Column

What has your college been doing to get ready for coronavirus?


Harry Nespolon


20/03/2020 3:14:27 PM

The safety of GPs and patients is first and foremost, writes RACGP President Dr Harry Nespolon.

Dr Harry Nespolon
RACGP President Dr Harry Nespolon is focused on GP and patient safety.

I know many of you are anxious about what will happen as Australia braces for the impact of coronavirus.
 
That anxiety is understandable – I have felt it myself.
 
But we GPs are doing our best to tackle this crisis, while trying to keep our personal risks as low as possible.
 
I wanted to write to update you on what your college has been doing behind the scenes.
 
Your safety
We have been focusing our efforts on two fronts: telehealth and better access to personal protective equipment (PPE).
 
That’s because your safety is the top priority. If Australia’s GPs are safe from the virus, the nation will be better protected.
 
We have had successes, particularly in telehealth, where our advocacy recently paid off.
 
We lobbied the Government for telehealth and telephone Medicare Benefits Schedule (MBS) item numbers in order to protect GPs at the front line. Those items are now in place, with many of you already using them.
 
We also succeeded in making it possible for GPs to be able to use telehealth from their homes if they are self-isolating. That means you can still earn income if you are in self-isolation.
 
We have also been ceaselessly lobbying for more supplies of PPE. I know the shortage of protective equipment is causing anxiety especially in light of the fact that you often cannot even buy it.
 
And that is to say nothing of the limited availability hand sanitiser for clinics, given the panic buying going on around the country.
 
The Federal Government does need to step up and release more PPE from its stockpiles, and/or obtain it from sources we cannot access.
 
There have been questions over access to coronavirus testing for healthcare workers. Fortunately, changes have been made to allow us access. We will continue to push for fast-tracked testing and results so we can get back to work when possible.
 
All of us feel a strong obligation to our patients. We want to be able to continue to provide healthcare in the safest way possible.
 
For some, that will be switching to telehealth wherever possible.
 
For others, it will be making the decision that your practice is not equipped to deal with possible coronavirus cases and diverting to new fever clinics as they are established. 
 
We have to be practising safely – and that may mean we consult with almost all of our patients who are at risk of having coronavirus by phone or video.
 
Such measures help to protect GPs and other patients, and saves our scarce resources of PPE.
 
What’s next?
We will be pushing for much greater access to telehealth so you can move as much care as possible to phone or video calls – if you want to.
 
The RACGP has consistently been calling for a single, centralised and authoritative source of health information during this outbreak to overcome issues with mixed messages.
 
Now that we have a national cabinet with the Prime Minister and state premiers, we should see better coordination of information flows to frontline responders, such as GPs.
 
Australia’s Chief Medical Officer Professor Brendan Murphy is now sending us regular updates, which we are publishing. That, too, is welcome. 
 
Taking this seriously
With recent reports that worried patients are concealing possible exposure or refusing to self-isolate, now is a good time to remind people that, yes, we absolutely must take this seriously.
 
All of us – GPs and patients – need to take as many steps as we can to decrease our risk of contracting and spreading the virus.
 
At-risk patients need to act on our advice, self-isolate and wait to be cleared. If people fail to heed this advice, their actions could affect a lot of people around them and spread the virus further.
 
Social distancing is – for now – our best hope in tackling this pandemic.
 
For our patients who may be particularly vulnerable to infection, we can also advise them about how to best stay safe at a time when cases are rising. We can tell them about the need to think very hard about whether they actually need to leave the house for anything. Maybe they can ask others less at risk to buy things for them at the shops.
 
And regarding our own personal communities, now is a time to look for those who might need help and offer it – at a safe distance, of course.
 
I think it is also worth raising that younger people are not bulletproof. People in their 20s through to their 60s overseas have been dying from this, too. It’s a timely reminder for us and our patients.
 
Given the fact older people are most at risk, it is also a good time for older GPs or those with medical issues that make them more vulnerable to consider how best to protect themselves. That may be telehealth or diverting cases.
 
To conclude, let me say that you have the support of your college in this fight against coronavirus.
 
It may be a long battle. But, working together, we can beat it back – just as other countries have.
 
The RACGP has more information on coronavirus available on its website.
 
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A.Prof Christopher David Hogan   20/03/2020 8:58:47 PM

Thank you for your advocacy & concern. We are all GPs & we are all in this together. We are the College


Dr Pradeep Samarakoon   21/03/2020 10:53:24 AM

To me and my GP colleagues having the capacity to consult by phone or video with ALL of our patients who are at risk of potential COVID 19 is essential so they can be triaged and treated correctly without unnecessarily exposing others.

With increasing person to person transmission within Australia and none of these patients getting tested (based on current testing protocol- unless they are admitted to hospital) wast majority of COVID 19 patients are likely to present to GP with upper respiratory tract symptoms.

This has been recognised in the recently published Department of Health COVID 19 Triage Protocol: Patients with symptoms (Fever, cough, sore throat, shortness of breast, tiredness) are advised to contact their GP clinic for advice whether patient needs to attend local clinic.

Currently Medicare item numbers do not to fully support this policy. We URGENTLY need a Medicare item number covering ALL patients with above symptoms.


Dr Charlene Fungai Chideme   21/03/2020 11:17:17 AM

All your diligence , dedication and sustained efforts through this sustaining and challenging times are greatly appreciated. Feel proud to be a part of this awesome college. Yes, together we can fight this and hopefully come out stronger.


Dr Geoffrey Ronald Greig   21/03/2020 1:21:57 PM

We really need access to telehealth for all patients. Given we have to have to bulk bill and there is no extra cost compared to a clinic appointment - why not. This is the only way we can protect ourselves. The current restriction make no sense except department distrust of us as a profession. If politicians, bankers etc can work remotely we should also be able to.


Dr Tawhid Mohamed Sayed Hassanien   21/03/2020 2:54:40 PM

I totally agree with Dr Pradeep. My Wife and all my grandchildren are all have the symptoms of Covid-19 or flu. However they do not fulfil the criteria for Covid-19 testing. I am lucky to have an apartment where I can isolate myself. I am totally in the dark when can go back home and mix with them again. The current huge increase in the number of positive Covid-19 suggest community transmission is already happening. Without testing we all are in the dark.


Dr Jonathan   21/03/2020 5:48:37 PM

Please help us to push for access to MBS rebates to provide telehealth/phone consults to ALL patients, as this is the only way we can fully protect ourselves and our patients!!!


Dr Janice Faye Sheringham   21/03/2020 10:17:38 PM

As per the majority of comments, I wholeheartedly agree that telehealth consultation items for GPs MUST be extended to cover ALL PATIENTS if the COMMUNITY is to help protect this segment of the workforce. AND during this emergency, the rebate MUST be increased to 100% of the Scheduled Fee! Couple these steps with adequate PPE supplies, delivered via PHNs if preferred (however that introduces an extra distributive step) direct to all GPs who have lodged Medicare Claims in this calendar year, and you just might have an adequately resourced Primary Care workforce to manage this crisis. On the matter of a central enquiry point, while a call centre is required, it may become unworkable if staffing and remote access issues supervene. My suggestion remains that we seek to copy the UKs NHS website, 111UK, which allows Joe Public to quickly and easily understand their risk level, receive simple management advice matched to their status AND, direction to the NEAREST APPROPRIATE level of care.


Dr Anusha Maduwanthi Liyana Lekamge Dona   22/03/2020 1:40:39 AM

Initially I thought the idea of Dr Pradeep to have Telehealth MBS number for the patients who have flu symptoms would be enough.But from last week my experience, people are coming for contraceptive pill prescription and after about 10 minutes explanation of contraception they tell they have sore throats.Its only one example.
Yes I think when the number of cases increase it better to have Telehealth MBS number for all patients if we have to keep on practicing as GPs for our community for longer period and at
same time taking care of our selfs .


Dr Paul Michael Tescher   22/03/2020 2:45:28 PM

Agree with all above comments re:MBS for Telehealth. Government needs to make all items available for all patients and all consults via Telehealth, and it needs to happen ASAP. This can help even more than PPE to keep our GPS safe. There is no good justification for this not being put in place now.


Dr Fiona McGovern   22/03/2020 6:11:34 PM

I agree with other doctors that telephone consult item numbers should be extended to all patients. I also think it vital that mental health items such as mental health consultations and mental health care plans be able to be claimed with telehealth. There is absolutely no need to expose patients or doctors for these items which will certainly be required and where other mental health providers are already able to claim telehealth items.


Dr Raymond Borcherds   23/03/2020 12:42:07 AM

It is sad that our response to the COVID 19 has been "to little too late" and we will look back with regret. We need to shut ALL non essential services (including Schools) ASAP.
I will be in PPE from tomorrow and for the next 3 months, - this includes mask, gloves and Eye shield - hopefully a reminder to our patients that we are at the most risk of both contracting and transmitting the virus.
Wonder if the patients will decide that their issues are not that important?


Dr Pradeep Harshan Jayasuriya   23/03/2020 11:33:33 AM

Thanks Harry for your advocacy and support. Telehealth for all consultation is needed urgently and a glaring omission form the stimulus package v1 and v2. Our premier refers to this as a 'war' and we are the frontline foot soldiers but with no protection and little support (We do not have any PPE other than gloves and surgical masks). The minister Greg Hunt lauded himself for getting companies to fast track ventilators , its a shame he did not do the same in securing PPE for GPs !. Amidst all of this our staff are making great sacrifices to keep our practices running.


Dr Sasidharan Somasunderam   6/04/2020 4:30:04 PM

Hi Harry
I am requesting you to discuss with the medicare/Health Minister to give after ours Telephone Item number, as we are loosing nearly $11 dollars for each patient when we do telephone consults .We all should close the clinics after hrs!!!