GENERAL PRACTICE

What is a GP?

The term ‘Specialist’ is usually used to describe as a doctor who specialises in one area of medicine or surgery. However, most GPs are Fellows of The Royal Australian College of General Practitioners and are recognised by Medicare as a Specialist. A GP has specialised as a Family Physician who who is trained to sort out health issues in kids, men, women & pregnancy.

There is an important practical difference between a GP and a ‘Specialist.’ The Medicare rebate to see a GP does not require a referral letter. The medicare rebate to see a ‘Specialist’ does require a referral from a doctor.

You are therefore free to pick any GP and go and see them – without a referral from a doctor.

There is a great deal of skills overlap between what a GP with advanced skills and a Specialist.

GP Training lasts at least 9-10 years. The GP is trained to diagnose a vast range of conditions, including rare conditions. To put this into perspective, GPs often arrange tests for a condition that might be seen once every 10 to 20 years. The GP is trained to be aware of their own limits & to refer appropriately.

HOW SHOULD I CHOSE MY GP?

Health outcomes are generally better if you have one ‘usual doctor.’

However, your usual GP cannot be an expert in the whole field of Primary Care Medicine. Practices tend to have doctors with different interests to increase the mix of skills available. You might see your usual doctor for your Type 2 Diabetes but be asked to see Dr X for your skin and a female doctor for your Cervical Screening Test.

We let you know our GPs Special interests on the website – as Services, and on the Blog.

We welcome second opinions at South East Medical.

WHAT CAN THE GP MANAGE?

The GP can recognise, advise, treat or refer patients with any medical or emotional condition. A patient could present with Asthma or Acne, bowel problems or backache, Diabetes or depression, IBS, or High Blood Pressure. You can expect to be helped by a highly competent, knowledgeable and skilled professional.

Procedures such as Iron Infusion are now routinely offered in general practices that have appropriate facilities.

GPs will vary in their ability or willingness to manage issues themselves. Attitude towards diagnostic uncertainty also varies from patient to patient. Most people will understand that there is often a degree of uncertainty in medical practice. General Practice is the most human of activities and outcomes will never be entirely predictable. The GP is guided by guidelines. Nothing stays the same, and guidelines are always changing.

REFERRING TO A SPECIALIST

Let’s look at the main reasons why a GP will refer to a ‘Specialist.’

  • For a diagnostic procedure such as endoscopy
  • For a therapeutic procedure, or surgery
  • For treatment with powerful drugs used in conditions like rheumatoid arthritis, severe psoriasis or severe acne
  • The patient is asking for the referral

For long term conditions, many patients routinely ask for an annual referral letter to see a specialist for a condition that would normally be managed in general practice. The GP is there to look after your health needs – but also to provide a service. Therefore, if you ask directly for a referral letter then the GP will likely do just that! To be clear about this, The GP will be sensitive to your anxieties. This is not a problem as long as you realize this is the reason for the referral.

If you are uncertain, or just curious, then simply ask your GP “Do I need to be seeing the specialist again?”

WHICH SPECIALIST SHOULD I SEE?

Most specialities have ‘subspecialities.’ Orthopaedics is the obvious one with upper limb, spinal and lower limb orthopaedics. However, even within these subspecialities there are orthopaedic surgeons who mainly do feet/ankles, or knees/hips, or shoulder/elbow, and some orthopaedic surgeons only do hands. It is not the case that a specialist who only ‘does’ one part of the body is always the best one to see because there may be multiple issues that need to be connected together.

Specialists read their referral letters in advance so that they feel comfortable taking the referral. However, specialists each provide a range of treatment options but not necessarily all treatment options. The GP will have an idea as to which treatment options are appropriate and can match this knowledge with a referral to a specialist who provides those range of treatment options. Often, The GP will do some digging around by asking a colleague or contacting the specialist themselves for advice about the best person to see.

The GP may also get feedback from patients regarding the specialist they were referred to. Whilst the GP can’t take responsibility for everything (not least cost – see below), good feedback or bad feedback (usually attitudinal) will be something that The GP will take into consideration, particularly when such feedback is recurrent.

What is the cost & waiting time for specialists?

The GP does not have access to a list of specialist charges or waiting times. This is an issue because your GP will refer you based on what they do know about the specialist which includes specific skills you may require & professional reputation (often through reading letters back).

It is well known that there are a wide range of fees a specialist may charge for a given service.

If you know that you need to see a specialist for a generic procedure then you may wish to ring around to establish the fees.

This is where larger specialist practices have the upper hand because one phone call to South East dermatology will give you access to 7 Dermatologists, a phone call to Westside Dermatology will give you access to 8 dermatologists, and a phone call to Toowong dermatology will give you access to 5 Dermatologists. Similarly, a phone call to Belmont will give you access to a large number of Psychiatrists. Gastroenterologists may also share the same phone number. Most private surgeons have individual numbers so you’ll need to make a number of phone calls to compare waiting times and prices.

Medicare requires that referral letters go to a named person. The GP would certainly benefit from a live list of prices and live waiting-list times that can be discussed with the patient at the time of making the referral.

One can only hope that a live referral database is developed in future because it would be a huge advance to transparency and consumer choice.

Public Referrals

For referral to public hospitals the referral will only be accepted when a number of clinical criteria (often over 10) are met. Even for private referrals, a referral instigated by your GP will need to be for a stated purpose.

SPECIALIST GP

THE GP & SPECIALIZATION

Specialist General Practitioner

We’ve said that a GP who is a fellow of The Royal Australian College of General Practitioners is recognised as a Specialist.

However,  a ‘Specialist General Practitioner’ is generally regarded as a GP with advanced skills. In other words, a GP with additional training and experienced. Primary Health Care Networks such as Brisbane’s Metro South are creating databases of Specialist GPs with Specialist Skills so that other GPs may refer to a colleague rather than a hospital-based Specialist.

A ‘GP’ cannot possibly know everything there is to know. Private GPs are tending to specialise and offer services beyond that of traditional general practice.

A Specialist GP in Australia is really considered by patients as a GP who has developed further skills in areas such as STD, musculoskeletal medicine, men’s health, menopause, Skin Cancer, & travel medicine.

south east medical specialist concept

Your Health in Good Hands

Private Billing General Practice

All Consultations at South East Medical are privately billed putting you in the driving seat of your health care. There is a lot of evidence from The UK that longer GP consultations does increase quality and improve patient satisfaction. Private practice ensures adequate time with the doctor of your choice.