Practice Made Perfect Issue 13
Issue 13 - April 2019
Welcome to our 13th issue of Practice Made Perfect – RDN’s newsletter for practice managers in rural and remote NSW.
We encourage you to share this newsletter with GPs and other colleagues who can subscribe to receive issues direct to their Inbox.
Issue 14 of Practice Made Perfect will be out in June/July.
In this issue
After 20 years working at RDN I wanted to pass on my thanks and gratitude to the stakeholders, practices and their staff members during my time here. I have found such a wonderful supportive place to be in working at RDN and have enjoyed coming to work almost every day (we all have those one-off days)…
I take heart in believing that RDN offers true support to our rural practices as an NGO and uses our funds wisely in providing that support in a space where finding the answers can be quite a difficult challenge, and then disseminating that information in an easier to understand and practical way. This, I feel, is a major forte of our team here at RDN.
I like to think that over the past 20 years I have provided advice and influence to doctors, practices and our stakeholders to help them; to somehow direct clinicians who may not have considered rural medicine before into doing so and then sometimes growing to love their rural communities.
Our team works in a sea of change, both externally and internally. Keeping track in that sea of change is a challenge, however I have always felt valued and respected over this entire 20-year journey. My opinions count here at RDN. We have gone from basic computers that were small, black and clunky to multiple slimline screens; from email and phone communication, faxing and posting of documents and paper files as high as the walls in old compactus (or are they collectively compacti?) to IP phones, skyping and teleconferencing, SharePoint and One Drive storage.
I will sorely miss talking to many of you, and most of all to my colleagues here at RDN, my other family, if you will. I have had some wonderful managers and role models here at RDN. Rebecca Francis and Emer O’Callaghan are true examples of this - always encouraging and supportive. I don’t expect that I will be a stranger at the office though, and I know there will be an open door and a cup of coffee for me.
My caseload is being met by Mr Chris Anderson, my replacement here at RDN. I have had the luxury of being able to introduce Chris into this role for some months, and to now sit across the office from him, hearing how well he is managing the same complexities I was introduced to 20 years ago so well, I know my work is in safe hands here.
It is our pleasure to introduce RDN’s Medical Workforce Consultant, Chris Anderson.
Chris is an experienced recruitment professional with a broad background, having worked for more than 15 years in the industry. Chris has recruited a range of positions across various industries including Registered Clubs, where he worked in rural areas across NSW. Chris also lived in China for seven years recruiting international teachers for various government and private schools across the country.
Working for RDN as a Medical Workforce Consultant, Chris is responsible for the Hunter/New England and Northern NSW regions. He is looking forward to supporting the towns in the region and developing relationships with our stakeholders to assist with greater access to health professionals.
Chris is an Associate of the Recruitment & Consulting Services Association.
If you are recruiting an International Medical Graduate (IMG), it is important to understand the various levels of supervision and that the nominated supervisor can comply with the requirements.
Every IMG granted limited or provision registration requires supervision. Supervisors require Specialist Registration with a minimum of three years full-time equivalent practice with general and/or specialist registration in Australia before being appointed as a supervisor.
There are four levels of supervision:
- Level 1: The supervisor must be present in person at all times the IMG is practising clinically. The IMG must consult their supervisor about each patient before they leave the practice, with the supervisor being responsible for each patient.
- Level 2: The supervisor and IMG share responsibility for each patient, and the supervisor must be physically present at the workplace at least 80% of the time.
- Level 3: The IMG takes responsibility for each patient and may work alone provided that the supervisor can be contacted by phone or video link.
- Level 4: The IMG can take full responsibility for each patient with the supervisors overseeing and periodically reviewing their practice.
Orientation reports must be completed after three months or by completion of the first quarter of practice.
This is a further reminder that access to OMPS programs has now ceased to new applicant doctors.
Non-VR GPs who were not enrolled on OMPs as at 1 January 2019 and are not participating in a formal training program will access the new fee arrangements referred to in the ‘Stronger Rural Health Strategy’ fact sheet.
Doctors who were enrolled on an OMPs program as at the above date may continue to access an OMPs program until 30 June 2023, subject to compliance with current program guidelines and timeframes.
You can advertise your GP vacancy at no cost on RDN’s website. RDN's Medical Recruitment team can assist you in preparing your advertisement and source applicants. If you have questions or would like support, email RDN email@example.com.
Alternatively, submit the details for your vacancy here.
RDN’s website can host three photos per vacancy so if you have any photos of your practice or town, consider displaying them to enhance your ad.
Students who completed their studies in 2018 are entering the workforce. Have you considered a new graduate for roles that are difficult to fill? Graduates may be interested in relocating to new locations to gain the invaluable experience that working in rural NSW can provide.
RDN provides free job advertising on our website and supports candidate management, plus eligible nursing and allied health professionals can access grants and funding to assist with their relocation and professional development.
For more information, please email or phone 02 4924 8000 to discuss your nursing and allied health workforce needs.
Does your practice struggle to retain GPs? While there may be many factors to lure staff away from a rural practice, there are measures you can take to entice staff to stay and provide ongoing service. The following is ideas may help to retain doctors at a general practice.
- Allow doctors time off to undertake further training – and they may be eligible for funding under the Health Workforce Scholarship Program
- Have a supportive and collaborative environment – monthly meetings with lunch provided to discuss case presentations or education topics
- Allow doctors to be innovative e.g. use the Practice Nurse, which allows the doctor to increase income capacity
- Have a collaborative environment working as a team e.g. cover others when they are on holidays
- Maximising billings
- Ensure plenty of patients per doctor – share the patient load equitably
- Provide activities that go towards creating a happy family for each of your doctors – hold social activities involving the whole family etc
- Have doctors be part of the decision-making process, enabling them to have a voice and input into the practice
- Investigate and seek to become a very strong teaching practice
- Remunerate well
- Give each doctor interesting work that goes across acute care into primary health care
- Encourage doctors to learn skills they are interested in and then establish them as the lead for that skill in your practice
- Have doctors on a training program
- Provide good rooms and infrastructure
- Ensure your practice is team based
You may also like to contact your Workforce or Practice Support person at your local Primary Health Network to discuss ways of retaining staff and/or to point you in the direction of a practice/practices in the area who have a high retention rate.
The Health Workforce Scholarship Program (HWSP) provides scholarships and bursaries to help health professionals in rural and remote Australia retain and enhance their skills, capacity and scope of practice. The Program is an initiative of the Australian Government Department of Health, administered in New South Wales by NSW Rural Doctors Network (RDN).
The HWSP is available to medical, nursing, midwifery, allied health, dental and Aboriginal and Torres Strait Islander health professionals providing primary health care in the Aboriginal Community Controlled Health Services (ACCHS) sector, non-government organisations and private practice.
The HWSP will provide either:
- a scholarship payment of up to $10,000 per year for up to two years to support participants to undertake full or part time studies (maximum of $20,000 in total over two years) to attain the qualification of either a postgraduate certificate, postgraduate diploma, Master or PhD; or
- a one-off bursary payment up to $10,000 for participants for development and upskilling to contribute toward the cost of training or course fees and training related expenses such as accommodation and transport, where appropriate.
Applications are open year-round and you can make more than one application, to the total value of $10,000 per financial year.
RDN would like to congratulate the following doctors who have achieved Fellowship with either the RACGP or ACRRM since our last newsletter:
Dr Lin YE FRACGP 31 July 2018
Dr Sithara BOGODA APPUHAMILAGE FRACGP 31 July 2018
Dr Chaminda WIRTHAMULLA FRACGP 21 August 2018
Dr Sameera ATHAPATTU FRACGP 31 July 2018
Dr Biswajit ROY FRACGP 7 August 2018
Dr Arif MEERAN FRACGP 31 July 2018
Dr Reiham IBRAHIM FRACGP 21 August 2018
Dr Igor SNITKOVSKY FRACGP 7 August 2018
Dr Anil RATNAM FRACGP 30 October 2018
Dr Shelina KIYANI FRACGP 16 October 2018
Dr Shauna CHEAH FRACGP 6 November 2018
Dr Shyama GONAKUMBURA 7 August 2018
Dr Adrian Hekel COFFES HARBOUR JETTY 7 August 2018
Dr Gammanage (Malkanthi) HEWAGE FRACGP 15 January 2019
Dr Emmanuel BELOVED FRACGP 29 January 2019
Dr Sarah DEMSPTER FRACGP 30 January 2019
Dr Kalpana THAKUR FRACGP 30 January 2019
Dr Hasan AL HASMIMI FRACGP 30 January 2019
Dr Srikanth SATREPATNA FRACGP 30 January 2019
Dr Bilal KARIME FRACGP 30 January 2019
Dr Seyedeh SEYED SALEHI FRACGP 31 January 2019
Dr Ahmed ELMENOFY FRACGP 12 February 2019
Dr Safaa AL AZRAQ FRACGP 12 February 2019
DR Khalaf Adib Haddadin FRACGP 12 February 2019
Dr Radeeka Liyanage FRACGP 12 March 2019
Dr Mihail Radalescu FRACGP 12 March 2019
Dr Arup Bhowmik FRACGP 21 March 2019
On receipt of Fellowship, it is the doctor’s responsibility to apply for specialist registration with AHPRA. If a doctor is fellowed, specialist registration clearly conveys their correct qualifications to both patients and practices. Fellowship is also a requirement of supervision. AHPRA’s Specialist Registration application form is available here.
If you know of a doctor who has recently achieved Fellowship and is not mentioned above, please notify our recruitment team as we would love to acknowledge their achievement.
Practitioners can check the status of their renewal applications here.
In our last edition of PMP we profiled Dr George Marcus, a rural GP. Today we introduce you to Bernie Martin, the Practice Manager at Cobar Primary Health Care.
Bernie moved to Cobar in the 1970s, commencing her career in the town at a mine site. She applied for a receptionist role but was hired as a tracer, a role that involved metric conversion for underground mine plans. Bernie continued this position through the 1980s until she and her husband Mark started their family.
After a break from the workforce, Bernie tried her hand at working as a medical receptionist for a week for a solo GP, a position that lasted five years. When that doctor moved on, Bernie was approached by the CEO from the Outback Division of General Practice. Bernie commenced there in 2008 and hasn’t looked back, now having 16 years’ experience in General Practice and her Certificate IV in Practice Management.
Today, Bernie and Mark have four adult children and two grandchildren – Benji, who is one month old and already smiling and talking; and Hallie, who is almost 3 years old and just starting preschool. Bernie’s daughter Kahlia has followed in her mother’s footsteps, working as a receptionist at a practice for 10 years. Brock, Bernie’s son, works as an electrician at Peak Gold Mine and her daughter Gina is currently at home. Bernie’s husband continues to work for APA on the gas pipeline from Condobolin to Moomba.
Bernie describes a career that involves ongoing learning, changes and challenges.
“The biggest challenge I face in Cobar is around GP recruitment and retention,” Bernie said.
“While the team is supportive and well organised, recruitment can be difficult due to the remote location. Doctors must drive in and out of Cobar, with the nearest airport in Dubbo, three hours from the town.
“As Cobar is a mining town, changes to rosters have also affected recruitment of nurses. Whereas many families used to reside in Cobar, changes to drive-in, drive-out rosters have led to families relocating to Parkes and Dubbo, meaning that partners who are nurses have left town.”
The practice implemented some successful changes in the face of such challenges. After struggling to fit additional staff into the building under the integrated care program, the practice was awarded an infrastructure grant and has successfully extended the premises. Currently, the building boasts six consulting rooms, three interview rooms, a telehealth room, practice manager’s office and large meeting/training room.
At one point, when there were just two doctors, Cobar Primary Health Care struggled to manage appointments. The team brainstormed a solution which involved the doctors taking an hour of five-minute appointments, where clients booked ahead for short requests. The result was that doctors were better able to get through lists, and clients didn’t spend excessive time in the waiting room.
Bernie says she is where she is meant to be. As someone who enjoys helping people, she describes practice management as a rewarding career.
When asked what she is most proud of about her career in remote health, Bernie speaks about the team at Cobar Primary Health Care.
“I am proud to be part of a team that supports each other as if they are family,” Bernie said.
Dr Virginia Reid, who recently completed a locum at the practice, agreed the whole team deserves acknowledgement.
“They are fantastic at covering and supporting Bernie and also have to deal with the ‘coal face’ of the practice - multiple calls and face-to-face interactions which, given the doctor shortages, can be dire.
“Bernie is always calm and very knowledgeable and really tries hard to make it all work under often very trying circumstances - an ever-changing doctor workforce of varying skill sets and idiosyncratic needs and wants! I am sure many practice managers in remote locations will be able to relate!”
Do you have a star performer in your team who has made a difference within your practice?
To feature them in an upcoming issue, please email their contact details, a paragraph about their achievement and a photo to RDN.
RACGP Fellowship exam attempts policy
As of 1 January 2019, the RACGP will permit candidates to attempt each Fellowship exam segment up to six times.
In the past, the RACGP did not cap the number of attempts. However, it has found that applicants’ chances of successfully passing an exam decrease when the exam is attempted more than six times. Candidates will have three years to pass all three examinations (AKT, KFP and OSCE). One six-month suspension during the three-year period will be permitted, and only with extenuating circumstances may candidates apply for further suspensions. Due to the transition, the RACGP will not count exam failures before 1 January 2019 towards a candidate’s six attempts.
Please share this information with doctors at your practice. If you have GPs requiring support on their journey towards obtaining Fellowship, please contact RDN so we can work with your doctor to provide appropriate guidance and referral where needed.
The Workforce Incentive Program (WIP) will replace the General Practice Rural Incentive Program (GPRIP) and the Practice Nurse Incentive Program (PNIP).
The new WIP will streamline current incentive programs used for GP, nursing and allied health. Nurse practitioners and allied health practitioners across Australia will now be included as eligible health professionals.
- Practice assessment
- Business structures
- Professional career management
- Business plans
- Practice teams and leadership
- Managing financial resources
- Managing people
- Starting a medical practice
- Managing quality
The Australian Department of Health recently announced that the Quality Improvement (QI) Practice Incentive Program (PIP) has been postponed to 1 August 2019. The PIP payments for asthma, cervical screening, diabetes, aged care access and quality prescribing – which were due to cease from 30 April 2019 – will continue through to 31 July 2019. The PIP incentives for after hours, eHealth, Indigenous health, procedural general practice, rural loading and teaching will remain unchanged.
To be eligible for the QI PIP, practices will need to:
- be an accredited general practice
- share a minimum set of aggregated data with your local Primary Health Network, such as the number of patients who are diabetic, the percentage who smoke, the cardiovascular risk and weight profile
- demonstrate a commitment to quality improvement.
The Royal Australian College of General Practitioners, the Australian Medical Association, the Australian College of Rural and Remote Medicine, the Rural Doctors Association of Australia, the Australian Association of Practice Managers and the National Aboriginal and Community Controlled Health Organisations are all working together as members of the Practice Incentives Program Advisory Group (PIPAG), along with the Department of Health, to ensure this initiative is focused on quality improvement.
Medicare offers a range of education resources to help you understand its health programs and how to do business with it.
- AIR education for vaccination providers
- CDBS education for health professionals
- Compliance education for health professionals
- DVA education for health professionals
- HPOS education for health professionals
- Incentive Programs education for health professionals
- Indigenous health education for health professionals
- MBS education for health professionals
- Medicare digital claiming education for health professionals
- PBS education for health professionals
- PRODA education for health professionals
The items will fund a heart health assessment lasting at least 20 minutes by a general practitioner (699) or a medical practitioner working in general practice (177). The new items will provide patients with a comprehensive assessment of their cardiovascular health, identification of any physical or lifestyle-related risks to their cardiovascular health, and a comprehensive preventive health care plan to improve their cardiovascular health. Read more.
There was exceptionally high demand for the flu vaccine across Australia in 2018, with more than 2.3 million doses of National Immunisation Program (NIP) flu vaccine distributed in NSW alone. NSW Health has developed this toolkit to assist providers with managing roll-out and implementation of their flu vaccination program in 2019.
For more events and education, subscribe to RDN’s weekly Monday Message e-newsletter.
Australian Association of Practice Managers (AAPM)
Did you know the AAPM offers a mentoring program? This is a free program to AAPM members. Register your interest today.
University of New England partnerships
Certificate IV in Leadership and Management (for Health Practice Managers). Are you interested in developing your skills in leadership and your ability to improve the daily operations of a practice? Funding is available through the NSW Government’s Smart and Skilled Program that could contribute to the fees for this education.
What: NSW/ACT Rural Virtual Network for Practice Managers in the South Coast/Southern Monaro area
When: 17 April 2019
General Practice Conference and Exhibition (GPCE)
What: Fully accredited by both the RACGP and ACCRM, the GPCE is now in its 25th year.
When: 18-20 May 2019
Where: Sydney Showground, Sydney Olympic Park
Receptionist/admin and Practice Managers Workshop
When: Wednesday 19 June 2019
Where: Opal Cove Resort Coffs Harbour
Receptionist/admin and Practice Managers Workshop
When: Wednesday 3 July 2019
Where: International Hotel Wagga Wagga