The AMA Council of Rural Doctors reports that an investigation uncovered scenarios where rural GPs are denied access to work opportunities with local hospitals, while locums are hired. Worse still, the local hospitals pay more in the locum agreement than with a standard contract with a GP.
In a Position Statement, the AMA issues recommendations that address these shortages and denied GP opportunities, with benefits to local hospitals and better healthcare for regional communities.
According to AMA President, Dr Omar Khorshid, the ideal scenario would be an arrangement where GPs receive remuneration for services provided in their private practice by the MBS, and remuneration from the State for services provided in their local hospitals.
“At a time when our hospitals are under immense pressure, it’s extraordinary that regional hospitals and health services are appointing locums - often at higher costs - when there are highly-skilled GPs prevented by administrative barriers from bringing their experience in the community to their own local hospitals,” he said.
Dr Khorshid also added to this, saying “we need clean and fair arrangements in place so GPs and health services can work together to deliver better health outcomes for our regional and rural communities.”
One of the recommendations in the Position Statement is increased support for local GPs’ clinical up-skilling or re-skilling by local hospitals. Additionally, there should be fair and non-restrictive credentialing that assess competency in rural settings, while also providing easier access so GPs can work in local hospitals.
According to Dr Khorshid, “the best model for our communities is where the talent and expertise in local rural general practices is harnessed by local hospitals and remunerated through the hospital system while the MBS covers GPs’ work in their practices. This increases job satisfaction for the GPs, contributes positively to retention of the rural workforce, and means hospitals won’t have to rely on a costly, impermanent workforce.”
Some of the main recommendations include:
Rural hospitals and health services must have a local GP or rural generalist involved in decision-making processes
Telehealth and virtual services should not be seen as a direct replacement for face-to-face service in a rural town
You can read the full Position Statement on the AMA website.
People who have fully recovered from Covid-19 will have vaccine exemptions for up to six months - NSW Health
NSW is currently at the forefront when it comes to recognising natural immunity and implementing exemptions for people who have them. According to a spokesperson, “...based on currently available evidence, most people who have recovered from Covid-19 develop natural protection from reinfection for up to six months.”
This is why from 22nd September, individuals who have fully recovered in NSW will get a medical clearance notice from a medical practitioner or nurse to confirm that they are no longer infectious. In effect, they will have the same privileges as fully vaccinated people.
This means they are considered fully vaccinated, don’t have to take a Covid-19 test, and aren’t required to self-isolate even if they are identified as a close contact of a Covid-19 case.
The problem is, a system to monitor progress and ensure that people don’t slip through the cracks with this clearance is currently lacking. As Dr Michael Tam, a GP in Sydney put it, “There isn’t necessarily a clear central database to say this person was diagnosed Covid positive on this particular date.”
There are no documents after discharge that patients can take to their GP to show that they have fully recovered. And that complicates things.
According to Dr Tam, “...you sort of have to go with what the patient just says. We really need to have a system that doesn’t allow people to fall through the cracks because it does become potentially quite discriminatory.”
Some individuals may require a third vaccine dose - ATAGI
In a statement released on Thursday, ATAGI said it will likely issue advice in the next few weeks concerning a third dose of the Covind-19 vaccine for “severely immunocompromised individuals.”
The statement reads, “ATAGI anticipates that a relatively small cohort of individuals, such as those with severely immunocompromised conditions, are likely to require a third dose as part of their primary cause of vaccination to ensure optimal vaccine effectiveness.”
Other high-risk patients are also being considered for the third dose but the statement doesn’t include details on who they might be.
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