North East Valley DGP eNews

No 1421: July 2, 2014
eNews is a weekly electronic newsletter sent to all GP practices (with email addresses) within the NEV catchment. The aim is to provide up to date information relevant to GPs and to disseminate the latest activities and resources from the division. All feedback and enquiries welcome and should be addressed to Patty Marshall. You can also visit our website at: http://www.nevdgp.org.au/.
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In this issue:

Editorial                                                Nurses time no longer counted in the preparation of health assessments, Summary of changes included in the 1 July 2014 edition of the MBS, Maternal Mental Health Service from Engage 1on1          

Chronic Disease Management            DAFNE (Dose Adjustment for Normal Eating)

Professional Development                 CPD events   

Immunisation                                       Melbourne Vaccine Education Centre Survey for GPs

Information Management                  Medical Director, Best Practice & General Computer Tips

Items of interest                                  Cancer Council National GP Portal – NEW features, GP Network News

Mental Health                                      Caring for patients with intellectual disabilities

News for Practice Staff                       New RACGP Infection prevention and control standards 5th Edition, APNA National Bowel Cancer Screening Program – new online learning course for nurses, Newsletters

Positions vacant/wanted                  

Fun stuff                                              

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A Word from the Editor

Nurses time no longer counted in the preparation of health assessments

In a surprise announcement Medicare through its June 2014 “Health Professional News” has announced a record keeping requirement for health assessments (items 701 to 715) and the legal requirements for the claiming of those items. You may remember that from 1 May 2010, the MBS Review of Medicare primary care items resulted in the reduction of ten health assessment items to four time-based items 701(brief), 703 (standard), 705 (long) and 707 (prolonged). These health assessment items continue to apply to individual target groups.

However in its June 2014 review Medicare states that “Previously we advised that the time spent by nurses contributing to health assessments could be included with the medical practitioner’s time when choosing the time-based item to bill. This was incorrect (our emphasis). Medicare than further clarifies that “it is only the time that the billing medical practitioner spends with the patient that determines the choice of item number” (our emphasis) and that “this information supersedes any contrary MBS itemisation advice that may have been provided to you by the Department of Human Services prior to this notification”.

In other words the time spent by nurses in assisting the preparation of a health assessment no longer counts towards the applicable item number!

For the full article click here.

 

The division will however, adjust the clinical software versions of these affected templates and these can be found in the template section of the NEVDGP website. Please ensure that you download the revised template which will have a “Revised July 2014” annotation. Also see Medical Director hint for more help.

(Many thanks to Ann McCormack, Practice Manager Greensborough Road Surgery, for alerting us to this news)

 

Summary of changes included in the 1 July 2014 edition of the MBS

The MBS General Fee increase that was postponed in Nov 2013 has now been applied as of 1 July 2014. Summary of changes included in the 1 July 2014 edition of the MBS: General Fee Increase

The following changes to Medicare schedule fees will apply from 1 July 2014: A 2% increase in Schedule fees will apply to all items in Group A1, Group A5, Group A6, Group A17, Group A18, Group A20, Group A22, Group A27, Group A30 and Group M1. A 2% increase in Schedule fees will also apply to the following items; items 193, 195, 197, and 199 in Group A7, items 597 and 599 in Group A11, items 701 to 715 in Group A14, items 721 to 758 in Group A15, and item 139 of Group A29.

There has been no increase in the Schedule Fee for all the other items listed in the MBS.

Further information here.

 

Maternal Mental Health Service from Engage 1on1

Following a substantial loss in income for our very popular Mental Health Nurse program, which will seriously affect our Mother/Baby program, NEVDGP is pleased to advise Engage 1on1 Psychology has agreed to provide our member GP’s patients with an in home Maternal Mental Health Service - bulk billed at no cost with a GP Mental Health Care plan. 

Engage 1on1 focus on ‘Secure attachment of mother and baby’ as the basis for early childhood development, and provide help coping with anxiety, depression, or other issues causing distress:

·         Emotional distress, anxiety, depression

·         Adjusting to pregnancy and parenting

·         Receiving too much unsolicited advice

·         Not receiving enough practical support

·         Adjusting to change in relationships

·         Engaging with child and family

To organize this service, fax the referral and care plan to Engage 1on1 on 03 9489 3004, indicating it is for ‘Maternal Health’, and Engage 1on1 will contact the patient to discuss the day and time of the home visit. They will confirm back to you as the GP when the first visit has been attended. [Further service information and contact details].

 

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Chronic Disease Management

DAFNE (Dose Adjustment for Normal Eating)

Do you have clients with type 1 diabetes? DAFNE is a 5-day group self-management course for people with T1 diabetes who are not using an insulin pump. It covers topics such as insulin dose adjustment, carb counting, exercise, and illness management. Participants also get to meet others with T1 and share their experiences.

The next Melbourne course runs from 7 – 11 July. Clients can self-refer by calling Susan on 03 9667 1719 or visit the website for more information www.dafne.org.au.

 

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Continuing Professional Development

Get Healthy Information and Coaching Service

ThinkGP invites you to take part in the activity Managing a Patient's Lifestyle - Get Healthy Information and Coaching, developed with the NSW Department of Health. This activity explores the Get Healthy program as an accessible tool that helps GPs to assist their patients in setting and achieving healthy lifestyle goals. The Get Healthy Information and Coaching Service is a free 6 month telephone-based coaching service to help your patients make sustainable life changes in relation to healthy eating, being physically active and achieving and maintaining a healthy weight range. 

 

Seminar - Working with young people diagnosed with ME/Chronic Fatigue Syndrome

Thursday July 24th 2-5pm at the Alfred Hospital in Prahran. Learn about ME/CFS in young people and strategies to improve outcomes.

For more information contact ME/CFS Australia (VicTasNT) on 03 9529 1344 or Email: admin@mecfs-vic.org.au

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Immunisation

Melbourne Vaccine Education Centre Survey for GPs

Part of a University of Melbourne, 3rd year medical student scholarly selective project.

Click here for survey 

The Melbourne Vaccine Education Centre website (MVEC), launched in February 2014, is a new web based initiative. It is a collaboration between The Royal Children's Hospital Immunisation Service (Parkville) and their Melbourne Children's campus partners (Murdoch Childrens Research Institute and The University of Melbourne), as well as Monash Children's Hospital, Monash Health and Monash University (Clayton, Victoria, Australia).

The aim is to provide relevant, up-to-date clinical information based on the latest available evidence, as well as practical tools to assist in education and decision-making around new vaccines for healthcare professionals, parents and the public.

As an example, we have recently added a joint position statement from RCH & Monash Immunisation services re the new Meningococcal serogroup B vaccine (Bexsero), a common query from GPs since it became available earlier this year. See here.

 

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Information Management

Medical Director Tip - What to do about “Nurse time” in time-based health assessment templates

In today’s editorial you are told that there are modified health assessment templates available on the NEVDGP website. These templates have been modified so that there is no mention of “nurse time” on the templates. When a nurse is assisting in a health assessment you have 4 choices on how to use the health assessment template:

1.      Use your existing template and delete the reference to “Nurse time” – you would have to do this each time you use the template

2.      Modify the template yourself, removing the reference to “Nurse time”

3.      Download the new template from the NEVDGP website and delete old versions.

4.      Do nothing, using the old templates but not filling in the “Nurse time”

Whichever method you use, please refrain from swearing or cursing at this latest “clarification” from Medicare.

 

This week’s MD problem - Hyperlinks

Question: Can I insert a hyperlink into a LetterWriter template?

Answer: No.

 

Best Practice Tip - LetterWriter – creating Letter Writer template favourites

Rather than scrolling through a long list of templates you can create a list of your frequently used templates. This will take a few minutes to do but will save you time.

1.      Open any LetterWriter template. On the left of the screen you will see where a list of favourite templates can be stored.

2.      Click on the Add button (bottom left of the screen).

3.      Select a template and click on the Add button. Repeat the process until you have selected all your most used templates.

4.      When it comes to the time you wish to choose one of these templates, simply double click on the template you wish to use from the listed favourites.

Note: This can’t be done in Medical Director.

Hint Number 2: Please refer to the Medical Director hint for what to do about “Nurse time” in time-based templates.

 

Best Practice problem - Adding a hyperlink to a letter

Question: Can I modify a template so that it adds a link to a website in a referral or other correspondence?

Answer: The answer is yes and you will be pleased to know that MD does not have this feature at the time of writing.

1.      Open LetterWriter by clicking on the LetterWriter icon.

2.      From the Templates menu click on Edit template and select the template you wish to add the hyperlink. 

3.      Insert the cursor where you wish to add the hyperlink and from the Insert menu select Hyperlink – this opens the Insert Hyperlink window.

4.     

Type in the text and the website address (URL) and then click on Insert – this will place a blue hyperlink in your template – clicking on it will take you to the designated website.

 

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Items of Interest

Cancer Council National GP Portal – NEW features

The one stop shop for GPs with up-to-date cancer information and resources has been redesigned to make it easier to find what you need. This national website offers the latest news, evidence-based research and resources on cancer prevention, diagnosis and treatment. Other features include clinical guidelines and position statements, printable fact sheets for patients, online videos, accredited professional development educational resources, state-by-state workshops and events, information for culturally and linguistically diverse communities and information on state-based clinical trials. More information here.

 

GP Network News

This week’s edition can be found here.

 

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Mental Health

Caring for patients with intellectual disabilities

ThinkGP invites you to watch a new video series produced in partnership with the NSW Agency for Clinical Innovation, examining how to best manage with patients with intellectual disabilities.
Watch these four videos and consider the different ways that health professionals can work alongside carers and specialists to provide the best outcomes for patients with intellectual disabilities: 

·         Orientation to caring for a patient with Intellectual Disability

·         Continuity of care in Intellectual Disability: Jimmy’s Journey

·         Diagnosing Patients with Intellectual Disability

·         Accessing care for a patient with Intellectual Disability

 

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News for Practice Staff

New RACGP Infection prevention and control standards 5th Edition

They are written specifically for general practices and health professionals in other office-based and community-based settings. Free to download.

 

APNA National Bowel Cancer Screening Program – new online learning course for nurses

Developed in conjunction with Cancer Council Australia and reviewed and updated in 2014, this course provides primary health care nurses with an understanding of the risk factors and symptoms of bowel cancer, different screening tests for bowel cancer, features of the National Bowel Cancer Screening Program (NBCSP) and duty of care associated with the management of NBCSP participants. More information here or email education@apna.asn.au.

 

Newsletters

Latest APNA newsletter is here.

Remember you can find monthly newsletters on Infection Control here at Margaret Jennings’ website

 

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Positions vacant/wanted

Please note: only new ads or resubmitted ads will be posted here. All other ads can be found on the website

 

Positions vacant

Doctors

Bundoora - Female GP with Mandarin/Cantonese speaking skills wanted to work part-time in a DWS position. Tel: 0433 155 451.

 

Carlton - Full Time/Part Time VR GPs wanted (flexible hours). We are a group of female medical practitioners running a high-quality, family-orientated general practice, with a practice manager, practice nurse and allied health personnel onsite (podiatrist, dietitian, psychologist and women’s physio) plus on-site pathology. The practice is fully computerised and accredited. Phone 9380 4655, Email carltonmedical@bigpond.com, Web www.carltonmedicalcentre.com.au

 

Greensborough Road Surgery is currently seeking a Full-Time GP, approx 8 sessions pw. A position is available for an enthusiastic GP to join our team in a modern, well-equipped 10-doctor practice, offering high-quality care in an experienced and supportive environment. Private billing, computerised, 2.5 full-time nurses, (clinical CVC, and CDM.)  Contact Ann McCormack (03) 9435 0711 or email grs@grs.net.au or see www.grs.net.au

 

Northern Suburbs - Modern and well equipped practice seeking full time VR GP's, great support from nursing and allied health, in house pathology.  Partnership available for the right candidate.  Genuine enquiries most welcome.  Please contact Medprac@outlook.com.

 

Reservoir - Summerhill Medical Centre is seeking Full Time/Part Time VR GPs (flexible hours) to join a well-established practice of over 18 years. The practice is going through an unprecedented growth and is located in an ideal location only 15min from the CBD and in a shopping complex that will soon have Aldi, Coles, Kmart and IGA.  Excellent remuneration of 70% plus. The practice is computerised and accredited. Phone John on 0403 178 141 or email - summerhill@iinet.net.au.

 

West Heidelberg - GP wanted to join a solo GP practice, part time or full time. Please call 0435 815 187 or email lathaherath@hotmail.com.

 

Practice Staff

Bundoora - Div 1 Nurse to work part-time (Tuesday and Thursday) in a busy Practice. Good remuneration and friendly environment. Tel: 0433 155 451.

 

Craigieburn - Experienced Practice Nurse required for busy medical centre.  Two days per week, additional hours may be available.  Fully computerised practice. Award rates. Contact Leanne craigieburncentralmedical@gmail.com.

 

Northcote - Division 1 Nurse. An old, established, solo, fully computerised practice with warm and friendly atmosphere is seeking a Division 1 Nurse to work Monday, Wednesday and Friday from 9 am to 1 pm - total 12 hours. Salary: Award Rates. Contact details: Neelam Berera on 0411 196 940 (mobile).

 

West Heidelberg - Div 1 GP nurse wanted to join a solo GP practice. Initialy 22 hours per week. Please call 0435 815 187 or email lathaherath@hotmail.com.

 

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Humour

A few weeks ago we were severely criticised for recycling an old doctor joke and dressing it up in a current day event, namely the concerns of various specialists towards the release of the coalition’s May budget. We apologise for this and have decided over the next few weeks to explain what is behind some humour and to provide a little education about the specific type of joke. These jokes revolve around either misheard words, use of the wrong word, contradictions in terms, or just incorrect pronunciations.

Here we are in the world of malapropisms. aphorisms, homophones, oronyms and mondogreens. We won’t do puns however!

 

Malapropisms

This week we will start with malapropisms – the world of verbal slips and gaffes, Bushisms, Colemanballs and, maybe now Abbottisms.

This happened recently, by a politician on TV: “I don’t like to see these types of issues brandied about”. Surely it should have been “bandied”.

There was the more famous one by PM Tony Abbott who stated that “no-one can be expected to be the suppository of all wisdom!” and by calling Canada “Canadia”.

In America malapropisms are often called “Bushisms” because of the President’s frequent verbal slips. A few Bush examples:

1.      "We cannot let terrorists and rogue nations hold this nation hostile or hold our allies hostile."

2.      "The law I sign today directs new funds... to the task of collecting vital intelligence... on weapons of mass production."

3.      "It will take time to restore chaos and order."

4.      "They have miscalculated me as a leader."

5.      "Natural gas is hemispheric... because it is a product that we can find in our neighbourhoods."

6.      "I am mindful not only of preserving executive powers for myself, but for predecessors as well."

7.      "We need an energy bill that encourages consumption."

8.      "We are making steadfast progress."

In Britain, malapropisms are often called “Colemanballs a term coined by Private Eye magazine and is derived from David Coleman and other BBC sports commentators who were particularly prone to such slips.

"If Gower had stopped that [cricket ball] he would have decapitated his hand." Farokh Engineer.

 

Origin of the word “malapropism

In his 1775 Restoration comedy, “The Rivals”, Richard Sheridan introduced a humorous character by the name of Mrs. Malaprop, a name derived from the French mal à propos, which means inappropriate (we also have the word malapropos in English), and describes the manner in which she used many inappropriate words in her speech, often with hilarious nonsensical sentences. A few examples:

1.      "...promise to forget this fellow - to illiterate him, I say, quite from your memory."  [obliterate]

2.      "He is the very pine-apple of politeness!" [pinnacle]

3.      "Sure, if I reprehend anything in this world it is the use of my oracular tongue, and a nice derangement of epitaphs!" [comprehend, vernacular, arrangement, epithets] 

 

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And remember

 

            … A lot of money is tainted - taint yours and taint mine.