Fee increase on July 1st 2018 at Erskineville Doctors

On July 1st 2018 Erskineville Doctors will be introducing a small increase to our fees. For a standard appointment it will cost $80 and for a long appointment $128. Your medicare rebate has increased by 1.5% for these items (now $37.60 and $72.80) which will help limit your out of pocket costs.

This is a first increase for Medicare rebates since 1 July 2014. It is a positive start, however a 1.5% increase in Medicare rebates for a limited number of attendance items is still well below the annual increase in our operating costs.

The fees charged by this practice cover all of our practice costs including employing receptionists and practice nurses, and meeting our operating expenses such as rent, medical equipment, electricity, computers and insurance. These costs increase annually.

If you have extenuating circumstances and are unable to afford this increase, please do discuss these with your treating medical practitioner.

Easter opening hours

The practice will be closed for the 4 days from Good Friday to Easter Monday.

National Home Doctor Service, 13 7425, is our nominated after-hours locum service. A locum GP can visit you at home and provide a report directly to our practice for the next working day.

Emergency services are available at Balmain Hospital GP Casualty, Royal Prince Alfred Hospital, Sydney Children’s Hospital and Canterbury Hospital.

Remember you can book online for next week by registering on our website for appointuit.

We hope you all have a lovely Easter.

Doctors’ leave – December/January

December already! Just a heads up on what our doctors are up to over the next 2 months:

The practice will be closed on any public holidays in December and January.

Dr Annabel is away from Saturday 16 December and will be back on Tuesday 2 January. She is then away for the last week of January, starting Monday 22 January and back when school starts on Monday 29 January.

Dr Jenny will take a break from Thursday 21 December, and be back at work on Monday 8 January.

During the Xmas/NY week, the practice will be open in the mornings only on Wednesday 27, Thursday 28, Friday 29 and Saturday 30 December. Dr Shereena will be the only doctor working on those days.

Through January the other doctors will work their usual hours. Please be assured our doctors will hand over to each other to make sure you have continuity of care for any ongoing medical issues.

 

 

Changes to Pap test screening

From 1 December 2017 there are some important changes the Pap test screening program (now known as the National Cervical Screening Program).

The key messages  are:

Younger women can wait to have cervical screening tests at the age of 25, where it used to be 18

Older women should have their next test at the time it is due (that is 2 years since your last Pap test, or sooner if you have been advised to do so previously)

Women will now be offered ongoing screening up to the age of 74

The test will still be like a Pap test, using a speculum, and with the doctor checking the cervix and taking a sample. The first test the lab will do is for Human Papilloma Virus (HPV) – this is the virus known to induce changes in cervical cells which could lead to cancer

If your result is negative for HPV, this is regarded as “low risk” result and you will be advised to have screening again after another 5 years

If your test is positive for HPV, the lab will do further testing to look at the cells and will provide advice about referrals or the optimum timeframe for ongoing monitoring

Even if you have had HPV vaccination (Gardasil) you should still participate in the screening program

If you are very nervous about having  a Pap test please discuss with your doctor. There is an option for women over 30 to provide a self-collected sample, though this has lower pick up rate for abnormalities.

This test is a screening test, which means that it is for a woman who does not have any symptoms. If you have any symptoms such as bleeding between your periods or after sex, an irregular menstrual cycle, vaginal discharge or pelvic pain you should come and see a doctor

Regardless of the timing of your cervical screening test, it’s a good idea to discuss sexual health screening with your doctor at any time and at any age if you have ever been sexually active. This is especially the case if you have a new sexual partner. This could include tests for sexually transmitted infections such as chlamydia.

________________________________________________

We encourage all women to participate in cervical screening. Since it’s introduction it has had a significant impact on the rates of cervical cancer in Australia, but there are still cases diagnosed every year. The group of women who are haven’t had screening in more than 4 years are at higher risk.

Several organisations have put together more detailed information about the changes, and we are including some useful links below. If you still have questions, please talk to your doctor and make a plan for your next test. We can put a reminder in our system to email you when it’s due.

Some useful links

Family Planning NSW https://www.fpnsw.org.au/changes

Department of Health http://www.health.gov.au/internet/screening/publishing.nsf/Content/about-the-new-test#1

http://www.abc.net.au/news/health/2017-09-20/what-you-need-to-know-about-pap-smears-being-phased-out/8753278

http://theconversation.com/five-myths-about-the-new-cervical-screening-program-that-refuse-to-die-74077

Organ donation registration

You may have come across the recent campaign to increase the number of people registered for organ donation. It’s important to note that even if you have ticked this on your driver’s licence, you should go to this page  and register linking your name and Medicare card number to your consent for organ donation.

There is a lot more information at the Organ and Tissue Authority website, including FAQs about organ donation and the process, why you need to register, and how to have the important conversation about your decision with your family.

 

https://register.donatelife.gov.au/

Going up!

You will have noticed the practice has been very busy the last few months. We are excited to let you know that we have finally taken lease on the upstairs in our premises, which gives us an extra doctor’s room. As of 8 May we will be using this room for consulting sessions, initially 2 days a week.

To start off Dr Chris Ganora will work upstairs on Tuesdays and Dr Shereena will work upstairs on Mondays and Wednesday afternoon. There may be changes over time and other doctors will also be working in the upstairs room. If you have any concerns about not being able to climb those 20 stairs, please let our receptionist know when you are booking. As always, strollers and prams can be left in the waiting room.

We anticipate that the extra appointments will take the pressure off for everyone. However, we are still in the process of upgrading our phone system and working out the logistics of dealing with extra patients in a small practice. We appreciate your patience as we deal with any teething problems.

Remember you can book appointments online. You will need to call us if you have an urgent need on the day and can’t find an appointment, or if you want to check that your doctor is not working upstairs. If you are unable to find an appointment with your regular doctor that suits you, please book with another doctor. We are happy to deal with acute issues and hand you back over to your regular doctor for follow up.

Free shingles vaccine for 70-79 year olds

A new vaccine is being provided free of charge for people aged between 70-79 through the National Immunisation Program. Zostavax is a vaccine to prevent shingles (see below for more information about shingles and the vaccine)

At Erskineville Doctors we currently have small stock of Zostavax. A doctor will write the order for the vaccine, but it can be given by our practice nurse. There are a few situations where we would not advise the vaccine, this is mainly in people whose immune system is severely compromised by a disease process or medications. You should discuss this with your doctor.

SHINGLES AND VACCINATION

Shingles (also known as herpes zoster) is a localised, painful, skin rash resulting from reactivation of the same virus (the varicella-zoster virus) that causes chickenpox earlier in life. Although usually self-limiting, shingles can lead to chronic neuropathic pain syndrome, and other complications.

About 20–30% of people will have shingles in their lifetime, most after the age of 50 years. Older people (particularly those aged over 70 years) are also more likely to have shingles complicated by chronic pain.

Vaccination of people aged 70–79 years is estimated to prevent about 41% of the cases of shingles and two-thirds of post-herpetic neuralgia cases in that population. In vaccinated people in whom an episode of shingles occurs, the pain, severity and duration is reduced by 50%.

For further reading go to NCIRS

When you phone for an appointment, please let our receptionist know that you would like this immunisation. If you are booking online choose the Immunisation appointment (15 min). You can book with our practice nurse if this is the only reason for your appointment, otherwise book an appointment with your GP. If you are likely to see us in the next few months you can just make a note to ask us about vaccines then.

My Health Records

my health record
My Health Record is a Commonwealth Government initiative to allow patients to create a personal online e-health record that contains important medical information for health practitioners to access in different locations. This can be particularly useful for patients with chronic medical conditions who see a number of specialists and sometimes require hospital care.

Your GP will be able to upload a Shared Health Summary to your Health Record. This will list your allergies, medications, significant medical conditions and immunisations.

Currently the My Health Records are also collecting information about:
• Medicare items claimed
• PBS medications prescribed and dispensed,
• children’s immunisation records
• Australian Organ Donor registry information

We have been advised by the Local Health District that hospitals are also ready to upload discharge summaries. In the longer term pathology and radiology reports will also be uploaded to your My Health Record.

Erskineville Doctors is already set up to access and upload information to your MyHealth Records. You can register for MyHealth Records at www.myhealthrecord.gov.au and if you already have a myGov account it can be linked to this account.

We can arrange assisted registration for our regular patients if you fill out a form giving us permission. You will need to have your Medicare card and photo ID for us to do this. Forms are available in our waiting room.

Once your registration is done you will receive a code (IVC) via SMS or email to access your health record online. You will be able to:
 add personal health notes and emergency contact details
 register your children for a My Health Record
 set privacy controls to allow you to control what information is uploaded and who is able to look at your record.

For more information about the privacy of your health information go to www.oaic.gov.au/individuals/faqs-for-individuals/health/resources-on-health-for-individuals.

Disclaimer: Erskineville Doctors does not administer the My Health Record program. This is a summary based on information available at https://myhealthrecord.gov.au. Patients are asked to read more detail at this website. Patients should review their medical records with their doctor before any information is uploaded to their MyHealth Record.

Medicare indexation freeze

In 2014 the Government put a freeze on indexation of Medicare rebates for four years from 1 July 2014 until July 2018. In the Federal Budget this week they announced extending this freeze until 2020.

Freezing Medicare rebates for four years is simply winding back the Government’s contribution to patients’ health care costs. In practice it means that the $37.05 rebate you currently receive for a standard consultation will not increase at all until 2020. The relative value of this and any other medical rebates will decline significantly over time, as businesses providing medical care will likely increase fees in line with the increased costs of running a business.

The chart below shows you how little Medicare rebates have grown in the past 30 years compared to other economic indices such as the CPI.
indexation freeze

Rebates are frozen across the whole sector, and will include GP, Specialist service, medical procedures and also pathology and imaging (the rebates for those services have not increased in 15 years). The proposed funding for hospitals will prop up existing services, which we know in some areas of medicine are quite patchy (eg. non-existent public outpatients clinic in many specialities).

What it all adds up to is less money being given back to you to cover your medical costs. It also reduces the capacity of small businesses such as Erskineville Doctors to bulk-bill our less well-off patients. We aim to be a practice that is for everyone in our local community, and we pride ourselves in already being what the government is now calling a “healthcare home” for all of our patients and their families, not just those with chronic and complex health needs. We don’t want to reduce the quality of your care by rushing you through appointments.

We will be writing to the major parties about these budget proposals now and in the lead up to the Federal Election. We urge you to take the time to read the detail of these proposals and make up your own minds, and write your own letters as you see fit.

Some useful sources of information:
https://ama.com.au/media/prof-brian-owler-ama-tv-2-july-2015-medicare-rebate-freeze
http://yourgp.racgp.org.au/Your-GP/antifreeze (see the bottom of the page for draft letter to Sussan Ley, Minster for Health)
https://croakey.org/health-budget-analysis-part-1/ – for wider discussion of budget implications for health

Antenatal Shared Care

Antenatal Shared Care

Antenatal Shared CareDr Jenny, Dr Patti, Dr Cara & Dr Annabel can manage your pregnancy care in conjunction with RPAH or RHW. We will explain the process for shared care in consultation during early pregnancy.