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COVID 19 October 2023

Dear all

Covid is sadly an ongoing part of our lives. I encourage keeping up with your vaccinations, particularly if elderly or immunosuppressed.

On the positive front, masks are no longer mandated unless the community COVID situation changes dramatically. We still maintain a policy that patients or support persons cannot attend their face to face appointment if they have cold, sore throat or cough symptoms that might be consistent with an infection. In this case, please book a Telehealth appointment.

During the COVID crisis it has been clear that people have for obvious reasons not attended their GP, and at times not have exercised or self-cared as well. In 2023, we need to move forward with regular GP attendance for good health maintenance and get that gym or Pilates membership back again. Stay well, Shane

COVID 19 rooms policy Aug 2022

Dear all, we have this year instituted a policy that requires all patients and support people to be double vaccinated to physically attend the rooms. In the event that they are unvaccinated they can present an unused RAT test to the rooms fifteen minutes prior to their appointment and present their negative test to the front desk to be seen.

I hope this is not regarded as discriminatory but our patients are more likely to be elderly, with advanced cancer, or on chemotherapy and therefore are less immunocompetent. In the interests of protecting our patients and the staff who see these patients everyday ,we will maintain this policy into next year.

If this does not align with your beliefs, we will respectfully decline your attendance and refer you back to your GP. Telehealth is not an adequate alternative as we cannot examine you for the above reasons.

Apologies to all, this remains a very unpleasant time for health care workers and vulnerable patients, even if others choose to move on with their lives.

Of course, an appropriate fitted clean mask remains a requirement for rooms attendance for the above reasons.

E-scams

Dear all, scamming is unfortunately part of our life. Scams may be by phone, text or email. If at any stage you have been called or messaged by us and if you are unsure, do not respond or open any links. Contact us by usual means to confirm the veracity of any communication. Do not open any links or files proported to be from the rooms unless you are sure.

Shane.

Update on Telehealth July 2022

As of the start of July 2022, the Federal Government is no longer Medicare reimbursing telephone consultations. Telehealth (TH)(i.e. video) consultations are still reimbursed. In my view medical care is more effective face to face. It removes distractions and allows me a better chance to assess your health.

However, I may on occasion feel a TH appointment is reasonable or appropriate, maybe for geographical reasons, physical frailty , or because a recent physical examination was completed. By all means discuss with me if you feel TH is reasonable for your next appointment.

Note TH is charged the same amount as a F2F consultation. As mentioned in previous blogs, if anything they generate more work for our team.

Stay well Shane

COVID-19 in 2022!

June 2022

Dear all, we are in a post-lockdown era where we are living with the virus, thankfully in a well-vaccinated community. Nevertheless, oncology patients are a more vulnerable group, due to their condition, their treatment or because many of our patients are elderly .

It is therefore mandatory for patients and their carer (s) to continue to wear an appropriate mask to the rooms that covers nose and mouth. We would ask that a maximum of two carers be present at any consultation.

Patients and carers must be at least double vaccinated for COVID -19; alternatively unvaccinated patients or carers must present with an unused RAT test to be performed in the rest room adjacent to the consulting suite. This is mandatory for ongoing attendance at the rooms.

Finally, whilst many non-COVID coughs and colds are about, we ask you do NOT attend the rooms with these symptoms regardless of a negative RAT or PCR. We can change your appointment to telehealth for the day.

Many thanks to my patients and families who have thus far respected the need for caution at this time.

Telehealth update Oct 2021

Oct 2021

dear all, it does seem as though in the peri-COVID world we are all getting more used to video communication like Zoom and we have the opportunity WHEN appropriate to use telehealth (TH) as a way to conduct appointments.

It needs to be clear that this is simply for the moment a risk minimization strategy during the pandemic to protect the staff and patients from exposure to COVID 19. It is not intended to replace face-to-face consultations, particularly for patient, carer, or doctor convenience.

A TH consultation will miss the benefits of a face-to-face (F2F) consultation which includes a better assessment of the physical state of the patient, and improved rapport. If we have recommended or requested a F2F consultation it is important to comply with this to optimize the quality of care. If a patient requests a TH consultation, it will be approved if it is considered safe and reasonable.

You’re most welcome to request a F2F consultation if that is your preference. We do feel very strongly that patients and carers need to have received at least one CV19 vaccination. If this is not the case, please let us know prior to attendance so this can be discussed further. Mask wearing will be a requirement for the foreseeable future.

TH (or telephone ) consultations are billed the same as a F2F appointment except in occasional cases. These appointments still demand secretarial time with treatment and test bookings, script management, and letter dictation. We do not regard them as a ‘soft option ‘ requiring less time or focus from the staff or patient.

Please allocate time for your appointment and carry it out in a quiet space free from distractions. The car or dog walk is not an appropriate time to discuss medical care.

If you have concerns about the quality of the interaction during a TH appointment please feedback your concerns immediately to our office so we can address your concerns.

Warm regards all, Shane.

Vaccination Covid 19

July 2021

Dear all, it has been a while since I blogged, a tricky time for all. Reflecting back, twelve months ago there was speculation we may never have a vaccine against this virus. Fast-forward twelve months, the world will become we hope a safer place with the development of a number of vaccination strategies , including two available in Australia.

Many of my patients are particularly vulnerable to this virus, if they have advanced cancer, undergoing chemotherapy , or simply because of their age or other health issues. However, recent transmission of the Delta variant with illness occuring even in young, previously healthy people tells us noone is guaranteed safety from COVID19.

I strongly recommend you all get vaccinated. If aged 60 and over, you can access the AZ vaccine and i strongly urge you to do so. The TTS (thrombosis/ thrombocytopenia syndrome) associated with the AZ vaccine is exceedingly rare and far outweighed by the protection provided against death and serious illness from COVID 19. If you are under 60, ATAGI has recommended non-AZ vaccines (Pfizer and later in the year, Moderna) but the decision about waiting for access to these vaccines or receiving AZ now might be aided by a discussion with your GP or myself. AZ is a highly effective vaccine that is worthy of consideration even in younger age groups who want to move forward with vaccination immediately. Remember you won’t achieve adequate immunity from COVID 19 till your second shot. For the AZ vaccination, the interval between shots is 12 weeks, based on current recommendations. My comments as of today July 26th may not be relevant if the community numbers of COVID19 change in the next few months.

You can book a vaccine through coronavirus.vic.gov.au/book-your-vaccine-appointment or at Austin Health https://www.austin.org.au/getvax/.

Update Telehealth

Aug 2020

Unfortunately with Covid19, we are back to telehealth for the time being. If you have some issue that requires a physical examination please discuss with my staff. With masks and distancing a face to face appointment is manageable. For other patients, we will defer routine breast examinations for a recall date in September or October. Remember this is intended to protect all patients and staff and their families, but particularly those patients who are immunosuppressed.

Please endeavour to be set up with an appropriate device. This is far preferable to a phone call. Please allocate the time and be in the right physical and mental space for a discussion. Have a pen and pad ready for any notes and have questions prepared and support people sitting with you. Having a consultation whilst driving or walking the dog is not ideal and will be unlikely to result in a quality outcome.

Most have so far been supportive of this process. Please note that telehealth should not be regarded as an inferior consultation and it should not be expected to be discounted. The consultation still requires expertise, thought, a letter to the GP or referring doctor and more work from my administrative staff faxing and posting scripts and investigation requests than usual. We have also had numerous requests for letters for work and travel exemptions that take time. Your understanding at this time is much appreciated

COVID 19 update presentation

April 2020

From Assoc Prof Pat Charles infectious diseases physician at Austin Health.

Telehealth

Dear all, given the current situation -our rooms have moved to teleconferencing or phone calls for appointments unless there is an extreme need for a face to face appointment. This is with the intention of protecting; 1) the patients, who may be at higher risk of significant infection from age or. being immunocompromised, and; 2) the staff, because we cannot guarantee backup if we fall ill.

There is government funding to bulk bill patients deemed at risk of COVID 19. This funding does not realistically support the cost of a private practice in the medium term and we may still need to charge you a private fee rather than use the bulk bill consultation code depending on the time of the consultation, the need to post scripts, dictate letter and so forth.

With regard to the choice of teleconferencing or phone, I would much prefer to ‘see the patient’ by video. I am using encrypted software for privacy. This will work best on a computer, especially with a direct Ethernet connection rather than WiFi although the latter is reasonable.

These consultations are intended to be equivalent to a room consultation, without the examination. Please take the time to eliminate distractions at home so you can get the most value from your consultation. I recommend you have a pad and pen ready, with prepared questions as you might when you normally come to the rooms.

The software will also work with any smartphone. We can either email the link to your computer or SMS it to your phone. All you need to do is accept the link. Please contact Melissa if you have any concerns by phone or email.

I am hoping this will only be short term, although I can see the advantages in the future for telehealth when a short chat is required without an examination.

Good luck, stay well and #stayathome. Shane