There’s no question that COVID-19 has changed the way we work, socialise, shop and pass our time. It’s also greatly changed the way we seek medical care, with the term telehealth now a part of our normal vocabulary in Australia. Whether you’re pregnant, have little people or not, we all need to see the doctor at some point for things like:
- Cancer screening (pap smears and breast checks)
- Contraception & sexual health
- Pregnancy planning, pregnancy, and postnatal care
- Mental health
- General medical problems (thyroid, heart conditions, diabetes, blood pressure, etc)
- Skin and joint problems
Why has my face-to-face appointment been changed to a telehealth consultation?Wherever possible at the moment, healthcare providers, including myself, are trying to minimise unnecessary face-to-face appointments to help protect you and their staff. By limiting the number of people interacting in the waiting rooms and moving throughout the practice, we are better able to manage safe social distancing. For now, your GP will more than likely offer you the option of a telehealth appointment. In the vast majority of situations (and until government restrictions are eased), it’s safer for you and your family to be at home. If at all possible, we also advise that you continue to see your regular GP, as it makes it much easier for all involved if they’re familiar with you and your medical history.
Do I have to pay for my telehealth appointment?When you see your GP normally, you’ll either receive a Medicare rebate for a portion of the cost (usually around 50%) or you will be bulk-billed. Bulk billing is when your GP accepts that rebate as full payment for your consultation, so you don’t have any out-of-pocket expenses. In pre-COVID-19 times, patients were unable to access a Medicare rebate for telehealth consultations with their GP. However, as of 30th March 2020 the Australian Government has introduced new Medicare item numbers so that healthcare workers can provide rebated consultations by either phone or video calls during the COVID-19 pandemic. During the pandemic, Medicare has mandated that GP’s bulkbill any person who is considered ‘at risk’ of COVID-19, which according to their definitions is a person who:
- is required to self-isolate or self-quarantine in accordance with health department guidance
- is at least 70 years, or:
- if the person identifies as being of Aboriginal or Torres Strait Islander descent and is at least 50 years old; or
- is pregnant; or
- is the parent of a child aged under 12 months; or
- is being treated for a chronic health condition (see definitions here); or
- is immune compromised; or
- meets the current criteria for suspected COVID-19 infection.
What if I need to see my GP?Of course, there will always be times when you’ll need to see the GP face-to-face. Some things simply can’t be done over the phone such as immunisations, pap smears, wound care, and baby checks. Your GP will liaise with you before and during your appointment to ensure that they are providing you with the best primary care for you and your situation.
How does telehealth actually work?It will depend on your healthcare provider, but several different systems can be used including a good old-fashioned phone call, Skype, Zoom, Health Direct, and GP Consults. You can use these different platforms on your phone, laptop, tablet, or desktop. The details of how your appointment will take place will be finalised before your appointment, but if you have any questions at all simply ring your GP’s surgery for clarification. If you’re having a phone consult, expect that the call will be coming from a landline or private number as your GP will more than likely have their caller ID blocked. Like a regular GP appointment, you’ll be given your estimated appointment time but you may have to wait (also, just like a regular GP appointment!) Connectivity issues with telehealth can make it more difficult for your GP to run exactly to time, so we really appreciate your patience. Once on the call, your GP may ask you a few details such as your DOB and address, just to make sure that they’re speaking with the right person. If you need to have any additional testing, such as blood tests or imaging, these request forms can be faxed or delivered to pathology and radiology services of your choice. If you require any prescription medications, your scripts can also be sent directly to your preferred chemist. After the consult, if your GP believes that you need to be seen face-to-face or need treatment administered by them, they will then arrange for this to be done. How to make the most of your telehealth appointment: To make the most of your telehealth appointment, try and be as prepared as possible beforehand. Here are some tips to help you prepare:
- Have your phone or device with you with the alert sound on so you don’t miss it
- Be prepared to answer a private number
- If you have more than one thing you want to discuss, write down your list and prioritise points. If it’s more than 2-3 things you want to speak about, make sure you book a long appointment or be prepared that you may need to make another appointment.
- If you normally have your weight and/or blood pressure checked by your GP and you have a machine/scales at home, you can take these measurements prior. Find a quiet moment just before your appointment time for the most accurate results.
- Find a quiet, private space if possible so that you can speak freely.
- Consider using an earpiece if you have one, which helps to make video calls a little more private especially if you’re home with family.
- If you have any physical symptoms such as a rash or skin lesion that you wish to discuss, take a photo and email it to your GP before the consultation.
What if my baby or child is sick?Even though it’s not the same as a face-to-face appointment, there’s still a lot of information your GP can ascertain over the phone or video call. Once you’ve had the initial consultation, your GP will then be able to better assess whether your child needs a face-to-face appointment or a visit to the Emergency department. Hopefully though, they’ll advise that your child can be safely managed from home. There are plenty of things you can do before your appointment to help make sure your telehealth appointment is as productive as possible. It’ll make the appointment less stressful for you as a parent and enable us to make the most accurate assessment. Be prepared for your GP to ask questions about the following. If it helps, jot down a few notes about the following before your call.
- Make note of your child’s overall colour and appearance. Are they more pale than usual? Do they have any rashes?
- Has there been any change in their behaviour?
- Inputs such as breastmilk, formula, food, and water
- Outputs e.g. wees and poos. Have there been any noticeable changes?
- How hydrated are they? Are their lips and tongue moist?
- A record of their temperature and any medications given
- Their breathing pattern. How fast and hard are they breathing? You can do this by taking off your child’s shirt when they are laying or sitting still – count how many times they breathe in 60 seconds
- What is their heart rate? You can measure this by pressing between their ribs underneath the left nipple. Feel the heartbeat and then count how many times it beats in 60 seconds.
- Strip them down and weigh them before the appointment if possible