General Medical issues thread

[whatmeworry]

Amputation?

Currently in the process of updating my medical alert bracelet now I have to wear it all the time. Current one is too surgical. There are some rather nice ones out there but some of their prettiness could mean that their purpose might be overlooked.

I was reading how those charity and festival wristbands harboured of bacteria. Just remember to wash regularly.

 

[whatmeworry]

Never put the opening of your drink bottle anywhere near the spout of any faucet. Let the stream run free.

Also let the water run for a while. Water that is stagnant in pipes, microbes can breed. Same thing with shower heads.

 

[Pushka]

I was reading how those charity and festival wristbands harboured of bacteria. Just remember to wash regularly.

I don't do rubber.

 

[bosox76]

Mrscove got sick on Saturday night with a gastro bug in Sydney on this long weekend. I was very grateful that I could get a doctor to come to our place to get her a shot and some medication. Certainly glad we didn't try the 5 hour flight back to Perth on Sunday. Could have been more than a bit messy on the plane. Naturally I have been a tower of strength under the "in sickness and health" deal.
Surprisingly the doctor was free and the medication he carried saved me having to find an all night pharmac_. Apparently our medical group in Perth are subscribers to an Australia wide GP after hours service. That was wonderful news.
Thank you for coming Dr Tom. He even wrote the treatment in legible hand writing....wow!

Happy to hear that Mrs Cove improved with the treatment. Be aware though these after hour services are actually placing an increased financial burden on our health care. Although they "cost you nothing", they're often (1) provided by overseas trained doctors who are yet to be fully accredited with any local colleges (even if they are AHPRA registered) and (2) they usually bill for an after hours long consult which is substantially more than a GP who is open later would be billing.
Obviously there's a cost for convenience but I think the general public aren't fully aware of the added costs involved with these services. As Princess Fiona as said the advertising is definitely very slick.

 

[Cynicor]

Happy to hear that Mrs Cove improved with the treatment. Be aware though these after hour services are actually placing an increased financial burden on our health care. Although they "cost you nothing", they're often (1) provided by overseas trained doctors who are yet to be fully accredited with any local colleges (even if they are AHPRA registered) and (2) they usually bill for an after hours long consult which is substantially more than a GP who is open later would be billing.
Obviously there's a cost for convenience but I think the general public aren't fully aware of the added costs involved with these services. As Princess Fiona as said the advertising is definitely very slick.

They don't bill a long AH consult, which would be fine. They bill urgent item 597 most of the time, this is the massive rort. No AH service can survive on bulk billed after hours numbers alone, the rebate is tiny.

All the rest of what you say is correct, there are many 3rd year grads who may have also worked that day, many overseas doctors and very few fellowship qualified doctors in the service.

On the ortho front, private knee replacements have heaps of beds in WA, I reckon with the current glut of specialists I could get you from X-ray to knife within a week. Cardiologists and anaesthetists are also a dime a dozen. Soon to be followed by general surgeons and ED specialists.

On the noro front- someone mentioned hand washing won't kill it- this is inaccurate. Proper hand wash with soap should be sufficient. Straight alcohol gels will not kill all noro but most cruises use a gel that will kill noro (I hope, considering it's the main outbreak they get!).

 

[equus]

Why then do we read of elite footballers heading straight off the football field and into surgery for knee reconstructions etc?

All to do with the referrer as well, as any other factor.

Many years ago, had a referral to an ortho for knee reconstruction (ACL). The ortho was the top knee specialist - that was all he did.

His waitlist:

* General referral - 6 months
* Elite footballers referred by club doctor (this was AFL territory), Monday morning after the weekend game
* Someone referred by doctor who happens to be AFL club doctor, but not footballer - Wednesday that week

I saw him same week.

 

[Pushka]

Maybe cove could check his Medicare online and let us know the $$.

 

[penegal]

They don't bill a long AH consult, which would be fine. They bill urgent item 597 most of the time, this is the massive rort. No AH service can survive on bulk billed after hours numbers alone, the rebate is tiny.

Yep, and they can add a 10992 on the top can't they?

So $139.05 per attend?

 

[Quickstatus]

Yep, and they can add a 10992 on the top can't they?

So $139.05 per attend?

597 would be a rort. It's only if Dr opens their usual surgery after hours specifically to see a patient.
10992 is an afterhours top up for certain regional areas. Usually marginal electorates sit in here as well


they would not keep the full amount. I believe they get paid a minimum retainer for the night or 60%

 

[Cynicor]

597 would be a rort. It's only if Dr opens their usual surgery after hours specifically to see a patient.
10992 is an afterhours top up for certain regional areas. Usually marginal electorates sit in here as well


they would not keep the full amount. I believe they get paid a minimum retainer for the night or 60%

Half true. It's a legal use of it for home visits, but it is being used for anything, including med recharts in nursing homes. The claiming on the item has more than doubled in 3 years.

They are not on 100% of billings but will be up for all of it when they fail medicare's audits.

 

[blackcat20]

I used to wonder why people dropped towels on the floor behind the exit door in public toilets. I'm a bit slow, but now I reckon it is so that they can use a paper towel to open the door and then if the bin is not close enough, on to the floor it goes.

The people that use towel to open the door take it with them (theres only one person that does that). The rest is just poor aim and laziness.
I'm also bamboozled by the person that layered a tonne of paper on a toilet set, then just left it when they were done...they're obviously germphobic but dont seem to have any respect for anyone else who comes along after them.

 

[Princess Fiona]

597 would be a rort. It's only if Dr opens their usual surgery after hours specifically to see a patient.
10992 is an afterhours top up for certain regional areas. Usually marginal electorates sit in here as well


they would not keep the full amount. I believe they get paid a minimum retainer for the night or 60%

Half true. It's a legal use of it for home visits, but it is being used for anything, including med recharts in nursing homes. The claiming on the item has more than doubled in 3 years.

They are not on 100% of billings but will be up for all of it when they fail medicare's audits.

Not to mention the fact that lots of them are on 19A/B Class Exemptions for billings.
A lot of OTD's work for these "Dr to your Door" services to supplement their income. I don't know the figures but I believe it's definitely worth their while.

 

[JohnM]

Not to mention the fact that lots of them are on 19A/B Class Exemptions for billings.
A lot of OTD's work for these "Dr to your Door" services to supplement their income. I don't know the figures but I believe it's definitely worth their while.

Translation please .

 

[Cossie]

On cruise ships there is either a door that opens automatically or there is a bin by the door for this purpose. I am not a germaphobe but I HATE touching the toilet door after I have washed my hands. It seems pointless given others awful behaviours.

Agree totally, I don't suffer from ocd related issues, but I hate having to touch toilet door handles after watching what some people do, or don't do when they are in toilet washrooms.

 

[Princess Fiona]

Translation please .

Overseas Trained Doctors have a 10 year moratorium on obtaining a Medicare Provider number.
Cannot bill Medicare unless they have an exemption. Many such available on individual basis e.g. Area of Need or Specialist in need. In 2014 the Federal Govt gave Out of Hours services the ability to claim a section 19A/B exemption for medical services and thus add Overseas Trained Doctors to their books to provide Dr house calls and bill Medicare for these services.

 

[Cossie]

In a way yes.

I am not going to bend down to lift seat, pee and then put seat back down again. I will not be held responsible if the seat is wet. Wife knows. Have to teach daughter later.

Can I ask a silly question? Why didn't the previous occupant of the mens bathroom leave the seat down? That's the burning question.

Sorry I don't understand, when I went into the cublcle the seat was down and covered in pee, very yellow it was, obviously they don't drink enough water! It was obvious that the previous occupant had not bothered to lift the seat before doing a pee whilst standing up and therefore splashing everything with their very yellow urine.

It isn't a case of someone not putting the seat down after doing a pee when they are standing up, it was a case of not bothering to lift the seat before doing a pee, do I have to be anymore descriptive than this?
Not the first time I have seen this, some males are disgusting......

 

[cove]

Actually the doctor who attended Mrscove was an Aussie with great handwriting, clear English speaking with no accent. We received a call after 6pm letting us know he had 6 to see before her so he thought he would arrive around 9 pm or a bit later.
That was a good guess and I stayed up to do the medication as per the written notes.
Mrscove is now back in Perth with an uneventful business class flight where she ate 2 slices of bread and drank some water.
Now that was a great result for us.

 

[Princess Fiona]

Actually the doctor who attended Mrscove was an Aussie with great handwriting, clear English speaking with no accent. We received a call after 6pm letting us know he had 6 to see before her so he thought he would arrive around 9 pm or a bit later.
That was a good guess and I stayed up to do the medication as per the written notes.
Mrscove is now back in Perth with an uneventful business class flight where she ate 2 slices of bread and drank some water.
Now that was a great result for us.

Forgive me I do not mean that it is only OTD's that provide these services or that those OTD's aren't able to safely do that (after all I am an OTD myself way back with an accent as well )

The set up, marketing and ongoing sustainability of these services is questionable I think under the current fiscal climate.

 

[k_sheep]

Actually the doctor who attended Mrscove was an Aussie with great handwriting, clear English speaking with no accent. We received a call after 6pm letting us know he had 6 to see before her so he thought he would arrive around 9 pm or a bit later.
That was a good guess and I stayed up to do the medication as per the written notes.
Mrscove is now back in Perth with an uneventful business class flight where she ate 2 slices of bread and drank some water.
Now that was a great result for us.

Glad to hear she's on the mend. But the point is, the doc is highly unlikely to be qualified a year or so beyond med school. The medicare item they use is also entirely likely to be bordering on fraudulent. This is a ticking timebomb that is going to bite an awful of of junior doctors in the butt when/if
1/ they're audited by medicare and/or
2/ they make a mistake, are found to be practicing above their level of expertise and are negligent.

I'd be happy to sign up for one of these companies if I wanted to make plenty of cash - but that's not why I'm in medicine. Also, I know that the billing is unethical at best, and refuse to be part of such things. Brand new junior residents with giant HECS debts and a hankering for a shiny new car might not feel the same way.

 

[Pushka]

Cove's issue is not an ongoing health issue but a traveller issue. That is why travel doctors are helpful; they give you appropriate antibiotics and the information when travelling. Travel illness requires a completely different treatment approach.