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Opinion - Rebirth of the branch practice? |
 Branch general practices have been declining in recent times mainly for economical and logistical reasons. It is hard and expensive enough to run a practice in one place and keep it up to accreditation standards, let alone to do the same for a branch practice.
Medical records are frequently a problem and people often turn up at the remote practice when their records are kept at the parent practice. Duplication of infrastructure and equipment is also expensive for practices that are already struggling economically because of high and escalating overheads.
Despite this the world is changing and more and more people looking for a seachange are actually moving to small coastal communities where the lifestyle is more in line with their dreams. If anything, the need for smaller practices may be growing.
A good local example of this is Wardell. Ballina Shire Council is working to put medical services into the village and has recently provided the facility and staff to run it. Local GPs are being asked to provide the service. It is also envisaged allied health services will operate there, hopefully in close co-operation with the GPs. Is this concept viable for GPs?
There are also remote Aboriginal communities in our region where access to medical services is inadequate. Can we do more to assist these needy communities by taking medical services to them?
Even if the premises and equipment were provided, there would still be the need to provide a medical record system infrastructure. Well, suppose the system from the parent practice could be accessed from the remote site? Would this make a difference?
To test this notion, GP IT expert David Guest has been able to demonstrate how the Goonellabah Medical Centre’s IT system can be readily accessed from a remote site such as a home office using appropriate encrypted passwords for security. Checking pathology results and work emails from home has many advantages. What’s more, the remote computer only needs to be a basic machine as it relies for speed on the central server and not the computer itself. Access is via a simple internet connection.
The next step has been to see how it may work at a more remote site and it was heartening to see the system work well and fast in Tabulam using local phone line access. The potential and value of this for the regional Aboriginal community where people often present to different sites for medical services is very encouraging. There are now moves afoot to expand the number of accessible clinics around the region.
Crucial to the success of this will be access to a quality, electronic medical record system through a centrally located server. In addition it will be much easier to attract doctors to provide services to these remotes sites if there is a familiar medical record system such as Medical Director available. Having access to good medical records is also important for contributing to better standards of care.
So maybe it is time to reconsider the branch practice option in bringing medical services to remote and often disadvantaged communities using the best technologies we currently have. But haven’t we already got more than enough to do in our own practices without looking for other outside work? Well “variety is the spice of life” and it can be very satisfying going to a remote site and practising a very different type of medicine.
Doctors are needed for these sites. Enquiries about provision of these services can be directed to Andrew Binns on 6625 0000 or abinns@gmc.net.au or to the NRDGP through Chris Clark on 6622 4453.
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