.. the person responsible (apparently) was on leave .. now she is back from leave the assertion is that there are no signed timesheets to go with my invoices.
Interesting .. I stapled the time sheets to my invoices and personally observed the timesheets being signed off while at Mossman. I wonder how the invoices managed to get where they should have but the signed timesheets didn't.
Cheryl, while you are getting paid a regular wage to handle these things I am living off a line of credit because the system you work with fails miserably to respect the needs of the locum doctors. I know you are not necessarily personally responsible for this but you are now in the "firing line" ... I look forward to your speedy resolution of this matter.
This is not the first time QH in general and Cairns District in particular has been excessively slow in paying for work done.
I am curious to see if my Gladstone payment is made on the 15th of this month as it should be under the new "policy" arrangement where a third party handles the payments. I was informed that "receive the invoices by 10:00am Monday" is actually "if you want to be paid by the 15th of the month, all invoices/signed timesheets must be in before the end of the previous month".
/sigh
*edit
15th October - paid as expected by GN for my first "third party" payment for Gladstone, and the monies for Mossman appeared in my account same day. Was a good day to pay bills !
Thursday, October 8, 2009
Friday, September 18, 2009
Next bookings ...
Intermittently in Gladstone, then booked for three weeks at Mossman over Christmas and New Year, where Lesley and possibly Caroline will come for part of the time.
Monday, September 14, 2009
Locums not being paid by Queensland Health ??
The regions responsible for paying locum doctors under the new directive from Queensland Health that obligates locums to be paid by a third party, not directly by QHS, (see the document here) seem not to be paying as required under the new policy. You work after hours and get called back, no pay ?? ... the regions concerned appear to be insisting on the old "daily rate for all work" but happy to proceed with the disadvantages imposed on us by the new arrangement.
Have it both ways hey ? if you are locuming in Queensland, watch your back and your purse !
ps ... I actually have my first locum coming up next week under the new system. I am in possession of a signed contract (signed by the district CEO) that states clearly I will be paid call-backs at the rates specified in the QHS policy. I will post here the outcome of whether or not I get paid as they have agreed to.
Update 18th September :
I am uncertain of the circumstances any more than what I have been told by the locum service but it now appears that the two regions in particular who were appearing to be not paying for call-backs will pay. There may also be an issue with locums charging for oncall time as call-back time ... hopefully this teething stupidity settles quickly.
I have also been told that the QHS policy is going to be changed. Bet you they will attempt to remove call back payments all together. Watch this space.
Have it both ways hey ? if you are locuming in Queensland, watch your back and your purse !
ps ... I actually have my first locum coming up next week under the new system. I am in possession of a signed contract (signed by the district CEO) that states clearly I will be paid call-backs at the rates specified in the QHS policy. I will post here the outcome of whether or not I get paid as they have agreed to.
Update 18th September :
I am uncertain of the circumstances any more than what I have been told by the locum service but it now appears that the two regions in particular who were appearing to be not paying for call-backs will pay. There may also be an issue with locums charging for oncall time as call-back time ... hopefully this teething stupidity settles quickly.
I have also been told that the QHS policy is going to be changed. Bet you they will attempt to remove call back payments all together. Watch this space.
Tuesday, September 8, 2009
Apparently ...
... the med super here booked a long time in the past a training weekend this weekend in Cairns.
Apparently the locum that was booked to cover this weekend let the administration services who look after locums three weeks ago that he could not cover this weekend.
Apparently the administration services forgot to let the med super know this - she found out this morning.
The advanced rural trainee registrar is also on pre-planned training leave, starting tomorrow and over the weekend.
Today is Tuesday. A locum who will be arriving tonight to start tomorrow will be doing a 24hr shift Friday and a 24hr shift Sunday. Obviously that locum cannnot also do 24hrs Saturday to make it a 72 hours shift without a break. Safer to have no doctor than a "dead tired" doctor.
Apparently if urgent cover cannot be found Mossman Hospital will be without a doctor for 24 hours 08:00am Saturday to 08:00am Sunday.
Interesting ... very interesting.
*waves at the minister's office media monitors*
PS. I plan on being up here 21st December - 10th January ...
Apparently the locum that was booked to cover this weekend let the administration services who look after locums three weeks ago that he could not cover this weekend.
Apparently the administration services forgot to let the med super know this - she found out this morning.
The advanced rural trainee registrar is also on pre-planned training leave, starting tomorrow and over the weekend.
Today is Tuesday. A locum who will be arriving tonight to start tomorrow will be doing a 24hr shift Friday and a 24hr shift Sunday. Obviously that locum cannnot also do 24hrs Saturday to make it a 72 hours shift without a break. Safer to have no doctor than a "dead tired" doctor.
Apparently if urgent cover cannot be found Mossman Hospital will be without a doctor for 24 hours 08:00am Saturday to 08:00am Sunday.
Interesting ... very interesting.
*waves at the minister's office media monitors*
PS. I plan on being up here 21st December - 10th January ...
Saturday, September 5, 2009
How long is too long ?
I wonder sometimes how one knows if you have been in a place too long ... is it when you start getting emotionally attached to the local politics of an area ?
This place suffers from the disease of many ( I can't say "all" as I have not been "everywhere" yet to find out, but it would be fair to say that every rural area I have worked in has so far qualified) rural communities - the lack of resource.
And why would this be so ? ... I ask myself tempting myself to make a gratuitous, opinionated reply ... would it possibly be due to the lack of political will of those possessively grasping the purse strings ? What does it take for the focus of attention to be placed where it needs to be ?
Did you know that this area used to have two helicopters for medical transport ? ... there is no local airstrip so RFDS cannot provide a fixed wing service. Well apparently one of those helicopters is broke (rumoured permanently) and the other has been relocated to Townsville. It also appears that this gap in service has not been compensated for by increasing the resources to the local ambulance service who are now required to do the three hour round trip to transfer patients to the next level of medical care at Cairns. Earlier this week I needed an urgent transfer of a patient to Cairns but because the local service had been already overworked and for safety reasons was off duty, "fatigue leave" I think its called, an ambulance was required to drive the hour an a quarter from Cairns to pick up the patient. Fortunately the delay did not compromise significantly her care, but it could have.
The doctors who work here (currently three but a minimum of four is required for safe, quality service) work, when they do their 1 in 3 nights oncall, can work quite long hours, and sometimes unsafely so ... who provides them with fatigue leave ? .. yeah you guessed right, no one ... well actually they could, but then no one is available to provide the medical service needed (unless of course a doctor was able to come from Cairns to cover the 8 hours fatigue break .. its only a short helicopter flight !!). Maybe the local GPs could organise a roster to help out ?? And of course the penny-pinchers looking at the costs of the services in Mossman are complaining because the medical services budget is running "over budget" ... cut costs ? ... well where are those excess costs ? .. the overtime and the additional cost of employing locums of course. Cut costs ? ... Yes Minister, sure easy, no after hours medical service for the whole of the region, including the very significant population of Port Douglas who would no doubt prefer to travel the 20 minutes to Mossman instead of the well over an hour to Cairns.
Funding needs to be urgently found and committed - not like the funding that just mysteriously disappeared to employ an allied health worker just this week - really committed, to employ four doctors here full time (this would actually be cheaper than the current three doctor costs). This place is the perfect place for advanced rural general practice training leading in the a Rural Generalist specialty recognition. There should be no shortage of people wanting this sort of work - it just needs the funding.
And why not have an intern rotation here ?? ... in the next year or so there is in fact going to be a shortage of internship positions and it appears that only australian citizens will be guaranteed a position. Overseas students paying (very big) money to train in Australia may not be guaranteed a place for their first year after graduation. Give interns 3 months here under the mentorship of the doctors here and they will get a life-time of experience here. There is "good medicine" to be had here for all.
Caveat ... no I did not get paid, bribed or receive favours for this, as those of you who know me will be aware, I speak my mind.
This place suffers from the disease of many ( I can't say "all" as I have not been "everywhere" yet to find out, but it would be fair to say that every rural area I have worked in has so far qualified) rural communities - the lack of resource.
And why would this be so ? ... I ask myself tempting myself to make a gratuitous, opinionated reply ... would it possibly be due to the lack of political will of those possessively grasping the purse strings ? What does it take for the focus of attention to be placed where it needs to be ?
Did you know that this area used to have two helicopters for medical transport ? ... there is no local airstrip so RFDS cannot provide a fixed wing service. Well apparently one of those helicopters is broke (rumoured permanently) and the other has been relocated to Townsville. It also appears that this gap in service has not been compensated for by increasing the resources to the local ambulance service who are now required to do the three hour round trip to transfer patients to the next level of medical care at Cairns. Earlier this week I needed an urgent transfer of a patient to Cairns but because the local service had been already overworked and for safety reasons was off duty, "fatigue leave" I think its called, an ambulance was required to drive the hour an a quarter from Cairns to pick up the patient. Fortunately the delay did not compromise significantly her care, but it could have.
The doctors who work here (currently three but a minimum of four is required for safe, quality service) work, when they do their 1 in 3 nights oncall, can work quite long hours, and sometimes unsafely so ... who provides them with fatigue leave ? .. yeah you guessed right, no one ... well actually they could, but then no one is available to provide the medical service needed (unless of course a doctor was able to come from Cairns to cover the 8 hours fatigue break .. its only a short helicopter flight !!). Maybe the local GPs could organise a roster to help out ?? And of course the penny-pinchers looking at the costs of the services in Mossman are complaining because the medical services budget is running "over budget" ... cut costs ? ... well where are those excess costs ? .. the overtime and the additional cost of employing locums of course. Cut costs ? ... Yes Minister, sure easy, no after hours medical service for the whole of the region, including the very significant population of Port Douglas who would no doubt prefer to travel the 20 minutes to Mossman instead of the well over an hour to Cairns.
Funding needs to be urgently found and committed - not like the funding that just mysteriously disappeared to employ an allied health worker just this week - really committed, to employ four doctors here full time (this would actually be cheaper than the current three doctor costs). This place is the perfect place for advanced rural general practice training leading in the a Rural Generalist specialty recognition. There should be no shortage of people wanting this sort of work - it just needs the funding.
And why not have an intern rotation here ?? ... in the next year or so there is in fact going to be a shortage of internship positions and it appears that only australian citizens will be guaranteed a position. Overseas students paying (very big) money to train in Australia may not be guaranteed a place for their first year after graduation. Give interns 3 months here under the mentorship of the doctors here and they will get a life-time of experience here. There is "good medicine" to be had here for all.
Caveat ... no I did not get paid, bribed or receive favours for this, as those of you who know me will be aware, I speak my mind.
Monday, August 31, 2009
How many crabs ?
Today I went into the Daintree and spent some time retracing the path our family took on the guided tour we took a couple of months ago, but on my own was at a much more leisurely pace, and with my camera indulged in quite a few photos. The "marsh" area was a lot drier, has not been much rain at all. But the wet season will return soon no doubt.
Oncall Staurday night was a little bizzare - expected to be busy so stayed in a room at the hospital. Put my head down at about 9:30pm and woke to my alarm at 6:30am. No attention required of me, although I did wake a few times overnight to check my phone was still working !
Sunday I went into Port Douglas ("Port" to the locals) and strolled around the markets ... bought a few things, including something for Allison and Caroline for their upcoming 18th birthday.
Wednesday, August 26, 2009
Mossman - Day 3
What can I say folks ? ( thats a rhetorical question ! )
Anyone who wants to consider rural general practice as a career path an extended stay at Mossman is on your list of "must do" positions.
A surprisingly good bunch of local GPs (okay I am biased because of some less than inspirational experiences with GPs in many locales over the years - btw - I am a GP who sets personally high standards so I speak from an informed opinionated position now, unlike my arrogant, ill-informed position as a hospital resident in the mid-80's), an energetic med super, one of the world's most beautiful places to work, and a job that gives the opportunity to be at the coalface of medical presentations and then directly involved in the ongoing responsibility of care for any admissions to the ward - continuity of care at its best and with the support of the local medicos (especially currently the med super and an advanced rural GP trainee), there is a great opportunity for experience in the style of medical management of patients one just does not get in city practice anymore. Wow that was effusive wasn't it !? .. sorry.
I have not worked a night oncall yet (thats tomorrow, Thursday) nor a weekend shift yet (thats Saturday with Sat night oncall) so the "honeymoon" period might vanish with a flash, but first impressions are good.
I met up with Mike who was leaving as I arrived (one day overlap) ... he has been here twice now and he enjoys working here (and the patients and staff love having him around too !). It brought back memories of "handover" time at Knox ED.
We have three medical students with us here - they are seeing (as I am of course) some great medicine, even this morning in ED we diagnosed a young man (incidental to his presentation really) Wolf-Parkinson-White syndrome. We may have just saved this guy's life.
I will post again after my Saturday working ... Sunday is off and what I do is dependent on whether or not I need some sleep catchup from Saturday night. Sunday I will probably check out the Sunday markets in Port Douglas, and Monday will be a trip into the Daintree.
Catch you all again soon.
Anyone who wants to consider rural general practice as a career path an extended stay at Mossman is on your list of "must do" positions.
A surprisingly good bunch of local GPs (okay I am biased because of some less than inspirational experiences with GPs in many locales over the years - btw - I am a GP who sets personally high standards so I speak from an informed opinionated position now, unlike my arrogant, ill-informed position as a hospital resident in the mid-80's), an energetic med super, one of the world's most beautiful places to work, and a job that gives the opportunity to be at the coalface of medical presentations and then directly involved in the ongoing responsibility of care for any admissions to the ward - continuity of care at its best and with the support of the local medicos (especially currently the med super and an advanced rural GP trainee), there is a great opportunity for experience in the style of medical management of patients one just does not get in city practice anymore. Wow that was effusive wasn't it !? .. sorry.
I have not worked a night oncall yet (thats tomorrow, Thursday) nor a weekend shift yet (thats Saturday with Sat night oncall) so the "honeymoon" period might vanish with a flash, but first impressions are good.
I met up with Mike who was leaving as I arrived (one day overlap) ... he has been here twice now and he enjoys working here (and the patients and staff love having him around too !). It brought back memories of "handover" time at Knox ED.
We have three medical students with us here - they are seeing (as I am of course) some great medicine, even this morning in ED we diagnosed a young man (incidental to his presentation really) Wolf-Parkinson-White syndrome. We may have just saved this guy's life.
I will post again after my Saturday working ... Sunday is off and what I do is dependent on whether or not I need some sleep catchup from Saturday night. Sunday I will probably check out the Sunday markets in Port Douglas, and Monday will be a trip into the Daintree.
Catch you all again soon.
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