GP pelvic pain clinics to collaborate in pursuit of better outcomes

The first of 20 planned pelvic pain and endometriosis clinics has been launched in Perth at an event attended by the Assistant Health and Aged Care Minister Ged Kearney.
 
The clinics, each supported by more than $700,000 in funding over four years, will aim to improve access to care for a condition that impacts more than one in nine women across Australia.
 
Dr Andrew Leech, GP and owner at Garden Family Medical Clinic, which hosted the event, told newsGP patients who experience chronic pelvic pain and endometriosis generally struggle for significant periods without a clear diagnosis.
 
‘The average time for a diagnosis of endometriosis in Australia is 10 years,’ he said.
 
‘We aim to not only improve this wait time, but also improve the quality-of-care patients receive during the process.’
 
Endometriosis can lead to chronic pain, subfertility and a high psychological burden, which Dr Leech says is currently all too common.
 
‘Endometriosis and pelvic pain can be complex … there can be difficult conversations around trauma, sexual health and fertility that doctors may not always have time to approach,’ he said.
 
‘Symptoms can [also] be misdiagnosed as other abdominal causes of pain, as testing modalities such as ultrasound or pathology are not always helpful in forming a diagnosis.
 
‘Other issues such as infertility, mental health, pain and suffering are significant. Patients are often lost to follow up and may lose hope that nothing can be done.’
 
Minister Kearney hopes that gathering experts ‘under one roof’ and fostering knowledge to improve diagnosis and streamline services, while also having established referral pathways in place, will help affected women access the support they need.
 
‘This is a crucial step forward for part of the population that has too long been dismissed,’ she said.
 
‘Too many women suffer for years with what we know can be debilitating conditions. They deserve to have their concerns be taken seriously with better access to specialised care.
 
‘These clinics are about providing women with an accessible front door to the care that they need.’
 
Another of the 20 clinics due to receive funding is Northside Health in the Northern Territory.
 
Dr Danielle Stewart, practice owner and GP at the clinic, told newsGP she has set up a collaboration network between all of the centres funded by the new initiative.
 
‘The 20 clinics selected to run this important service are all unique,’ she said.
 
‘We each service different populations and geographical areas, vary from three or four GPs to more than 20, and have different allied health practitioners on our teams.
 
‘We all have one thing in common, however, which is a genuine passion to contribute to the improvement of endometriosis and pelvic pain care in the three years we have been funded to do so.’
 
She says it will be crucial for them to collaborate from the outset.
 
‘[We need] to share ideas and resources, and update each other as we go along with what is or isn’t working and what we are learning,’ she said.
 
‘We also see a huge opportunity to contribute to the greater good by collecting data, which adds to the research pool in this area and hopefully show good outcomes from our interventions.’
 
In Dr Leech’s experience, services are disjointed across the public and private sectors and may lead to poor collaboration on managing patients, which is where these 20 clinics can help.
 
He says his clinic plans to use the funding to increase training and upskilling of staff, recruit additional nurses for triage, improve screening and patient support, run workshops and education for patients, and purchase essential equipment such as gynaecology examination beds.
 
‘We have also considered more broader opportunities that we would not normally have had the opportunity to provide [such as] trialling a TENS machine, training in acupuncture, purchasing virtual reality goggles for pain management during procedures and for mindfulness, running regular Zoom education sessions and improving our resources online and through social media,’ he said.
 
Dr Stewart can see her clinic implementing similar therapies.
 
‘This is where life-changing education happens for the patient, to address chronic pain,’ she said.
 
‘It is very multi-disciplinary involving teaching the neuroscience of pain and medical, dietary, exercise, psychological and other approaches.
 
‘A range of practitioners would be involved in different clinics.’
 
Dr Stewart also says billing has been a ‘big area of discussion for the 20 practices’.
 
‘It is no different to normal general practice in that it is impossible to provide good care for complex, time consuming issues like this in a bulk-billed model,’ she said.
 
‘The difference here is that we have grant funding, so the practices will be using the grant funds to subsidise consultations to different degrees. This depends on their patient numbers and demand.
 
‘Some clinics are servicing population areas of millions of people, and others in the hundreds of thousands or less. In the NT, we are covering a large geographical area so will need to use telehealth and other innovations, but our population is small, so we plan to make the program free or very low cost to access.
 
‘For us, it will be a specific program outside of our standard GP service. For other practices, it will be incorporated into their day-to-day appointments.
 
‘Everyone’s goal is to make these services as accessible as possible, with the cost as low as is feasible, including no cost to vulnerable populations.’
 
According to Dr Leech, he likely sees a mixed billing method for his demographic.
 
‘However, we are looking at ideas around how to offer some of the grant funding towards allied health, diagnostic imaging and specialists so that these services are not unaffordable for patients,’ he said.
 
‘We also hope to value-add to the service we already provide through funding the education workshops and resources so that patients are not out of pocket for these.’
 
The full list of endometriosis and pelvic pain clinics is available online.
 
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