Clinics switch to telephone-only to ward off virus threat

Dr Todd Cameron took the drastic step across his three M3 Health clinics in Melbourne after a patient lied about their travel history and symptoms in order to be able to see a GP.
 
That left the GP potentially exposed to coronavirus, as they had no warning to allow them to use masks or isolate the patient. The risk was lowered, however, due to earlier social distancing efforts by clinic staff.  
 
‘People are fearful. They’re going to lie. Humans are going to be human,’ Dr Cameron told newsGP.
 
‘The doctor had an appropriate distance [from the patient], but this is increasingly going to happen. It’s naive to believe you can prevent people coming in, especially when a reasonable proportion don’t have symptoms.
 
‘If we’re telling people to socially distance themselves, but that it’s fine to pile into a doctor’s clinic – that seems stupid.’
 
That incident prompted Dr Cameron to accelerate the move away from in-person consultations and shut the doors of his three clinics.
 
He has also closed his Ascot Vale clinic to use as a ‘burner clinic’ or central operations area if he needs an area guaranteed not to have coronavirus contamination. The clinic has been offered to the local Primary Health Network for use as one of the forthcoming fever clinics, if needed.
 
‘Moving to telemedicine for everyone has been highly appreciated by doctors, patients and staff,’ Dr Cameron said.
 
The Federal Government made new telephone and video call Medicare Benefits Schedule (MBS) item numbers available on Friday.
 
RACGP President Dr Harry Nespolon has urged the Government to expand the scope of the new telehealth options as a way to reduce the risk of having potentially infected patients gathering in practice waiting rooms.
 
‘Facilitating more telephone consultations makes sense rather than having sick people turn up in a crowded GP clinic waiting room where they can spread the virus to others,’ Dr Nespolon told The New Daily.
 
‘It’s straightforward, it’s accessible for all people in the community and it will help in combating COVID-19.’
 
Dr Cameron has been agitating for faster movement on the coronavirus, warning that Australia’s increasing rates of infection mean the country could be two weeks away from becoming a virus hotspot – unless strong action is taken to slow the spread.
 
Under the new telephone-only policy, GPs at M3 clinics will undertake clinical diagnosis of coronavirus over the phone and direct possible cases to a government testing station.
 
Dr Cameron admits the move is pragmatic, given challenges sourcing personal protective equipment (PPE) and the need to ensure GPs remain safe from infection.
 
‘We only had PPE for eight cases, which is similar to most clinics,’ he said.
 
‘Our biggest job is to ensure our current patient population is well and applying appropriate social distancing, with an appropriate supply of medications, and don’t unnecessarily present at hospitals.
 
‘We know that most COVID-19 can be managed at home. Our job is to reduce the workload on hospitals, as we know it will be massive in coming months.’
 
Dr Cameron’s clinics are using telephone-only MBS items to avoid any teething issues with video calling over the internet.
 
Only last week, all M3 clinics had social distancing guides – in the form of gaffer tape on the floor – installed to indicate to patients what 1.5 metres of distance represents, while reception staff were instructed to avoid physical contact, such as holding a Medicare or credit card.
 
Other practices are following suit on social distancing after Dr Cameron publicised his approach on social media.
 
Dr Cameron acknowledges that the temporary shift to telemedicine will come with a pay cut, but he believes it is safer than the alternative.
 
‘Having patients with coronavirus pile in here next to little kids who will pass it around – it’s not safe,’ he said.
 
Dr Cameron said early action is vital.
 
‘Being a week ahead is like a month at the moment. We have an important leadership role in the community to encourage safety,’ he said.
 
‘A pandemic can end in two ways, through immunity from the virus or immunisation from a vaccine, and both are a long way off. This is a marathon.
 
‘We’re about to see widespread social upheaval. I don’t know how you prepare for it, but you need a certain plan even if you’re uncertain about the outcome.’
 
Overseas, telemedicine has been used to reduce the risk of coronavirus spread in nations like China and South Korea.
 
The CEO of telehealth software maker Corviu Dr Silvia Pfeiffer told The New Daily that the coronavirus would likely lead to a major uptake of telehealth globally.
 
‘[It’s] one of the best ways to get [the virus] under control’, she said.

The RACGP has more information on coronavirus available on its website.
 
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