GP calls on more practice owners to offer vaccination on weekends

Anastasia Tsirtsakis

20/08/2021 3:43:51 PM

Victorian GP Dr Ern Chang is among those running weekend COVID vaccination clinics. But is it profitable and sustainable longer term?

A GP holding a box of AstraZeneca.
As well as the convenience, Geelong GP Dr Ern Chang says patients feel safe and reassured getting vaccinated in community general practice. (Image: Supplied)

When Victoria recorded 29 new cases of COVID-19 on 6 August, two days into the state’s sixth lockdown, Dr Ern Chang felt compelled to help.
The Geelong-based GP decided he would open his clinic for vaccinations on Saturday morning. Within two hours of updating his availability online, appointments were already filling up.
‘We decided that there’s a place for vaccinating on Saturday and opened up another session for the weekend just gone, and we had 51 patients come through in the afternoon,’ he told newsGP.
Dr Chang is one of a number of GPs extending their operating hours into the weekend. Vaccination numbers, however, remain low when compared with weekdays, with GPs raising concerns about profitability and sustainability.
For example, on Sunday 14 August 39,563 doses had been delivered by primary care in the previous 24 hours, compared to 176,280 in the previous 24 hours on Wednesday 18 August.
Mindful of the small size of his practice and the lack of parking, Dr Chang decided to start small, rostering only himself on to vaccinate.  As the sole vaccinator, he can cater to one patient every five minutes, so long as the consent forms have been submitted and lodged ahead of time.  

‘From the time they come through my room, sit down, greet, talk through the process, pop the needle in, settle the paperwork – they’re in and out in five minutes,’ Dr Chang said.
‘Opening the consult with, “Did you have any questions? Your consent form’s complete” most times, they don’t have questions. So I just go into the spiel about the early and potential side effects.’
While there is a state-run vaccination hub located in Geelong that is open seven days and accepts walk-ins, Dr Chang said patient feedback indicates a preference for the general practice setting.
‘They found the small practice environment safe,’ he said.
‘And the fact that they are not in a large vaccination hub being corralled through crowds of people made them feel like they are looked after.’
Sydney GP and practice principal Dr Jas Saini has been running vaccine clinics from 9.00 am – 3.00 pm every Saturday for the past month, and says there is certainly demand, with appointments tending to book up quickly.
‘The reason we offered that was because of respecting people’s lifestyles; recognising that they have commitments during the week, [particularly] as the younger generation of people start coming forward,’ he told newsGP.
Like Dr Chang, Dr Saini operates with two staff members – one GP and one administrative staff member. Five patients are booked in per 15-minute slot, equating to around 110 doses per day, with the process simplified by having the consent completed prior to the patient’s arrival.
‘So there’s a lot of pre-appointment work that happens prior to them physically arriving at the practice,’ Dr Saini said.
‘We aim to do this in a way where, by the time they’ve arrived at the practice, they’re already fully committed or at least reasonably committed to having the vaccine so that the conversation is just reassurance.’
Dr Chang was so enthused by the response he received from patients that he put the call out to other practice owners online to do the same.

But the question remains: are weekend clinics profitable?
Dr Chang says his practice has so far not faced much financial strain, thanks to drawing on the skills and time of his wife and two adult daughters to assist with the administrative side of operations.
‘So it was a real family affair – that helps save on manpower costs,’ he said.
‘Once we get a process, we’ll probably get our non-family staff involved in the afternoon, being mindful that it is not a workday, and it is one extra day for them to come in.’
GPs are eligible for additional MBS payments if vaccine services are run outside of usual working hours, which includes Saturdays before 8.00 am or after 1.00 pm, Sundays and public holidays. This adds between $12.20–$12.30 per dose.
But for Dr Chang, he says it is not so much about the money; though he doesn’t expect doctors and staff to work for free.
‘We all have a part to play in this pandemic,’ he said.
‘We are not open on Saturdays, anyway, so our sacrifice was giving up our own free time, time that we would have rested and rejuvenated. So it’s not so much about the cost at the end of the day.
‘If you plan your workflow properly, you probably won’t earn, but you shouldn’t be losing money on it as well.’

Of the patients coming through, both Dr Chang and Dr Saidi say there are more people under the age of 40 interested in AstraZeneca, with Dr Chang estimating at least 80% were aged 20–39. They believe the tide is slowly, but surely, changing around the viral vector vaccine.
‘Before they came, they already put behind them the risk of clots,’ Dr Chang said.
‘When I tried to explain to them the risks and benefits, they all tell me, “Yes, I understand my risk of clots is really low. I do a lot more things that are dangerous”. So they all rationalised it in their personal ways, which made things a lot easier for me.’
But with increasing interest in vaccination, while working off the momentum is important, keeping weekend vaccine clinics sustainable while avoiding burnout among staff is a concern.
Dr Saini says maintaining staff morale has been key at his practice, and that they have introduced a rolling roster to ensure it is not the same staff each weekend.
‘There’s certainly a moral and ethical obligation for us to play our part as general practice in the vaccination rollout. But it does need to be balanced out with the capacity and resources each practice has,’ he said.
‘We’ve divided it up in a way that our practice manager is very involved in the care and supervision and wellbeing of our reception and admin staff.
‘I, as the practice principal, am heavily involved in looking after the doctors, making sure that they’re getting the adequate rest and breaks that they need, and also clinical support as well. So that structure for us works really well in helping us continue to drive this.’
At his own clinic, Dr Chang has started to take an afternoon off for himself, while another doctor covers the workload.
‘It’s a bit of a compromise, but I guess for the greater good this has to be done,’ he said.
‘We can’t think of just doing a two-day weekend of vaccinations and not revisit it over the next few weeks … it is keeping it sustainable for the next 3–6 months, possibly.
‘I always said that this is not a sprint, but a marathon.’
Log in below to join the conversation.

after-hours AstraZeneca COVID-19 pandemic Pfizer vaccination vaccine rollout

newsGP weekly poll Is it becoming more difficult to access specialist psychiatric support for patients with complex mental presentations?

newsGP weekly poll Is it becoming more difficult to access specialist psychiatric support for patients with complex mental presentations?



Login to comment

Dr Suresh Gareth Khirwadkar   24/08/2021 6:48:43 AM

So does it twice, with free labour from his family (which raises all sorts of confidentiality issues), and ends up taking a weekday session off instead, and admits they don't make a cent from it so presumably only viable due to free labour. And claims we should all be doing this?

Let us know how it's going in 3 months and if you still think it's a good idea and viable.

Dr Alan Graham MacKenzie   24/08/2021 7:35:31 AM

Great idea All we need is an adequate regular supply of age appropriate vaccine ie Pfizer This is not happening

Dr Mark Robert Miller   24/08/2021 8:05:57 PM

Our practice has been doing after consulting hours sessions and weekend sessions since the roll out of vaccine. We are up to 7200 vaccine delivered into our rural
Community of Az and will commence Pfizer at 120-300 per week once available at the end of month as we have delivered Az to most of the age matched patients now. We usually run with 2 doctors 2 nurses and about 2-3 staff a session lasts around 3 hours. We are able to give 120-160 vaccines per session. You need to be organised and liaise closely with the community and collect and review the paperwork ahead of time to flag potential problematic patients and those requiring more time who may elect to vaccinate in hours or smaller clinics.