GP Clincs – super or ordinary

GP Super Clinics
An unfortunate name but typical of this new govts media attention approach
I do not believe that these new Clinics will provide a caring health service as the Brisbane GP would like.  I do not believe that doctors employed in these clinics will do house / nursing home /hostel visits.  Why should they? they would loose money if they are away from the consulting intensity of life (because they will probably have to bulk bill)
As I have said before Clinics of the future will have large numbers of doctors (super clinics or not).  They wiull be able to attract doctors because of working conditions – pert of which are no house calls etc.  Smaller clinics will not be able to cope and they will have to look at the service levels they provide.  So you will end up with bigger clinics scattered around (both the new Super Clinicxs and the enhanced larger current clinics)

So what can be done about the too frail etc in order to provide good comprehensive community care.  This is the backdrop of the future of Primary Health Care in the community.  All the newer prononcements on targets etc mean that doctors will only be able to function in large groups.  There will not be many 1-2 doctor practices left and those that are left will have to be focussed on trying to survive and might not be financially able to do non consulting room jobs.  I do not think you can attract new GP’s to work in smaller GP units.

So I will accept your challenge and try to come up with a workable solution for these disadvantaged inyour community.  This is a group that will get bigger over time and not be able to visit the consulting “silos”.

So wait till next blog

Reform or repression

I cannot understand why people are excited about a “series of explicit targets” especially Paul Smith in the 16/5/08 issue of Australian Doctor.  “Why shouldn’t GP’s get involved?” WE ARE INVOLVED!! I fear it will be just one more thing that will be forced on GP’s.  There will come a time that i have spoken about before where doctors will be forced to choose between being a caring flexible doctor vs being someone focussed on his / her future in order to survive.  Gradually gradually our discretionary management options are being eroded.  This new federal govts insistence on performance targets will back fire.

How can the govt be responsible for making sure a proportion of asthma patients have action plans or that type 1 diabetics must have hb1ac <7…unless the govt is going to take over their management.  What will happen is that somehow GP’s will be forced to achieve these goals with all the attendant red tape.  How ?? well by tying it into the PIP paymemts.  But what about those practices not accredited., They will have to be accredited or get less per consult in an unaccredited parctice.  This is the recommendation of the Reform Commission.

Interesting days ahead as small practices will have to fold and just walk away; perhaps to join the Mega Clinics

 

Why Bother in seeking solutions?

Really, I do not know why I am bothering to be concerned about this issue, which is more than a local Stones Corner issue.  See Blog in http://needmoregps.blogspot.com
In light of the Budget I should now not work as hard or try as hard.  Why get penalised?
But I cannot seem to do that.  I have outlined how I can see metropolitan primary health care moving in the future and it seems that has not been challanged,
What has to be done is to seek some solutions within that framework.   So…….(next blog).
Trebor

A way forward

The great thing about blogging is that you do not have to formulate great works of prose.  You can just say it as you want to.
At first I set out my ideas in an unstructured way, trying to get rid of my pent up frustrations.  Trying to say things in an open forum that I have wanted to say for some time.
But now some type of structure is emerging and the future map is to
1. Comment on how I see GP’s delivering health care in the future.  This includes those much touted Super clinics. (shades of the old Community Health Centres from the Whitlam years)
2. Then to look at some of the forces that drive this behaviour of the doctors, using Professional Service Review information
3. Comments on revalidation and recertification that we will import from the UK and apply to GP’s (locum too!!!)

Then having got all this of my chest– at last, I will proceed to comment about real medicine and problems and not the other stuff that gets in the way of treatment of patients.
Of course there will be outbursts in response to other information that will appear.

Trebor

Government policies

There is a new proposed policy that doctors will soon have to validated every 5 years.  This is apparently what is happening in UK.   This was mentioned some time ago in the medical press.  Along with this was the announcement from the RACGP when they said that in the future QA&CPD will have to be targetted to each doctor and his supposed deficiencies.  No longer just able to go along to a drug dinner function that I might choose and learn about something I want to hear. 

It is not good because gradually the govt is forcing us into a mold of their making so that we will be forced to deliver the health care they want us to deliver.,  Not what we think a patient should have.  I am uneasy about this but I do not fully know why.  I would appreciate any comments

See my next blog about these policies.