General Medical issues thread

[prozac]

It's one of the anomalies in our dual public and private health system. Medicare will cover a % of both inpatient and outpatient care episodes. Private health is only allowed to cover inpatient care; in emergency departments, despite being in a hospital, you are considered an outpatient until a decision to admit you has been made.

The $500 (or other amount as per you policy) excess payment is only payable once per calendar year; admissions subsequent to that have no additional excess payment due.

No idea why but I haven't been charged the one-off $500 in a few years. My wonderful haematologist only ever bulk bills me in rooms and is happy to give me any amount of time required. And that is not why I tell her I am lucky to have her on my team.

 

[Himeno]

The GP had the test results I've been expecting. The GP that I normally see is on holidays, so I saw someone else in the same practice (who was using the normal GPs office).
The culture was somewhat inconclusive, showing "mixed bacteria". Nothing in large enough amounts to stand out, so "normal"?

He thinks that the blood (7 episodes over 3 days) was dissolving clots from the difficult SPC change the week prior and not an infection.
There's been no more blood passing, from either tube, since Friday. So unless there is some other symptom, there's nothing to worry about.

Just got a call from the GP. He wants the SPC changed as a precaution and sent a referral to the local community nurses to get it done.

 

[tgh]

Greenslopes ED is attached to and run by Ramsay Health care, a "disgusting" money grubbing profit seeking business……
All the rest are public and clogged to the rafters with scratches, coughs and sniffles….
We have found the facility to be excellent and it is our first choice ; if we have a say…...

 

[RooFlyer]

PHI does not cover ED visits.

I'm not sure what the 'official' status of the Hobart Private Hospital ED is but that's where I've had to walk into a couple of times and when its the first visit of the year, its the $500 swipe on the CC for health fund. Or maybe it was a swipe and "we'll see".

No idea why but I haven't been charged the one-off $500 in a few years. My wonderful haematologist only ever bulk bills me in rooms and is happy to give me any amount of time required.

But is that a visit it a specialist, or a hospital visit? $500 I'm talking about is a hospital visit under Medibank Private.

Greenslopes ED is attached to and run by Ramsay Health care, a "disgusting" money grubbing profit seeking business……
All the rest are public and clogged to the rafters with scratches, coughs and sniffles….
We have found the facility to be excellent and it is our first choice ; if we have a say…...

I was pretty lucky then! I was having brunch with family at Mt Gravatt when I decided I had to be seen to. We just searched for private hospitals on Google Maps, filtered by ED and chose Greenslopes because it was sort of easy to get to.

 

[prozac]

But is that a visit it a specialist, or a hospital visit? $500 I'm talking about is a hospital visit under Medibank Private.

Not charged on admission last year as a private patient when diagnosed with cancer and was first admission of the year. Was there almost a month. No idea why I wasn't charged. Maybe this happens when you step up from Bronze to Silver FF.

 

[Pushka]

And possibly at the same time. 'Ablation' was mentioned in my consult yesterday (basically, wires threaded up into the heart to cauterise spurious beat-causing-loci) . That's something I'd like to avoid.

I also want to add a cheer for out oft-maligned health care system. I was able to walk into an 'ED' and be seen quickly, treated and sent off with a small out-of-pocket. Then able to get an appointment with my cardiologist at home just an hour after I landed back from Brisbane. That timing was lucky, but I'm sure he would have seen me that day, somehow.

Agree. As long as the arrival triage is done well it seems to work. I was seen within 15 minutes and the waiting area was packed.

 

[RooFlyer]

Advice sought from our docs.

Recently I had an ultrasound-guided injection at at radiology clinic. Referral noted 2 places for injection and words to the effect "Same as successfully last done at your clinic".

Discussed the radiologist doctor's subsequent report with my referring GP and it appears from it that only one site was injected (and not the important one, so the treatment failed). I said I'd ask to see if the second site was injected and therefore if it was an oversight on the report and he printed off a copy of the referral for me to work from.

The clinic has been difficult. After first agreeing to put me in touch with the radiologist doctor, the clinic then refused, saying "speak to your GP". My reply "I have and we agreed I should ask you". Reply was "You need to speak to your GP". Reluctantly they gave me an e-mail to ask my questions but this seems to be being ignored.

Question here is:

* Do I have a "doctor-patient" relationship with the radiologist doctor who treated me?

* Is it reasonable for me to approach them direct (via their clinic) to have it clarified what was actually done in the treatment?

* Or is it conventional that I should waste my GPs time in them being an intermediary? Can only he ask "what was actually done?"

I have the RANZCR complaints site bookmarked in case the clinic continues to ignore me.

 

[CaptainCurtis]

And possibly at the same time. 'Ablation' was mentioned in my consult yesterday (basically, wires threaded up into the heart to cauterise spurious beat-causing-loci) . That's something I'd like to avoid.

I had one done for Wolff-Parkinson-White (WPW) syndrome a few years ago - the concept is pretty terrifying, but seems to be fairly routine.

 

[Quickstatus]

I'm not sure what the 'official' status of the Hobart Private Hospital ED

Emergency departments are always "outpatient".

The $500 fee is the facility fee that is not covered by the health fund of medicare if a private ED. A public ED of course is free

 

[Quickstatus]

Do I have a "doctor-patient" relationship with the radiologist doctor who treated me?

Always. The treating Dr is stil lthe treating Dr regardless of what the referral arrangements are - even if it was a locum or a trainee dr

* Is it reasonable for me to approach them direct (via their clinic) to have it clarified what was actually done in the treatment?

Ask specifically for a copy of "procedure records" to be sent to you. Dont tell them you think they might have forgotten to do a second injection.

If they continue to fob you off then as you are in tas : healthcomplaints.tas.gov.au rather than the RANZCR route

 

[StayGoldPonyboy]

I'm not sure what the 'official' status of the Hobart Private Hospital ED is but that's where I've had to walk into a couple of times and when its the first visit of the year, its the $500 swipe on the CC for health fund. Or maybe it was a swipe and "we'll see".

Yes $500 sounds like the going rate for fee charged by private EDs, can't claim on your private health fund as you are not an inpatient at that point. Nothing to do with health fund excess.

If they ask for your health fund details it's probably to do an online eligibility check so in case you are admitted they have verified your policy cover. And probably ask for your Medicare details for the pathology and radiology providers.

 

[Pushka]

Sigh. I've bitten my tongue. Maybe about three hours ago. A chunk in the middle. Ok. Now have large Hematoma. Went to urgent care - Medicare - public system that saw me immediately. Now waiting for ambulance to take me to hospital. They can’t let me go because they don’t want my tongue to swell anymore and block airway. Just sitting with a wad in my mouth. Sigh.

 

[RooFlyer]

Emergency departments are always "outpatient".

The $500 fee is the facility fee that is not covered by the health fund of medicare if a private ED. A public ED of course is free

Yes $500 sounds like the going rate for fee charged by private EDs, can't claim on your private health fund as you are not an inpatient at that point. Nothing to do with health fund excess.

I must have been mistaken in thinking the $500 health fund was charged up-front at arrival to the ED at Hobart Private. I must have been admitted each time, different years and that's when the charge occurred. When entering an ED, I'm a sort of 'waving the credit card, take it, just get on with it' sort of guy.

Sigh. I've bitten my tongue. Maybe about three hours ago. A chunk in the middle. Ok. Now have large Hematoma. Went to urgent care - Medicare - public system that saw me immediately. Now waiting for ambulance to take me to hospital. They can’t let me go because they don’t want my tongue to swell anymore and block airway. Just sitting with a wad in my mouth. Sigh.

If its any comfort, tongues are pretty resilient. I once had a small benign lump on mine - they cut it out and it just healed without any drama.

 

[prozac]

...

If its any comfort, tongues are pretty resilient. I once had a small benign lump on mine - they cut it out and it just healed without any drama.

Tongues heal well. Look at those millenials that get the tattooists to divide the tip of their tongue. I am sure that there are no stitches involved.

C'mon @Pushka tell us it is really a fishing accident. MrP was casting and ...

 

[Pushka]

I must have been mistaken in thinking the $500 health fund was charged up-front at arrival to the ED at Hobart Private. I must have been admitted each time, different years and that's when the charge occurred. When entering an ED, I'm a sort of 'waving the credit card, take it, just get on with it' sort of guy.



If its any comfort, tongues are pretty resilient. I once had a small benign lump on mine - they cut it out and it just healed without any drama.

Yep. Mine won’t stop bleeding. Now at QEH. The Hematoma was the size of my tongue. All the ambos wanted to see it. Ghastly.

 

[RooFlyer]

Ask specifically for a copy of "procedure records" to be sent to you. Dont tell them you think they might have forgotten to do a second injection.

My e-mail enquiry was fairly low-key. To the effect:

"I note that the referral requested procedure at A and B, as was done 3 months prior. Report notes procedure at A but not B. Was B treated?

 

[blackcat20]

My kneecap went for a bit of a wander last night. Popped it back and it popped out again. All back in place but feeling a bit tender today so off to see my trusty physio tomorrow. I like to bring her new and interesting injuries every few months

 

[andye]

Heart work is interesting, two trades involved..plumber and electrician.
So far I have only needed a plumber..

There's also the surveyors. Quite a few Cardios now specialise in echocardiography, CTCA and cardiac MRI

 

[Pushka]

Back in the land of the living. Hematoma sorted out last night. And all good to eat now. What a stupid thing. The issue in the first place was the location as everyone was concerned it could block airways as it grew.

I went to one of those Emergency Critical Care places that the Govt set up recently to stop people going to Emergency. Interestingly the wait for that at 11.30 that morning showed times at the various Emergency Public Hospitals. The wait at the Critical Care was 3 hours, at the local Emergency Hospital it was 2 hours . Anyways I arrived to the counter, looked at the sign and thought 3 hours likely might be an issue. Turned out it wasn't. Likely to the disgust of everyone waiting they took me into a cubicle immediately. And within 30 minutes was out again in an ambulance and past the same people who then would have felt a little better about me going in straight away. In that 30 minutes I was on ECG and so on as they just didn't know what was going to happen next. Ambos were great, two women in their late twenties. Guess I was like their mum. Took me to one place who'd agreed to take me, got me off, then they said they couldn't deal with it, didn't know what to do. So back to Emergency which is a brand new one at QEH. (public Hospital). Then was seen in about an hour.

So those on blood thinners esp Xarelto. Do not bite your tongue. It is no longer a simple thing for us if it bleeds. I still have the four pads stuck on me as I don't risk pulling them off until in the shower as they are stuck on so hard I don't want to risk bleeding again. . Too late last night and just wanted to crash to sleep. Thank goodness I'm in St John's Ambulance insurance so ambo ride was free.

 

[Quickstatus]

So those on blood thinners esp Xarelto. Do not bite your tongue. It is no longer a simple thing for us if it bleeds.

Can attest to that
Had one bloke (think MAMIL>50yrs) fall off his bike and landed on hs face. In the process he # the jaw and bit his tongue. He was on warfarin for the AF

In Emergency, suddenly he became very agitated.
Code Blue
His tongue stuck out of his mouth which it didn't before and started asphyxiating and trashing about. Telling him that we needed to cut the front of his neck didn't seem to alleviate his agitation.

My first and last emergency tracheostomy. I was a registrar then. INR at the time was not overly high but elevated cant remember number, so it was a very bloody tracheostomy (think making a large 10cm slash).
I seriously think MAMILS on bikes should refrain from bikes if they are on Warfarin/Xarelto/etc etc