Dear Patients,

We would like to inform you of an upcoming change to our bulk-billing policy at Emerald Medical Centre, effective from Monday, 14th October 2024.

All patients, doctors, nurses, and staff at Emerald Medical Centre are aware that Government support of Bulk Billing in General has degraded over the past 15 years. Emerald Medical Centre is a Private Medical Practice where each doctor sets their own fee structure. Patients who are bulk-billed receive a 50% discount, and this is no longer sustainable.

Although we have resisted taking steps to remedy government underfunding, we are now forced to make changes to our bulk-billing arrangements to retain our doctors, clinical and administrative staff, and continue to provide the excellent community care of which we are so proud.

Currently, our doctors offer bulk billing to Concession Card Holders and children under the age of sixteen from opening until 5:00 pm, Monday to Friday. However, beginning Monday the 14th October, this discounted rate to eligible patients will be available only between 12:00 pm and 4:00 pm. All consultations, including Medicare, DVA, TAC, and Workcover outside of these hours, will be charged at the full private fee.

Doctors adopting the new bulk-billing policy are:
• Dr Kasuni Hematilaka
• Dr Johnathan Tham
• Dr Micaela Kemm
• Dr Safire Valentine
• Dr Nasir Bhuiyan
• Registrar doctors (Dr Eli Caliara)

Meanwhile, doctors continuing with the current policy (with no changes) are:
• Dr Nazmul Hoque
• Dr Vassili Lapchine

Telehealth phone consultations remain unchanged and will be privately charged regardless of the time.

Nurse led consultations such as routine injections & vaccinations (eg. scheduled childhood immunisations), wound dressings, cervical screening, care plans & health assessments, will continue to be bulk billed regardless of time Monday to Friday.

This unavoidable billing change will mean that patients who wish to be bulk billed – including concession card holders, children, DVA, Workcover, and TAC patients – must schedule appointments between 12:00 pm and 4:00 pm, Monday to Friday. Any special considerations to your financial situation should be discussed directly with your doctor.

We understand that this is a significant change for some of our patients. You may wish to express your concerns to your local government representatives, as these changes have been driven by government underfunding of General Practice. We appreciate your continued support of Emerald Medical Centre as we navigate these changes. Our priority remains delivering high-quality care to our community.

Kind regards,
The Team at Emerald Medical Centre

We recognise that many of you may be experiencing feelings of anxiety and concern. You may not have ever sought mental health support or perhaps you have. Regardless of your past experience we are in unprecedented times and it is important that YOU check in with YOUR own mental wellness.

This simple checklist aims to measure whether you may have feelings of depression and anxiety during the past four weeks. The higher your score, the more likely you are experiencing these feelings. Click the K10 test and take advice from Beyond Blue.

No matter what your test score is you can call us anytime to discuss your concerns. Our doctors are expertly trained to consult with you via telehealth or in person. If appropriate a Mental Health Treatment Plan can be created which provides you with Medicare subsidised psychology appointments.

You can book an appointment with one of our GPs here.

Written by Clinical Coordinator and Occupational Therapist – Jonathon Somers

PLEASE RESPECT THAT AT EMERALD MEDICAL CENTRE WE ARE BEING CAREFUL ABOUT ALLOWING ENTRY OF ANY POTENTIAL NOVEL CORONAVIRUS CASES IN ORDER TO PROTECT OUR PATIENTS AS WELL AS OUR STAFF.

If you are unwell with a new cough, fatigue, sore throat, and/or shortness of breath and need to see a GP then please call the practice before attending, and inform the receptionist of your concern.

• A receptionist will offer a telehealth appointment by the GP to assess your symptoms & needs.
• The GP may wish to clinically assess you – in which case you may be directed to come & wait in our car park. The GP will then don protective clothing in order to approach you.
• You may be asked to attend the local COVID-19 screening clinic in Berwick if you are deemed to be a high risk for novel coronavirus and do not have the capacity to see you here
• You should attend hospital if your symptoms are very serious and life-threatening.

If you are in doubt what to do there is a supportive online health questionnaire here. Or read more at https://www.dhhs.vic.gov.au/coronavirus

What is this virus?

Coronaviruses are a strain of germs that can make humans and animals sick with cold or flu-like symptoms, however this Novel Coronavirus, also known as SARS-CoV2 or COVID-19, is a new strain that can cause more serious diseases and be life-threatening, including Severe Acute Respiratory Syndrome (SARS) and Middle East respiratory syndrome (MERS), hence the need for some to require artificial ventilators to breath. This complication could happen to anyone, but is more likely in elderly people or those with pre-existing medical conditions. The novel coronavirus was first detected in the city of Wuhan, China in late 2019. It is likely that the virus originally came from an animal, it spread to a human causing an infection, and then it probably mutated, facilitating its spread from person-to-person. Until late February 2020, most people who were infected lived in, or had travelled to, mainland China, in particular Hubei Province. Sadly the virus has since spread to many other countries, with Italy being severely affected. Australia has an increasing number of cases, hence the need to take it seriously in our community with significant shutdowns of schools and businesses as well as social distancing to reduce the velocity that it spreads.

How is the virus spread?

The virus is most likely to spread from person to person in the droplet form, originating from someone’s mouth or nose:

• Direct (or within 1.5m) contact with a person whilst they are infectious
• Contact with droplets when a person with a confirmed infection coughs or sneezes; or
• Touching objects or surfaces (such as door knobs or tables) that were contaminated by droplets from secretions coughed or sneezed from a person with a confirmed infection, and then touching your mouth or face.

Close contacts of a person with a confirmed infection (such as people staying in the same house or sharing a closed space for a prolonged length of time) are most at risk of infection. It is important that you understand the symptoms of novel coronavirus and seek medical attention if you become unwell.

What are the symptoms?

Symptoms can include (but are not limited to):

• Fever
• New cough
• Sore throat
• Shortness of breath

With this extra infective symptoms may include:

• Tiredness/lassitude
• Muscle and joint aches

What happens now?

Your doctor will assess you, either over the phone or face-to-face with appropriate protection on, your symptoms and risk of having contracted the novel coronavirus. Testing, which involves a swab being placed in the nose and mouth, should take place with the GP wearing gloves, mask, gown and eye protection (PPE) to protect themselves. The swab test is currently being performed widely in Victoria. People should be tested if they have:

• Fever OR chills in the absence of an alternative diagnosis that explains the clinical presentation

OR

• Acute respiratory infection (e.g. cough, sore throat, shortness of breath, runny nose or loss of smell)

Testing is recommended for people with:

• New onset of other clinical symptoms consistent with COVID-19 (headache, muscle aches, stuffy nose, nausea, vomiting, diarrhoea)

AND are

• Close contacts of a confirmed case of COVID-19.
• People who have returned from overseas in the past 14 days.
• Healthcare or aged care workers

If you have been tested, it may take a few days for the test results to be returned and the doctor says you are well enough to return home while you are waiting for your test results you should isolate yourself entirely from the outside world.

What is self-isolation?

The precautions of self isolation include:

• Remain in your home and do not attend work or school (you should not leave your property nor allow visitors in)
• Wash your hands often with soap and water;
• Cough and sneeze into your elbow;
• Avoid cooking for or caring for other members of your household; and
• Wear a mask if close contact with other people is unavoidable.

There is more information on self-isolation here. In the meantime If your symptoms are getting more serious, you should call the GP and/or seek emergency help and possibly hospital admission.

What happens if my test is negative?

You no longer need to remain in isolation. You may return to normal activities on your doctor’s advice. You should continue to carefully monitor your health for up to 14 days after your last contact with the confirmed case. Report any new or returning symptoms to Public Health in this period. You may be required to be tested again.

What happens if my test is positive?

You must remain in your home until 1 day after your symptoms end. If your condition deteriorates, seek medical attention:

• Notify the Public Health officers managing your care by calling the number provided to you;
• Follow the direction of the Public Health officers who may advise you to go to a doctor’s surgery or a hospital;
• Call ahead to a doctor or hospital and inform them that you are a confirmed case of novel coronavirus;
• Put on the mask provided to you for if you need to leave the house;
• When you arrive at the doctor’s surgery or hospital, tell them that you are a confirmed case of novel corona virus.

If you are experiencing severe symptoms, such as shortness of breath:

• Call 000 and request an ambulance; and
• Inform the ambulance officers that you are a confirmed case of novel corona virus.

How is the infection treated?

There is no specific treatment for the novel coronavirus infection and in the vast majority of cases they will recover within a few days, like any cold or flu virus. Antibiotics are not effective against viral infections. However, your doctor will explain most of the symptoms can be treated with supportive medical care such as:

• Rest
• Fluids
• Panadol

Research is in place to find a treatment, yet this is not available yet and may take several months to be safely rolled out.

Where can I get more information?

Visit the Australian Government Department of Health homepage at www.health.gov.au Call the Public Health Information Line on 1800 004 599. Discuss any questions you have with the Public Health Unit.

The amazing Emily Somers has a new blog post at Bravery Co. about her battle with Cancer. She’s a great friend of everyone here and her post offers an insight into a trying time. Head over to Bravery Co. and have a read.

Dr Murphy, the founder of Emerald Medical Centre was devoted to Emerald and practised medicine up to the day he died. Here’s an article from The Trader published in 1981 after he died. It is an engaging story about this important figure in Emerald’s history.

Over the past year, everyone passing the first roundabout on the main road will have seen that Emerald has a large new building. Five years in the planning and over 18 months in the execution, the extensive redevelopment and refurbishment of the Emerald Medical Centre is finally due to be complete in early March 2017!

WE plan a Community Grand Opening to coincide with the PAVE Festival (hopefully on 8 April). The building has been totally redeveloped so that it will be fit-for-purpose for the newest developments in Primary Health Care, called the Patient Centred Medical Home, or PCMH.

General Practices like Emerald Medical Centre have always tried to deliver care to its people that is tailored to and based on the needs of the patient. It tries to be comprehensive, so that every need is met, preferably locally. We attempt to coordinate your care, so that your needs that are not available locally are sourced and arranged by our team. All care is integrated, so that each member of your health team is kept abreast of your progress. In particular, we will follow up your recent visits to hospital or specialists.

We have agreement from Physio, Podiatry, Psychologists, Counsellor, Diabetes Nurse Educator, Audiologist, speech pathologist, exercise physiologist and Pathology to work on-site. We are trying to attract an XRay service to Emerald, but this is problematic. We have identified a range of specialists who will visit EMC once or twice a month so that patients will not have to travel as often. We will offer a base for the RDNS, Palliative Care and other outreach services. We already have links with the Emerald Secondary School where our GPs and Nurses will have a presence in the new Wellbeing Facility.

All GPs and Nurses are co-located upstairs around our new bright and spacious waiting room. Our vision is that our staff will enable you to enter data into your file from Tablets we provide. There is a lift for access, although we urge you to use the stairs for your own exercise. We have built a multipurpose room to enable patient education, group meetings and mild exercise and relaxation classes. The room has videoconferencing facilities to enable consultations with distant specialists and public and staff education via webinars.

The new building will be supported by a 30 kW solar system with battery back-up. We will be largely off the grid! This will enable us to provide services during occasional blackouts, but more importantly, will protect our electricity supply during a major disaster, like a bushfire. Emerald Medical Centre is the Medical Centre for the local Emerald and District Disaster Plan. This will enable us to guarantee a cool and powered Emergency Centre in a major event.

All of these innovations, services, connections and additional health workers are designed to enable us to work with individuals and our community to provide a Patient Centred Medical Home of which we will all be proud. This is a shared opportunity between Emerald Medical Centre and our Community to increase Community Security and Resilience. We look forward to working with you all to fulfil our Vision.

George Somers and the Team at Emerald Medical Centre

We are excited to announce that we are almost at completion with the building. Your new “Medical Home” is rapidly taking shape and we expect the lift to be functional in the next week or so.

Things are moving quickly on our renovations! Here’s a photo we snapped of the latest developments.

An essential part of a GP’s work is controlling long term (chronic) medical conditions. Asthma is a common chronic respiratory condition that can cause a big impact on a person’s wellbeing, and can at times be life threatening. Many asthmatics are resigned to being regularly inconvenienced by poor lung function and frequent emergency visits to a GP or hospital, naïve to what triggers asthma attacks as well as how and when to use treatments available to them.

GPs work diligently to educate asthmatic patients on such matters but this is often not enough. This is where doctors are urged to empower their patients through the use of asthma action plans to ensure patients are receiving the right medication and recognizing when higher amounts of medication are required.  Research has shown how effective action plans can be, especially for children, for controlling asthma. Its benefits include:

• Reduced chance of needing to go to hospital, or for an urgent GP visit
• Improved lung function
• Reduced number of days off work or school due to asthma

Asthma action plans are effectively a contract of written instructions agreed upon by the doctor and patient to gain control of a person’s asthma, documenting:

• Usual symptoms when well, eg no symptoms, intermittent tight chestedness.
• Usual management, eg quick action ventolin reliever inhaler, daily preventer inhaler
• Triggers for worsening asthma, eg pollen, dust, viral infection, cold, exercise.
• Signs of worsening asthma, eg tight chest, wheeze, cough, increased use of ventolin inhaler.
• How to manage worsening asthma, eg increased use of a preventer inhaler, oral steroids.
• Signs of an asthma attack and how & where to access help, eg GP or hospital.

The asthma action plan is given to the patient or parent, is stored in a safe place for future reference and copies given to kinder, school, babysitters, sports coaches, workplaces etc. The patient is urged to study and refer back to the asthma action plan to become an expert in their disease, get to know what works and hopefully achieve a much better control and avoid bad symptoms and asthma attacks entirely. The asthma action plan can be reviewed with their GP yearly to see if any modifications need to be made to assist with asthma control.

For more information visit: http://www.asthmaaustralia.org.au/asthma_action_plan.aspx
Author: Dr Chris Madden, GP, Emerald Medical Centre