Opinion

New telehealth services a chance to show the strength of general practice


Harry Nespolon


30/03/2020 3:31:53 PM

RACGP President Dr Harry Nespolon says GPs must use the coronavirus pandemic to prove how valuable efficient, patient-centred primary care can be – if it’s done right.

Harry Nespolon
Telehealth is only one part of a comprehensive mix of services that GPs must continue to provide.

Unprecedented times call for unprecedented measures, and so it is with the Government’s $500 million embrace of expanded telehealth services.
 
The RACGP has been advocating for such an expansion for some time, and now it is here we must demonstrate its value to both patients and the wider healthcare system.
 
The sweeping changes are among the largest announced for general practice in decades but are only guaranteed to be in place until 30 September, after which time they will be up for review.
 
I must be clear: this is not an opportunity for doctors and practice owners to try to take advantage of a crisis by churning through as many patients as possible in anattempt to make money. It is a chance for Australia’s most valuable healthcare specialty to demonstrate how effectively modern medicine can be delivered.
 
It is an opportunity to showcase how valuable, agile and efficient GPs can be – that we are still able to provide the best-value care to vulnerable patients regardless of whether we are sitting face-to-face or not.
 
Of course, many patients cannot be treated properly without being in the same room or be treated by one of the practice’s team, which is why it is vital that telehealth remains only one part of the comprehensive mix of services we deliver as GPs.
 
But for those who can be treated via telehealth, we need to do everything possible to ensure they receive the same treatment as they always have.
 
Australians rely on GPs to take care of them in times of crisis. They trust us to protect their health and wellbeing, and help them get through the understandable anxiety and distress these sorts of disasters can produce.
 
Make no mistake, we are leaders in the community and we must keep that front of mind in every decision that we make – especially during such uncertain times.
 
Everyone must cooperate during a national emergency – doctors, politicians, grocery store workers – everyone. The Government will do what it can to look after us, so long as we continue to do the right thing.
 
I strongly encourage the Department of Health to not be overly officious in their auditing of GPs who are clearly trying to do the right thing in what is unfamiliar territory. Likewise, I strongly encourage the Department to hold those who are not to the highest levels of accountability.
 
We want to make sure we get this right so we can keep our options open after September.
 
If we maintain our discipline and our humanity, and continue our caring approach to patients, we will not only protect Australians when they are at their most vulnerable, we will show that GPs are capable of this flexible, effective, modern form of medicine now and into the future.

GPs who would like to find more information and advice on primary care telehealth consultations should access the new RACGP guidelines on the college website.

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Dr George Al-Horani   31/03/2020 7:24:50 AM

Dear Colleagues, what’s need to be done right , is we all hope these crises will pass with the least loss of lives of our community and the world .
What we don’t want to end up with is a health system depending on An artificial intelligence to control how we practice medicine .
We don’t want to end up depending on Telehealth to serve our community!!!
And we really pray and hope all this will end up soon and all these new confusing policies and item numbers will be wiped out and cancelled .
We want to stay face to face consulting with our beloved Australian fellows , we don’t want to end up after these crises stuck with IT nor AI intelligence to take over our human intelligence!!!!
Medicine has been and will always be a humane profession, it’s when the patients seeing their Doctor face to face which make them feel better even if they are sick ( how many times have we been told this by our patients ?! ) .
we Want all these item numbers cancelled once the crises are gone hopefully.


Dr Ian Mark Light   31/03/2020 8:05:13 AM

The Telehealth is a great and vital innovation to the crises but when the respiratory infectious season starts - the supply of PPE to the significant percentage of General Practitioners who need to do face to face consultations for example in the Aged Care Setting will need to be in place .
The window of opportunity is weeks and can be achieved even if raincoats serve as gowns industrial face shields and motor cycle type helmets are the face protection and gardening and dish washing gloves are protections for hands and wrists
In theory washing with already dilute bleach or bleach diluted 25 ml in 750 ml of water in the recommended hazard conditions may preserve some of the ad hoc protective gear .
Patients self swabbing at least the nasal swabs to the distal inferior turbinate if nasal congestion is part of the symptoms would spare resources .


Dr M Isaac   31/03/2020 10:24:33 AM

I love this RACGP president, sharp , witty and decisive ...
Telehealth consult definitely has its advantage in this current crisis but only for short period , medicine is the art of taking good history and examination ... we can not diagnose pneumonia through telephone or video call, but we need the stethoscope !
We can not determine or put a differential diagnosis of abdominal pain with no hand to examine the abdomen! and if you can not put your hands on , probably you are going to put your foot in the court of law ! ... good physical examination is corner stone of medicine .
We hope that we can pass this critical period in our life with the least loss of life .


Dr Peter James Strickland   31/03/2020 1:05:48 PM

This Telehealth initiative is something that should be used ethically and professionally to prevent and assist in managing our patients.
If it works well it is hoped it will be a permanent fixture, as GPs have been phoning and advising patients for decades without any remuneration whatsoever. It should have been part of Medicare all along, but limited to those patients who are infirmed at home etc., or need advice by phone on changed treatments in hospitals and home etc.
How many times has one virtually advised about patient care by phone, and then issued scripts, certificates, letters of reference etc.? Innumerable, sometimes in one day alone is the answer. I would like to see permanent item numbers introduced for Telehealth in all these genuine and ethical cases, as it is fair and reasonable in GPs working day.


Dr Jitendra Natverlal Parikh   31/03/2020 9:20:59 PM

The worst I have encountered now is that patient demands tele health and insist that there is no need for them to visit


Dr. Beloved   4/04/2020 12:54:47 PM

I appreciate the work done by the RACGP under the leadership of our President Dr Nespolon, as a specialty i believe we are not given the respect deserved compared to our collegueas in the other specialties, it behoves us to earn that respect we deserve. The presidents comments "It is a chance for Australia’s most valuable healthcare specialty to demonstrate how effectively modern medicine can be delivered" is important. I will need some help with right billing of my services.
Can i please be advised about this new and commendable intiatiave. If i i spend 17 minutes discussing on the phone with a patient as i did this saturday morning and then have to call the cardiology to discuss her case. Am i going to be billing for the time spent with this patient only or add the time of the consult with the cardiologist.
If a consult involve writting a script, faxing then posting to the pharmacy how do i calculate time spent on this consult.