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  • Dr Steve Osman-ToddHall

IMPORTANT: CHANGES TO TELEHEALTH + COVID19 + PRACTICE FEES + A COUPLE OF MISCELLANEOUS ISSUES

Hi, everyone!


MY RETURN & COVID19 UPDATE

So, I am back from surgery, etc. However, please forgive my reminding you that nothing has changed with Covid-19 rules at the surgery and from Public Health:

*you need a Covid19 test if you have a runny or blocked nose, sinus symptoms, a sore throat, a cough, laryngitis, a cold, conjunctivitis, suspected viral gastro, a fever that may be viral. There is no such thing as "it's just a bug" or "everyone has this virus that's going round". As Sydney has demonstrated, people are getting apathetic, not doing the right thing, and putting all of us at risk- especially the vulnerable, the elderly, etc.;

*you must be responsible and not attend the surgery if you have or have had within 2 weeks the above symptoms- get a Covid19 test, prove negative, and then if I really need to see you, and not just do telehealth, request that we consult OUTSIDE the surgery. It is not acceptable to come into my room with any of these symptoms. I have just had to have 3 days off precisely because I had been given a cold by someone, and was febrile >38C. 3 patients had come into the surgery in the preceding week with symptoms. This inconveniences myself and my patients, and causes major issues getting appointments for the week thereafter, which none of us want;

*PLEASE DISCUSS WITH RECEPTION IF IN ANY DOUBT- and thank you to everyone who already rigorously follows the above advice, which has not changed since the advent of Covid;

*PLEASE NOTE THAT EVEN AFTER COVID PASSES, IF IT EVER PASSES, THE RULE WILL STAY THAT I NO LONGER CONSULT WITH PATIENTS WITH THE ABOVE SYMPTOMS IN MY CONSULTING ROOM. What we do in the future will adapt to other issues and circumstances.



TELEHEALTH (VIDEO CALLING)

The Government has decided that speaking with you on the telephone is not the gold standard, and has changed Medicare rebates/benefits to reflect this and to favour 'telehealth', which means that we are looking at one another on the phone or computer screen- video calling.

This means that wherever possible, we need to use telehealth/video calling, not just voice over the telephone.

This is concerning to me, as I firstly don't see the evidence for this, but furthermore note the inverse care law- those most vulnerable, elderly, non-IT-savvy are least likely to be able to use telehealth, whereas telephone access has really improved access to me and the service that I can deliver, and has reduced the wait for appointments, etc. However, it is beyond my control.


So, wherever possible, from 1st July 2021, we need to try wherever possible to use telehealth. I have two principal ways that I can do this, as I have an iPhone:

*iPhone users or iPad users can FACETIME with me (but if your iPad is WiFi only, not cellular, then you will need to tell Reception when you will have access to an iPad facetime call, and ensure that it is on, and that we have your tel. no. or email contact that I can facetime you on on your iPad);

*Otherwise, please DOWNLOAD WHAT'S APP, and allow it to see your contacts, where you will usually have saved my 0458111548 work tel. no., and then I can video call you on that.

Reception will now routinely be asking what device, if any, I can video call (telehealthcontact) you on. Everyone can have what's app on their phones, android, iPhone, or samsung, etc., and this is an encrypted, secure service that I trust;

*ZOOM can be done, but is a pain...

*FACEBOOK MESSENGER is also an option, but my Facebook is personal, and I would prefer to avoid this where possible.


PLEASE NOTE THAT I WILL NOT BE ABLE TO OFFER LONGER CONSULTS BY TELEPHONE, OR CARE PLANNING BY TELEPHONE, DUE TO THE GOVERNMENT MEDICARE CHANGES FROM 1/7/21. I can, however, do these by telehealth/video calling, I believe. Where a longer telephone call is requested, or consented to and required, and video-calling is not available, please note that the gap fees will be significantly higher due to the limited Medicare rebate- even if you normally are bulk-billed. Hence the importance of finding a way for us to video chat.


PS: I need to be your usual, principal GP in order to claim under telehealth/telephone, and need to have consulted with you in person at home or the surgery within the last 12 months. For almost all reasons, you can only do these consults with one Practice's GPs. This will of course only be an issue for a handful of my patients, but especially affects those living some distance away, or in another State, and is an issue for those who see another GP, eg. for women's issues, for example. This may be a surprise, but it is the rule, and I can't break it. I can still do a call, but usual fees and no Medicare rebate would apply!


REMEMBER that you can ask family, friends, Sycamore Health staff or practitioners, as well as Telstra and others for help in setting up any of the above.



PRACTICE FEES (same for consults in-person or telephone/telehealth)

The gap fees are increasing from 1/7/21, for the first time since I have been at Sycamore Health, as costs rise, yet Medicare rebates only rise at a smaller %age rate, as usual...


*$12 up from $10 for a level a consult (brief, eg. B12 with my brief ok/consent, in person);

*$34 up from $32 for a standard level b consult;

*$54 up from $52 for a level c consult where 30mins (and complexity) has been requested or consented to in-consult;

*$84 up from $82 for a level d consult (>40mins and comprehensively complex)


*$15 for 16-21yo;

*$20 for those with HCC/PC who currently pay a gap, and for all who have been private who get a HCC/PC (we don't accept new bulk-billing patients now except for those under 16yo, and DVA patients)


Other fees are as advertised, eg. sending or re-sending scripts and referrals without a consult, $15-30



MEDICINAL CANNABIS

I just wish to remind patients that I am not a medicinal cannabis prescriber, and almost everyone requesting this will need to see another Dr for medicinal cannabis approval, prescribing, etc. No exceptions. I am, of course, very happy to refer patients on in the proper fashion.

Patients are reminded, as I do in consults, that they are not free from legal repercussions if drug-tested positive by the police or work due to their prescribed medicinal cannabis having THC content, as many preparations do. Patients are expected to inform the driving authorities if they are taking THC preparations. Evidence shows increased crash rates and impaired driving skills for at least 8 hours after a dose, and of course they may test positive for much longer than that, impaired, or not.



THE CVC (COORDINATED VETERANS CARE) SCHEME FORR WHITE CARD HOLDERS

From July 1st, white card holders with a diagnosed and accepted mental health condition, who are otherwise eligible for the CVC scheme, can be enrolled with me, and I will provide alongside CVC Practice Nurses Bec and Helen over-and-above care, monitoring, and access to those patients. Folders will remain hot orange. The cover sheet will change, and we will agree upon an ICCP (integrated coordinated CVC plan). I will discuss this with candidates, as I have been doing, opportunistically. Please feel free to make enquiries.

CVC Nurses Helen and Bec will call you each month to see how things are going, where changes have been made to care, and to check how we can improve things or better deliver on our agreed goals for care. PLEASE ANSWER THEIR CALLS / SAVE THE NURSES' NUMBER THAT THEY CALL FROM- this applies to gold card CVC participants too, thanks!



Best wishes, see you- talk to you- video call you soon!

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