Queensland’s Gold Coast has gone from being an after-hours “success story” to a cautionary tale
Queensland’s Gold Coast has gone from being an after-hours “success story” to a cautionary tale.
Last July, GPs on the Queensland surf strip organised a meeting with the National Home Doctor Service, the largest after-hours provider in Australia.
As NHDS was cutting a swathe across the country, the Gold Coast had been featured in its public relations campaign, touted as a region where its services had helped reduce costly hospital attendances.
The company made much of a comparison between the Gold Coast and the NSW Central Coast, linking its significantly lower rates of after-hours home visits with a higher incidence of low-acuity ED presentations. But GPs were not convinced.
Dr Graham Wright, a GP at the Gold Coast Super Clinic, kept a file which suggested that most after-hours call-outs were not urgent cases.
He says he was alarmed to see antibiotic prescribing by after-hours doctors going through the roof, mostly for children with upper respiratory tract infections.
Dr Wright said his records showed more than one in three URTI patients seen by after-hours doctors had been given antibiotics.
And hospital ED visits on the Gold Coast were not falling as claimed, he said.
Dr Wright said he presented this evidence to Ben Keneally, the-then chief executive of NHDS, who made certain undertakings.
For one, Mr Keneally promised the NHDS would tone down its direct advertising to patients and improve its triaging protocols.
GPs had been aggrieved by advertising that failed to differentiate between urgent and non-urgent care that could be provided in consultations during normal hours.
The private-equity backed market leader pledged its doctors would not attend routine complaints where a patient could reasonably wait until morning.
It would also crack down on antibiotic prescribing and ensure GPs could easily give feedback on any concerns about their patients.
Instantly, however, the peace offering came unstuck at a larger meeting with local doctors.
“During the meeting, one of us made a call [to the NHDS] and asked for a doctor to come out and write a script for a contraceptive pill,” Dr Wright said. “They happily said they’d come out and do that.”
Mr Keneally was confronted at the meeting, in what was described as a “volatile” atmosphere. He later resigned as CEO and left NHDS in early September.
Dr Wright told TMR that advertising of after-hours services on the Gold Coast now appeared to be less overt, but he believed triaging remained a problem.
Dr Stephen Withers, president of the Gold Coast Medical Association, commended the NHDS leadership team for facing a “blowtorch” reception at the July meeting. But he said the majority of local GPs were happy with the coverage offered by the company.
TMR understands NHDS has withdrawn from television advertising.
