne Orr is available for teleconsultations for anyone experiencing mental health issues.
I suspect our world will become smaller as well, as nations focus on the needs of their own populations. While this poses some geopolitical risks, it may encourage a stronger sense of community and belonging. We may travel less and learn to use virtual connections to replace face to face meeting, encouraging tele-work and leading to some positive environmental and quality of life outcomes.
As a community, we have also all learned more about infection control and reducing transmission of viral illnesses. This will have long lasting positive effects on our community if we can sustain cough etiquette, hand hygiene and social distancing when unwell. It might even result in your GP catching fewer of your colds and flus!
Whenever there is great social upheaval there is an opportunity for change for the better. Threats create opportunities. Revised workflows and strategies can result in improvements in quality of life and better outcomes in health and social care. We must take this opportunity as a community to reflect on what is important and how we can prioritise these issues going forward.
This is not to downplay the very real difficulties experienced by many of you, but I hope you can see that there is a light at the end of the tunnel and if we continue to support each other through this we can come out stronger, more resilient and more connected than ever before.
With my warmest regards
Dr Jared Dart
Director iHealth Australia