10 March 2020

Practices now directly addressing ‘coronavirus anxiety syndrome’

Communicable Disease General Practice Patients

After a few weeks of his patients arriving at his Brisbane based iHealth Fiveways Surgery  with misinformation, some panicked, others with flu-like symptoms who hadn’t rung ahead, Dr Jared Dart decided to write to all his patients, via email and SMS, pointing to a blog containing comprehensive information directly relevant to the circumstances of all his patients.

The information was comprehensive, and, for some, confronting, according to Dr Dart. One patient emailed back they would never visit his practice again. (That blog can be found HERE).

But Dr Dart is adamant for the most part, the information, was well received by his patient cohort who were becoming increasingly confused by the messages from state and federal governments and erratic and sensational media reporting.

Dr Dart also didn’t hold back on communicating where the crisis was made worse by the government’s lack of GP funding in the past few years, and its lack of support and communication to the GP community.

After detailing the protocols patients could expect from the practice, Dr Dart goes on to explain that some additional costs may be unavoidable and he hoped patients would understand the situation given the last few years of government policy on GP remuneration.

“All of this will take time, resources and commitment on our part (I have been doing many hours of work preparing our clinic for this situation), so we ask you to be understanding during this difficult time. We may need to charge you extra for certain services and items (like masks) – this is unfortunate, but necessary. You may be aware that the federal government froze GP Medicare rebates for seven years and that the rebate has only increased from $34 in 2010 to $38 in 2020. This has meant many general practices are struggling financially at a time when we are being asked to do even more for our patients. (If this upsets you please contact your local federal MP.),” Dr Dart told patients.

Dr Dart told The Medical Republic his group had incurred an additional $10,000 in consumable costs just in the past few weeks which had not been recouped.

As well as GPs, some specialist groups with vulnerable patients are getting on the front foot with their patients.

Dr Irwin Lim, who has a large rheumatology practice in Sydney, also wrote to his patients detailing current information relevant to potentially vulnerable patients.  He told TMR the practice had spent a lot of time modelling contingency plans in the event that doctors are forced to isolate and the practice workforce is compromised.

The statement didn’t go into any contingency planning, but was simple and clear expression of protocols that patients should follow if they were worried, protocols for current appointments and how the practice had made plans so it could always manage to service patients.

“Being a rheumatology centre, we know many of you are concerned about your immune system and the medications that you are on. At the same time, many of you also rely on the services we provide to help you do the things you need to do. We take this seriously and hence, are taking steps to make sure our clinics remain as safe as possible to give you the confidence that you can continue coming in to receive the treatment and advice necessary to allow you to live and feel better,” Dr Lim told patients.

His full message to patients is HERE

Many GP surgeries around the country are struggling with what one doctor is terming “coronavirus anxiety syndrome”, where a significant proportion of patients are arriving without any, or very mild symptoms, requesting a coronavirus test. One GP told TMR the issue with this was that it diluted “efforts to get to the patients who have genuine symptoms, and also delays treatment of the normal cohort of patients who are genuinely, and sometimes, seriously, ill”.

Most GP practices have protocols in place now for patients arriving without calling, or for those calling in prior to coming, as they are supposed to. Past AMA president Mukesh Haikerwal was pictured in this morning’s newspapers taking patient swabs from patients through the window of their cars in the practice car park.

But it isn’t clear just how many GPs are taking the step of directly contacting patients and instituting an ongoing engagement via SMS updates, and updates to their practice website information.

Most practices now have access to SMS patient communication alerts via their appointments system. Some of these systems, in particular Hotdoc and HealthEngine, offer sophisticated means of providing individualised and general ongoing patient engagement.

Earlier this week, HealthShare announced that any practice using the Best Practice Premier practice management system could now screen patients for COVID-19 before they arrived at the clinic using BetterConsult, which is now part of the system, and is free to download and use.

BetterConsult launched last year as digital clinical questionnaire that practices can SMS patients prior to their visit a link to answer questions. BetterConsult automatically codes the patients’ answers into medical terms and converts that into bullet points that are directly entered into a doctor’s clinical notes.

For COVID-19, BetterConsult asks about relevant symptoms such as fever or cough, whether they have recently travelled to high-risk countries, and had potential contact with COVID-19 positive people.

COVID-19 live update