Tuesday, September 21, 2010
Sunday, September 19, 2010
Eidsvold
Arrived a short time ago. Flew Melbourne, Brisbane, Bundaberg then drove 2.5 hrs inland to get to Eidsvold. It was dark for most of the trip driving so I didn't see much of the surrounds inland of Bundaberg. I'm in shared accommodation - own bedroom, shared kitchen and bathroom/laundry. No Optus service here so mobile phone is out of action ... will be communicating via Telstra 3G internet (email, blogging etc.) and the local landline. Meet the admin tomorrow 08:00 to get my orientation and I will find out what my role will be for the next two weeks.
Will post again in the next few days ... with some photos. Keep an eye on Facebook too ... will probably keep in touch there too.
Will post again in the next few days ... with some photos. Keep an eye on Facebook too ... will probably keep in touch there too.
Saturday, September 11, 2010
Mossman August 2010
Mossman ... what can I say ... yet again a great job and a beautiful place to be !
Wednesday, July 28, 2010
Heading back to Mossman soon ... but
.. I thought I'd post some photos from my Yarrabah trip. I have been conservative with taking photos in community as I do not know yet what is proper in respect to the cultural sensitivities of the community, but here are some of what is in fact one of the most beautiful coastal areas in Australia.
Second Beach - homes on the beach front.
Yarrabah from lookout.
Sunset at Yarrabah beach.
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Second Beach - homes on the beach front.
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| From Rural Locums |
Yarrabah from lookout.
Sunset at Yarrabah beach.
View Larger Map
Thursday, July 1, 2010
Seriously guys!
If you work as a locum don't put in claims for days you didn't work and don't inflate callback times!
Not only are doctors (very few I hope) defrauding QHS at least one locum service is attempting to get two days payment from QHS for a 24hour period starting 08:00am, claiming a "24 hour period" rolls over at midnight, not 08:00am the next day !
This is the wording of the QHS policy :-"... base rate includes any on call or recall allowance and the agency fee. Any hours worked in excess of 12 hours in a 24 hour period are to be paid at an hourly rate determined as ..."
It's hard enough to provide a decent service to the community without the blatant greed of some of the "service" providers.
Pathetic really, it's not like we don't get very well paid for what we do anyway.
http://www.health.qld.gov.au/hrpolicies/resourcing/b_45.pdf
Not only are doctors (very few I hope) defrauding QHS at least one locum service is attempting to get two days payment from QHS for a 24hour period starting 08:00am, claiming a "24 hour period" rolls over at midnight, not 08:00am the next day !
This is the wording of the QHS policy :-"... base rate includes any on call or recall allowance and the agency fee. Any hours worked in excess of 12 hours in a 24 hour period are to be paid at an hourly rate determined as ..."
It's hard enough to provide a decent service to the community without the blatant greed of some of the "service" providers.
Pathetic really, it's not like we don't get very well paid for what we do anyway.
http://www.health.qld.gov.au/hrpolicies/resourcing/b_45.pdf
Medicare disadvantages Indigenous communities.
Medicare rewards efficiencies of time ... current rebate for 6 minutes is $34.30, and it just happens to be the same for 19 minutes. That's $343 per hour with the old "6 minute medicine" policy implemented. For somewhere between 20 and 40 minutes of time the medicare rebate is $66.45 or lets say x3 for just under $200 per hour. For over 40 minutes the medicare rebate is $97.80 or less than $100 per hour.
No this is not another rant about equal pay for equal time, this is background for what I am about to say.
Indigenous health requires opportunistic care ... for example, someone comes in for management of a dog bite, you check their blood pressure, check their immunisation status (no not just their latest tetanus shot), check their urine for blood and/or protein, check their random blood glucose, review their medical past history and make sure their health check items are up-to-date (eg. HbA1c in diabetics), check their skin for other lesions (scabies, secondary infections with GpA strep etc.) look in their ears (chronic suppurative otitis media and cholesteatoma are not uncommon), check their drug and alcohol use, check their domestic situation is clean to return to, and then get on with cleaning and dressing the dog bite (at your own cost) AND then decide on whether or not a prescription of antibiotics will be filled (pension day is in five days time), whether the full course of antibiotics you provide (again out of your own funding) will be actually taken and completed, or you give a shot of long acting penicillin as the best of a not ideal treatment situation.
See where I am heading ?
The service at Yarrabah where I am currently working is funded by Queensland Health. Any attempt to fund the service primarily by medicare rebates will be doomed to a financial disaster.
Nicola's proposal to "voluntarily" register diabetic patients for block funding is another point of discrimination against the indigenous community. The whole care of a diabetic patient will be case managed by a GP (or will it be redirected to "Medicare locals"??) and all the care will be paid for by a single block fund. Block funding will be dependent on meeting outcomes, as yet unknown, but say for example, acceptable HbA1c levels (virtually impossible in a significant number of the indigenous community) perhaps even no admissions to hospital.
If the plan to hand over the medical services management to the community has in its hidden agenda switching over from Queensland Health funding to primarily self funding through the generation of medicare rebates, then this will be a disaster for Yarrabah and all communities like it.
*sigh* ... can I ever work somewhere and not get involved in the local politics and patient advocacy? probably not.
Otherwise .. working at Yarrabah has been a delight. The community has been appreciative, the staff a delight to work with and a medical and personal experience to not pass up. I have seen "medicine" I have not seen for years, I have done things I thought myself not capable of because I have not done the same for decades.
I have seen "the good, the bad and the ugly" and have had my own complacency challenged. I am most appreciative of the the opportunity of working here, and I will be back.
No this is not another rant about equal pay for equal time, this is background for what I am about to say.
Indigenous health requires opportunistic care ... for example, someone comes in for management of a dog bite, you check their blood pressure, check their immunisation status (no not just their latest tetanus shot), check their urine for blood and/or protein, check their random blood glucose, review their medical past history and make sure their health check items are up-to-date (eg. HbA1c in diabetics), check their skin for other lesions (scabies, secondary infections with GpA strep etc.) look in their ears (chronic suppurative otitis media and cholesteatoma are not uncommon), check their drug and alcohol use, check their domestic situation is clean to return to, and then get on with cleaning and dressing the dog bite (at your own cost) AND then decide on whether or not a prescription of antibiotics will be filled (pension day is in five days time), whether the full course of antibiotics you provide (again out of your own funding) will be actually taken and completed, or you give a shot of long acting penicillin as the best of a not ideal treatment situation.
See where I am heading ?
The service at Yarrabah where I am currently working is funded by Queensland Health. Any attempt to fund the service primarily by medicare rebates will be doomed to a financial disaster.
Nicola's proposal to "voluntarily" register diabetic patients for block funding is another point of discrimination against the indigenous community. The whole care of a diabetic patient will be case managed by a GP (or will it be redirected to "Medicare locals"??) and all the care will be paid for by a single block fund. Block funding will be dependent on meeting outcomes, as yet unknown, but say for example, acceptable HbA1c levels (virtually impossible in a significant number of the indigenous community) perhaps even no admissions to hospital.
If the plan to hand over the medical services management to the community has in its hidden agenda switching over from Queensland Health funding to primarily self funding through the generation of medicare rebates, then this will be a disaster for Yarrabah and all communities like it.
*sigh* ... can I ever work somewhere and not get involved in the local politics and patient advocacy? probably not.
Otherwise .. working at Yarrabah has been a delight. The community has been appreciative, the staff a delight to work with and a medical and personal experience to not pass up. I have seen "medicine" I have not seen for years, I have done things I thought myself not capable of because I have not done the same for decades.
I have seen "the good, the bad and the ugly" and have had my own complacency challenged. I am most appreciative of the the opportunity of working here, and I will be back.
Tuesday, May 4, 2010
Bidgerdii - Rockhampton
I find myself some time past the locum at the Rockhampton Aboriginal Health Service and not made a blog entry.
I spent four weeks at the service in the main town centre of Rockhampton. This job has left a number of impressions so I will list them as they come to me.
1) Rockhampton is a large sprawling country city that at its heart is a series of old, historic buildings. It lay on the bank of a large (I believe tidal) river. For its promising initial appearance it is not inspiring, at least to me. It's a little lifeless. The population spreads out from Rockhampton to the north and along the river to the coast, and this is where the life seems to have been dragged kicking and screaming. The city itself is nothing of note once the pleasure of the old buildings and the river passes.
2) I have an Optus 3G telephone network subscription - the coverage in Rockhampton is pathetic. I can cross from one side of the street to the other and I lose signal. I got to lunch in the local pub and once inside the signal drops out. Even 2G sometimes vanishes, so I am without a telephone signal at all.
3) I was accommodated in a house out of town, not within walking distance of work or shops. Had its advantages and disadvantages, but a 10 minute drive to work was not to be complained about.
4) The staff of the service were wonderful people, many of an aboriginal background, some not. The CEO was off on maternity leave, so never got to meet her. The clinic had undergone some major staff changes, including the departure of all the clinic doctors and the clinic nurse. I arrived as a locum with the place in transition,, doing much of the work of what would have been done by a full time clinic nurse, if there had been one. The second two weeks, a new nurse arrived and it was a joy to see her enthusiastic about taking over the role and being involved in the day to day management of the clinical services.
5) A mixture of electronic and paper records does not work well. The handling of correspondence inwards, recall and followup is hard to implement with such a system.
Would I work there again? Possibly, but a clinic in the middle of a larger town is not personally attractive to me - I left that behind in Melbourne.
Would I recommend it for an experienced GP for the experience of working in a supportive aboriginal health team? definitely.
I spent four weeks at the service in the main town centre of Rockhampton. This job has left a number of impressions so I will list them as they come to me.
1) Rockhampton is a large sprawling country city that at its heart is a series of old, historic buildings. It lay on the bank of a large (I believe tidal) river. For its promising initial appearance it is not inspiring, at least to me. It's a little lifeless. The population spreads out from Rockhampton to the north and along the river to the coast, and this is where the life seems to have been dragged kicking and screaming. The city itself is nothing of note once the pleasure of the old buildings and the river passes.
2) I have an Optus 3G telephone network subscription - the coverage in Rockhampton is pathetic. I can cross from one side of the street to the other and I lose signal. I got to lunch in the local pub and once inside the signal drops out. Even 2G sometimes vanishes, so I am without a telephone signal at all.
3) I was accommodated in a house out of town, not within walking distance of work or shops. Had its advantages and disadvantages, but a 10 minute drive to work was not to be complained about.
4) The staff of the service were wonderful people, many of an aboriginal background, some not. The CEO was off on maternity leave, so never got to meet her. The clinic had undergone some major staff changes, including the departure of all the clinic doctors and the clinic nurse. I arrived as a locum with the place in transition,, doing much of the work of what would have been done by a full time clinic nurse, if there had been one. The second two weeks, a new nurse arrived and it was a joy to see her enthusiastic about taking over the role and being involved in the day to day management of the clinical services.
5) A mixture of electronic and paper records does not work well. The handling of correspondence inwards, recall and followup is hard to implement with such a system.
Would I work there again? Possibly, but a clinic in the middle of a larger town is not personally attractive to me - I left that behind in Melbourne.
Would I recommend it for an experienced GP for the experience of working in a supportive aboriginal health team? definitely.
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