General medical care

Standard appointment – 1 basic issue or 2 quick eg prescription/referral renewal, or prescription renewal and Cervical Screening

Long Appointment – Complex issue eg Mental Health issue, Care Planning or multiple items to discuss. Please note that depending on the complexity of the issue and/or the number of issues to discuss, your doctor may deal with the most pressing issue on the day and request that you rebook to address/attend to additional items.

Our staff are happy to assist you to determine your appointment needs.

Our GP’s endeavour to run to time, however, we cannot always determine when a patient may require more time than has been allocated due to a pressing health issue or if an urgent issue may present. Where possible the doctor may ask the patient to return at a later time, but this is not always possible and we hope that you would appreciate your doctor not pushing a patient in need out the door in order to run to schedule. We appreciate your patience during these times.

We require a MINIMUM of 2 hours notice to cancel or change any appointment (excluding Dr Madawala’s Skin Cancer Clinic. 2 days notice is required and separate fees apply). If the minimum notice has not been given and the appointment cannot be filled a $50 failure to attend fee is charged. This fee must be paid before any further appointments can be made. If we manage to fill the appointment, no fee will be charged.

Surgical procedures

Surgical procedure will incur an out of pocket expense for all patients including children 15 years and younger. Resources such as suture materials, dressings, bandages, plaster and associated equipment and it’s sterilising incur a physical cost to the practice which cannot be covered by any medicare rebate. These fees are payable at the time of the procedure.

FEE: $60+ (higher fee would be due to extensive use of product)

Lesion removals will be booked after an initial consultation with your GP to assess the lesion and determine the best course of action or treatment.

Booking will then be made for the removal. Time is allocated for use of the treatment room, a nurse to assist and the doctor.

The facility fee is payable to the practice at the time of the appointment. In most instances the procedure is unable to be invoiced until the pathology result has be received in order to determine the correct item number to bill.

You will have a further out of pocket fee on this item. This fee will be dependant on your billing status eg private or concession card holder, and your out of pocket expense will be the same as for a consultation item ie $42.40 non-concession, $20 pensioner and healthcare card holders.

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Wound & leg ulcer management

Whereby a wound requires extensive or extended care, you will referred to the Community nurses for ongoing care.

Should ongoing treatment be provided at our rooms, you will be required to purchase your dressing materials from a pharmacy and you can bring them with you to your appointment or leave them at our rooms for your ongoing treatment. We require that you store them in a suitable container (eg. Lunch box), labelled with your name. Whereby the clinic provides the materials you will be charged for these items.

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Health screening

Advance Care Plan: Advance care planning allows health professionals to understand and respect a person’s preferences, if the person ever becomes seriously ill and unable to communicate for themselves. We encourage people of all ages to prepare their personal end of life care plans, to give certainty to themselves and their families. More information

Chronic Disease Management Care Plan: Summary
• There are two types of plans that can be prepared by a General Practitioner (GP) for Chronic Disease Management (CDM): GP Management Plans (GPMP); and Team Care Arrangements (TCAs)
• There are two types of plans:
• If you have a chronic (or terminal) medical condition, your GP may suggest a GPMP.
• If you also have complex care needs and require treatment from two or more other health care providers, your GP may suggest TCAs as well.
• Your GP or practice staff must obtain your agreement before providing these plans.
• If a provider accepts the Medicare benefit as full payment for the service, there will be no out-of-pocket cost. If not, you will have to pay the difference between the fee charged and the Medicare rebate.
• If you have both a GPMP and TCAs prepared for you by your GP, you may be eligible for Medicare rebates for certain allied health services. It is up to a GP to determine whether you are eligible for these allied health services which must be directly related to the management of your chronic condition.
• The practice nurse can provide support and monitoring between visits to your GP.
• Your GP will offer you a copy of your plan.
• You and your GP should regularly review your plan/s.

Chronic medical conditions
A chronic medical condition is one that has been (or is likely to be) present for six months or longer, for example, asthma, cancer, heart disease, diabetes, arthritis and stroke. There is no list of eligible conditions. However, these items are designed for patients who require a structured approach and to enable GPs to plan and coordinate the care of patients with complex conditions requiring ongoing care from a multidisciplinary care team. Your GP will determine whether a plan is appropriate for you.

GP Management Plan

A GP Management Plan (GPMP) can help people with chronic medical conditions by providing an organised approach to care. A GPMP is a plan of action you have agreed with your GP. This plan:
• identifies your health and care needs;
• sets out the services to be provided by your GP; and
• lists the actions you can take to help manage your condition.

Team Care Arrangements
If you have a chronic medical condition and complex care needs requiring multidisciplinary care, your GP may also develop Team Care Arrangements (TCAs). These will help coordinate more effectively the care you need from your GP and other health or care providers.

TCAs require your GP to collaborate with at least two other health or care providers who will give ongoing treatment or services to you. Let your GP or nurse know if there are aspects of your care that you do not want discussed with other health care providers.

Review of GPMPs and TCAs
Once a plan is in place, it should be regularly reviewed by your GP. This is an important part of the planning cycle, where you and your GP check that your goals are being met and agree on any changes that might be needed.

Referrals for allied health services
If you have both a GPMP and TCAs prepared for you by your GP, you may be eligible for Medicare rebates for specific individual allied health services that your GP has identified as part of your care. The need for these services must be directly related to your chronic (or terminal) medical condition. If you have type 2 diabetes and your GP has prepared a GPMP, you can also be referred for certain allied health services provided in a group setting.

Health Assessments: Your GP may consider a Health Assessment beneficial for you.
Health assessments are generally made up of the following elements:
• information collection, including taking a patient history and undertaking or arranging examinations and investigations as required;
• making an overall assessment of the patient;
• recommending appropriate interventions;
• providing advice and information to the patient;
• keeping a record of the health assessment, and offering the patient a written report about the health assessment, with recommendations about matters covered by the health assessment; and
• offering the patient’s carer (if any, and if the medical practitioner considers it appropriate and the patient agrees) a copy of the report or extracts of the report relevant to the carer.

Patient consent
The patient or their parent/guardian must be given an explanation of the health assessment process and its likely benefits, and must be asked by the medical practitioner, practice nurse or Aboriginal and Torres Strait Islander health practitioner whether they consent to the health assessment being performed. Consent must be noted on the patient record.

‘Usual Doctor’ and other health professionals
An MBS health assessment item may only be claimed by a medical practitioner, including a general practitioner but not including a specialist or consultant physician. A health assessment should generally be undertaken by the patient’s ‘usual doctor’, that is, the medical practitioner (or medical practitioner in the same practice) who has provided the majority of services to the patient in the past 12 months, and/or is likely to provide the majority of services in the following 12 months. Should a medical practitioner other than the patient’s ‘usual doctor’ or practice nurse undertake the health assessment, a copy of the health assessment record should be forwarded to the patient’s ‘usual doctor’ or practice, subject to the agreement of the patient or their parent/guardian.

The medical practitioner is expected to take a primary role in the following activities when providing a health assessment:
• reviewing and analysing the information collected;
• making an overall assessment of the patient;
• undertaking and arranging investigations;
• making referrals and identifying appropriate follow-up; and
• providing advice to the patient.

Practice nurses and Aboriginal and Torres Strait Islander health practitioners may assist medical practitioners in performing a health assessment, in accordance with accepted medical practice and under the supervision of the medical practitioner. This may include activities associated with:
• information collection; and
• providing patients with information about recommended interventions at the direction of the medical practitioner.

All other components of the health assessment must include a personal attendance by a doctor.
• a health assessment for people aged 45-49 years who are at risk of developing chronic disease
• a type 2 diabetes risk evaluation for people aged 40-49 years with a high risk of developing type 2 diabetes as determined by the Australian Type 2 Diabetes Risk Assessment Tool
• a health assessment for people aged 75 years and older
• a comprehensive medical assessment for permanent residents of residential aged care facilities • a health assessment for people with an intellectual disability
• a health assessment for refugees and other humanitarian entrants

The decision to use any one of these four MBS health assessment items to carry out a health assessment will depend on the practitioner’s clinical judgement based on the complexity of the presentation and the type of health assessment used.

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Diabetic counselling

Gaynor Paxton is the Diabetes Educator at our clinic. Gaynor consults on Mondays and Tuesdays to ensure that patient’s with Diabetes are routinely reviewed to ensure adequately managing their diabetes. Your usual GP will complete a care plan to enable you to attend a consultation with Gaynor.

Patients of the clinic will not incur an out of pocket fee where their GP has provided a visit as part of the patients Team Care Arrangements as part of their Care Plan.

Patients referred from an external source will be charged a fee of XXXXXXX

Initial consultations will be for 50 minutes and review consultations 30 minutes. Where you are given referrals via Team Care Arrangements it is important that you be aware that you can only be allocated 5 visits per calendar year (January – December) to Allied Health Professionals. Once the 5 visits have been claimed by the various Allied health providers, Medicare will not pay a rebate for any visits to these services and you will be required to pay for the services. It is therefore important that you keep a record of dates that you attend any allied health professionals that you have been referred to as part of your care plan.

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Antenatal care, Family planning & contraceptive advice

Your GP can provide your care for your contraception and family planning from conception to birth and beyond. Our GP’s are not on the obstetric roster and will therefore not be able to deliver your baby. They can however, provide the majority of your antenatal care (for low risk pregnancies).

Initial consultation should occur as soon as pregnancy is suspected and visits to occur as below.

These are shared between the hospital and the GP and it is important that you attend as per the schedule to ensure that the appropriate examinations and testing occur at the correct stages of your pregnancy. See list below:

• Booking visit 10-14 weeks gestation (at Antenatal Clinic)

• 16 weeks (with GP)

• 20 weeks (at Antenatal Clinic)

• 24 weeks (with GP)

• 28 weeks (with GP)

• 30 weeks (at Antenatal Clinic)

• 32 weeks (with GP)

• 34 weeks (with GP)

• 36 weeks (at Antenatal Clinic)

• 37 weeks (with GP)

• 38 weeks (with GP)

• 39 weeks onwards (at Antenatal Clinic)

More frequent visits or referrals back to the Antenatal Clinic or to an Obstetrician may be needed if complications arise. If the patient has significant complications, they may be asked to visit the Antenatal Clinic/Obstetrician for the remainder of their pregnancy.

More Information

Please return to your usual GP for your and your baby’s 6 week check up and the associated immunisations. This is particularly important as Victoria has a different immunisation schedule to NSW.

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Palliative & terminal care in conjunction with local home-based & hospital health services

Some of our GP’s provide palliative and terminal care to their own patients. They will only provide this care for their existing patients of 6 months or more. Admitting rights to Mercy Health are required to allow this to occur. Home visits will only occur at the doctors discretion.

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General immunisation, childhood vaccinations, & travel health care

Our Registered Nurse, Kathy Cherry is a qualified Nurse Immuniser. Where possible your usual GP will attend to ensure your child is well for vaccination.

Please ensure that you bring your blue book with you to maintain a copy of the vaccinations given and to allow our nurse to update our records with any vaccinations given elsewhere eg. The hospital.

See Schedule current at 23/10/2018

Travel vaccinations can be given after consultation with your GP to determine what vaccinations you will require depending on your destination.

You will be provided with a prescription to purchase your vaccine. (The decision to not hold travel vaccines on site is for your benefit as the Pharmacy can supply at a better price.)

When you return with the vaccine an appointment will be required with the nurse to administer the vaccine. Links to travel vaccinations and childhood immunisation schedule and prevaccination questionnaire

Yellow Fever (Stamaril) Vaccination: Providers Dr M Bartram, Dr N Madawala, Dr K Ebert.

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Nursing home and hospital visits, where admitting rights are held

Our GP’s will continue to provide ongoing care to their existing patients (attending our clinic for last 12 months) when to go into a nursing home.

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Women’s healthcare and advice. Hormone replacement therapy

Info to come.

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Men’s healthcare and advice

Info to come.

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Fitness advice and management of sporting injuries

Info to come.

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Info to come.

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Personal, family and relationship counselling

Info to come.

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Pre-employment medicals and work related injuries

Info to come.

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