North East Valley DGP eNews

No 1018: June 3, 2010
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/. To subscribe to eNews click on subscribe. To be removed from the eNews distribution list click on Unsubscribe

In this issue:

Editorial Confusion over time-based item numbers 701, 703, 705, 707

Chronic Disease Management Health Independence Programs direct referral and enquiry line for GPs, Carb Counting, it’s as easy as 1,2,3! Self Management Course

Professional Development CPD events

Immunisation Children 5 Years and Under Seasonal Flu Vaccine Program

Information Management Medical Director Tips

Items of interest BECC waiting times

Mental Health Making the Connection - The interplay between mental health & chronic disease, Cross Cultural Mental Health Care in General Practice

News for Practice Staff Women’s Health – Managing the Symptoms of Menopause, Practice Nurse Research update

Positions vacant/wanted

Fun stuff

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A Word from the Editor

Confusion over time-based item numbers 701, 703, 705, 707

There are 4 time-based health assessments items: 701 (brief), 703 (standard), 705 (long) and 707 (prolonged) covering 7 categories:

Over 75 Health assessment at surgery or in the home – annual [Replaces 700, 702]
4 year old health check – once only [Replaces 709]. Also Nurse item number 10986 [Replaces 711]
Type 2 diabetes evaluation for 40-49 year olds – every 3 years [Replaces 713]
45-49 health assessment “at risk” of developing a chronic disease – once only [Replaces 717]
Health assessment for people with an intellectual disability – annual [Replaces 718, 719]
Health assessment for refugees and other humanitarian entrants – once only [Replaces 714]
CMA in Residential Aged Care – annual [Replaces 712]

The decision to use any one of these four items to carry out a health assessment will depend on the practitioner’s clinical judgement based on the complexity of the presentation and the type of health assessment used. See the DoHA factsheet on Health Assessment Items.

The division is supporting practices to promote the Type 2 diabetes evaluation and referral to a LMP for 40-49 year olds and this support involves distribution of resources, assistance in mail out costs and other incentives. With item number claiming, however, it must be noted that:

You can only claim the time-based item number for a Type 2 diabetes evaluation for 40-49 year olds if the patient:

is between 40-49 years old
does not have a confirmed diabetes diagnosis
has a score in the diabetes risk test of 15 or more (soon to be changed to 12)
is referred to a Lifestyle Modification Program

If you carry out the diabetes risk evaluation and the patient does not qualify for referral to a LMP, you can:

complete it as a 45-49 year old health check
use item 23 or 36

If you complete the 45-49 health assessment you can’t do a Type 2 diabetes evaluation for 40-49 year olds for 3 years. As part of the 45-49 health check you can still refer to a LMP (but not claim).
If you complete a Type 2 diabetes evaluation for 40-49 year olds and refer them to a LMP you can still do a 45-49 health check from the following day.
Provided the patient meets the criteria you can refer to an LMP as part of “normal” consultation such as a 23 or 36.
If, in your health assessment you discover the patient has a chronic disease you can start the GPMP/TCA process (items 721, 723).

And finally…

Remember that nurse time is counted when using the time-based item numbers. The division is running a training session on the Lifestyle Modification Program for the 40-49 year olds + CAT training on June 15 (evening) at the division office [More Info and Application Form]
You should add a text annotation (service descriptor) to what particular health assessment you are claiming.

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Chronic Disease Management

Health Independence Programs direct referral and enquiry line for GPs

St Vincent’s and North Richmond Community Health have launched a combined initiative to improve the referral process for GPs to services which support the transition from hospital to home and prevent the need for a hospital presentation. This includes patients who are post-hospital discharge, sub-acute, ambulatory or have chronic or complex conditions. Call 1300 131 470.

Carb Counting, it’s as easy as 1,2,3!

Presented by Diabetes Australia – Vic: In this interactive session Accredited Practicing Dietitian/ Diabetes Educator Catarina Yeung, will provide easy carbohydrate counting tips, including advice for ‘tricky’ foods and when eating out. Wednesday 23 June 7-9pm at Charles Latrobe Theatre, Royal Melbourne Hospital. Cost: $5 for DA-Vic members plus one guest. $15 for non-members. Bookings Essential: 1300 136 588.

Self Management Course

Better Health Self Management aims to help patients manage symptoms so they can get on with their life. Tuesdays 22 June –27 July (6 weeks) 10-12.30 at Pauline Toner centre, 3/25-33 Grimshaw St, Greensborough. Cost: $5.00 per person per session. To register or for more information contact Lisa 9433 5111 or Prakashni 9450 2000.

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Continuing Professional Development

Lifestyle Modification Program for the 40-49 year olds + CAT training

Tuesday 15 June 7-9pm Registration: 6:30 pm For Practice Managers, Nurses and GPs - This program is for referring patients "at risk" of developing Type 2 diabetes to a FREE 6 session Lifestyle Modification Program, using the time-based item numbers 701, 703, 705 and 707. At North East Valley Division Office. Contact: Noel Stewart 9496 4333 Application form

Making the Connection - The interplay between mental health & chronic disease

Wednesday 23 June 7- 9:30pm (Registration/meal: 6:30). A workshop for GPs, Practice Managers & Practice Nurses, presented by Dr Lisa Engel at John Scott Meeting House, La Trobe University [Map]. [Application Form]

Term 2 GP Lecture Program

Meetings are held each Tuesday starting at 12.30 in the Lecture Theatre, Ground Floor, Pathology Building, Repatriation Hospital, Austin Health, West Heidelberg. Tea and Coffee provided. Course Leader: Dr Vin Nursey Phone: 9457 1736

June 8 - Review of Rheumatoid Arthritis - Professor Buchanan. For full term Tuesday lecture program click here

Austin Health - Division of Medicine Grand Round

“Seizure Management Stripped Bare” - Speaker Professor John Dunne, Professor of Neurology, Royal Perth Hospital.

Wednesday 9th June, 12:30pm at John Lindell Lecture Theatre, Level 4, Lance Townsend Building, Opposite Medical Library. Lunch is now at 1.15pm outside the Lecture Theatre.

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Immunisation

Children 5 Years and Under Seasonal Flu Vaccine Program

It is advised, that as a precaution, the suspension of seasonal flu vaccination should continue for healthy children under five years of age. See full media statement here

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Information Management

Medical Director Tip - Getting Austin Back and Neck Questionnaire into LetterWriter

It is a requirement that the Back & Neck Questionnaire accompanies orthopaedic referrals being sent to Austin Health. There is a pdf of this questionnaire on both the NEV division and Austin websites. Since it is a pdf, it cannot be imported into LetterWriter (which only accepts text-based file formats such as .doc and .rtf). I have created a Word document that has graphic images of the questionnaire – this means it is uneditable and has no MD fields. You can import it into LetterWriter but when importing into MD select Word document not RTF as the File type. When printing you only need to print the first 2 pages. Both versions (Word and pdf) can be found at:

· Back and Neck Questionnaire - to be completed and sent with Austin Outpatients orthopaedic referral. Please note: this is not a template but needs to be printed and then filled out by hand - July 2009 (pdf)

· Back and Neck Questionnaire - this is a Word document but there is no editable text. It needs to be printed and then filled in by hand. Unlike the above pdf version, this can be downloaded into LetterWriter. Please note: When importing select Word document not RTF. When printing you only need to print the first 2 pages - June 2010 (Word)

Too confusing – contact Noel or Alisa at the division on 9496 4333.

This weeks IM problem - Recording cannabis use

Question: We have a lot of patients who are cannabis users. Unlike smoking and alcohol there seems to be no place to record this. Where do I record this?

Answer: You could include this in the Comments: section of the Smoking assessment or under Social history but this is free text and tends to get lost. Many templates include Family and Social history so the latter method may be effective. It could also be added under Warnings but you may feel this inappropriate. If you want Cannabis use as a searchable item then you would create a New item under Past History – the coded item is “Cannabis use” or type “Drug” and a list of Drug abuse coded items appear, including Amphetamines, Cannabis, Ecstasy and Opiates.

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Items of Interest

BECC waiting times

Current inpatient waiting times for Northern Health Continuing Care Inpatient Services (Wednesday 02/06/10) approximately Gem 0 days, Rehab 0-2 days. Any queries regarding our waiting times please contact Access BECC on 9495 3443.

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Mental Health

Making the Connection - The interplay between mental health & chronic disease

See under CPD.

Cross Cultural Mental Health Care in General Practice

This is a distance education unit for GPs offered by the NSW Institute of Psychiatry and NSW Transcultural Mental Health Centre for 15 weeks from July 26, 2010. This unit of study will provide new and experienced GPs with the skills, knowledge and means of building better therapeutic relationships and working more effectively with patients from culturally and linguistically diverse (CALD) immigrant backgrounds. Scholarships for GPs are available. See here for further information.

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News for Practice Staff

Women’s Health – Managing the Symptoms of Menopause

Tuesday 22 June 7-8.30pm Registration: 6:30pm Target Group: Practice Nurses, pesented by: Dr Mary Levidiotis, NPS Facilitator, North East Valley Office [Map] [Application form]

Practice Nurse Research update

A joint collaboration between Monash University and the Melbourne East General Practice Network. Speakers include: Dr Chris Pearce—Practice Nurse Study, Dr Catherine Joyce—The Practice Nurse Work Survey: A National study of Practice Nurses' clinical patient care work, Ms Karina Gardner — Practice Nurse role in transition—Quantitative data from general practices. Thursday 15th July 1.30-3.30 pm, at Lecture Theatre, Monash University, Building 1, 270 Ferntree Gully Road, Notting Hill. Enquiries: Jill Kelly on 8878 3736 email: jkelly@megpn.com.au.

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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

Cheltenham - We are looking for a VR GP to join our midsized accredited practice. Comfortable new rooms, fully computerised, flexible sessions, pathology, physiotherapy, podiatry and psychology on site. Excellent remuneration, you will not be disappointed. Will suit GPT4 trainees. For further information please phone Peter Enten, 03 9584 9504, 0411 813 292 or email peterenten@bigpond.com.

Heidelberg West - VR GP, wanted Full or Part time with drug/alcohol/pharmacotherapy experience, to join Banyule Community Health. Hours/days are flexible, no weekends and attractive remuneration package. Practice hours are Mon-Fri 8-6. Re-accredited and computerized. Team support includes dedicated Medical Reception, Practice Coordination, Practice Nursing and Mental Health Nursing, with Allied Health, Counselling and Dental services on site. Contact Meni Stefanovski – Clinical Services Manager, on 9450 2013 or Mob. 0413 018 996 email meni.stefanovski@bchs.org.au

Ivanhoe - VR GP Full time or Part time required to work in this GP operated accredited medical centre. A friendly and supportive team environment in this computerised medical centre with allied health, nursing staff and radiology on site. No A/H’s flexible working hours family friendly. Please contact John or Ken on 03 9497 1188.

Kensington - GP, Full and Part-Time sessions available in The DGCHS Medical Clinic. Attractive salary, general medicine, Mental Health, Youth, Refugee and CALD communities. Reception, administrative and nursing support provided. For enquires please contact Janina De Silva on (03) 8378 1600 or email Janina.desilva@dgchs.org.au. For more information and a copy of the position description please visit our website.

Northcote – F/t P/T VR GP or Subsequent Trainee GP position. Fully accredited, computerised, long established doctor owned practice in a new purpose built facility with a fabulous work environment. Ancillary Health, Pharmacy and Pathology services on site. Inquiries Diane Cronin (Practice Manager) 9481 1214. Visit our website www.doctorsofnorthcote.com

Practice Staff

East Ivanhoe - Friendly General Practice in has a vacancy for an experienced Medical Receptionist. Availability to cover a variety of shifts including evenings and weekends as well as annual leave and sick leave cover. Excellent communication, computer skills and able to work in a team environment essential. Please email applications to: workfam@bigpond.net.au

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Humour

"Directions for use" - found on a number of products

1. On a blanket from Taiwan: NOT TO BE USED AS PROTECTION FROM A TORNADO.

2. In some countries, on the bottom of Coke bottles: OPEN OTHER END.

3. On a packet of Sunmaid raisins: WHY NOT TRY TOSSING OVER YOUR FAVOURITE BREAKFAST CEREAL?

4. On a Sears hairdryer: DO NOT USE WHILE SLEEPING.

5. On a bag of Fritos: YOU COULD BE A WINNER! NO PURCHASE NECESSARY. DETAILS INSIDE. (The shoplifter special!)

6. On a Korean kitchen knife: WARNING: KEEP OUT OF CHILDREN.

7. On a string of Chinese-made Christmas lights: FOR INDOOR OR OUTDOOR USE ONLY.

8. On a Japanese food processor: NOT TO BE USED FOR THE OTHER USE. (Now I’m curious.)

9. On Sainsbury’s peanuts: WARNING – CONTAINS NUTS.

10. On a Swedish chainsaw: DO NOT ATTEMPT TO STOP CHAIN WITH YOUR HANDS OR GENITALS.

11. On a child’s superman costume: WEARING OF THIS GARMENT DOES NOT ENABLE YOU TO FLY.

12. On packaging for a Rowenta iron: DO NOT IRON CLOTHES ON BODY.

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And remember…

…A will is a dead giveaway.