Gentlemen, I have just returned from a short locum at Apollo Bay where there is a problem common to rural general practice ... After hours cover.
AB has a small hospital with 4 acute medical beds, residential aged care, and a small A+E. In one general practice there are 2 GPs (husband and wife) aged in their 70s, and who do NO after hours cover or any hospital work (viz: no A+E or acute medical). The other general practice has a female GP doing about 6 sessions and NO after hours cover. This practice tries to supply 2 additional GPs who need to provide ALL the after hours cover. These GPs soon burn out, and there have been *28* GPs come and go over the past 2-3 years. It is also difficult to keep the "temporary" GPs busy in hours and well remunerated. There is no circuit breaker foreseeable in the next 5 years, with the permanent GPs "standing their ground". Solution: Remote on call GP. I would estimate that 9/10ths of after hours disturbances could be managed remotely by an experienced GP with the right IT setup. The remote on call GP could then be 1st on call whilst the local GP is "2nd" on call. The rural hospital would need to have electronic health records, with VPN access by the remote on call GP. Maybe a web cam, also. Obviously most of the crap such as inpatients needing medications/IV fluids ordered/recorded/signed during the night could be easily looked after remotely. But a lot of major emergencies could similarly be managed. Eg. patient presents to A+E with crushing chest pain, ECG shows acute AMI changes ... Nurses/paramedics insert IV, remote GP orders further investigations and meds (as per usual protocol), rings referral hospital, and ambulance transfers - all while the 2nd on call local GP sleeps. Comments ? John Mac _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
