Feedback Mechanism between GPs and Paramedics

GPs don’t work within the hospital arena and therefore sometimes make inappropriate referrals to hospitals or lack understanding of how the hospital works. There needs to be a feedback mechanism for paramedics and ED doctors to report inappropriate GP interventions, referrals, or assessment in order to improve patient outcomes and the efficiency of the health system in general. The mechanism must be a no-fault, collaborative tool to educate and empower GPs and not a punitive process. It should be led by a medical officer that is experienced in both general practice and emergency medicine, and should also encourage open channels of communication between GPs and receiving doctors to avoid unnecessary hospital referrals, and to improve the standard of GP treatment.

Why the contribution is important

GPs often lack understanding of the patient journey after they leave their surgery. This leads to misconceptions about what treatments and investigations are done in hospital for a given presentation, or lack of knowledge regarding contemporary management of conditions (eg. back pain patients only prescribed endone). As paramedics are the interface between GPs and EDs, we often identify inefficiencies or areas for improvement in general practice, but have no pathway to use this knowledge constructively.

by TrentWheeler on August 21, 2019 at 10:44PM

Current Rating

1.0
Average score : 1.0
Based on : 1 vote

Comments

  • Posted by mcrice August 22, 2019 at 15:36

    Trent, need to explain more about how just "reporting" alleged inappropriate GP interventions, referrals, or assessment might change things for the better.

    Patients have very limited purchasing power at the GP and very significant power in hospitals.
    That's where they go because they know that's where the resources are
    I suspect that if EDs had $37 per presentation their management might be different, too.

    What gets funded is what gets done.
  • Posted by TrentWheeler August 25, 2019 at 12:21

    Sorry, not sure I completely understand your comment.

    To clarify I'll give some examples -

    1. Patient with chronic lower back pain, GP prescribes Endone and Paracetamol - When management regime fails pt calls 000 or represents to GP who sends patient to hospital - ED and QAS is then required to manage patient with sub-optimal management plan when GP should be exploring further options (muscle relaxants, anti-inflammatories, physiotherapy, lifestyle modification)

    2. Patient with recurrent joint pain or injury is referred to ED for MRI by GP - patient gets transported to ED and told to go back to GP to get a referral to outpatient imaging clinic

    3. GP refers all patients with viral respiratory infection and muscle/joint aches to ED ?meningococcal

    4. Diabetics presenting with recurrent high BGLs due to sub-optimal or outdated medication regimes (or patients with primary hypertension with poor management)

    5. Asthmatics with frequent presentations to QAS with no preventer medications or asthma management plan

    The point of my submission is that these types of presentations represent avoidable ED referrals and sub-optimal patient care from the GP. They need to be addressed in a no-fault, supportive framework rather than as a "complaint" or punitive manner in order to encourage GPs to manage their patients better and give them access to the knowledge and experience of senior clinicians in hospital. This should foster better working relationships between primary care physicians and the broader health system and reduce inefficiencies and double-handling.
Log in or register to add comments and rate ideas

Idea topics