WHY ARE PRACTICE MANAGERS INVOLVED IN getGP?

Practice managers play a vital role in the running of the Gippsland GP Training Program.

Often GP supervisors get caught up with the day-to-day responsibilities of seeing patients, educating and assessing their registrars, and need the support of the practice manager to maintain and submit documents and claim forms and ensure the registrar is not lost in the system.

Practice managers usually have the responsibility of the registrar's financial and accommodation arrangements, as well as supervision of patient loads and appointment variations.

Even more importantly, the practice manager can provide orientation to the practical aspects of work in private general practice - its routines, administration, billing procedures, scheduling of meetings, use of computers and information management, replenishing of stocks, and even social activities. For example, a new registrar may be unfamiliar with item numbers or not sure where to find the Work Cover paperwork. They may not know which surgeons visit the local hospital. Or even what the hospital's phone number is. They will need to know what tasks the practice nurse performs.

Finally, the practice manager plays an important role in making the registrar feel welcome. Registrars want to socialise within their new community, and practice managers can help introduce them to the other staff and give advice on local sporting, social and other activities. Sometimes the practice manager is there when the supervisor is unavailable - or the registrar, new to general practice, is feeling a bit overwhelmed.

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AN OVERVIEW OF THE PRACTICE MANAGER'S ROLE WITHIN THE getGP TRAINING PROGRAM

If you are not familiar with the training program for our GP registrars, it is worth having a look at our pages under About GP Training in Gippsland . More specific details are in the sections For Gippsland Registrars and For GP Supervisors and Medical Educators .

TASKS RELATED TO THE REGISTRAR

• Make contact with registrar before their arrival to discuss accommodation arrangements etc.
   
• Check well before commencement date that  the registrar has applied for a GP registrar placement, provision of a provider number(s), and provision of a prescriber number

• Request from registrars well before commencement date: current certificate of registration from Medical Practitioners Board, proof of adequate current Medical Indemnity Insurance, copy of Medicare letters confirming 19AB exemption, entitlement to Medicare benefits etc. (if applicable), Tax File Number declaration form, details of nominated superannuation fund and fund membership   number, password for billing and clinical software inclusion    
   

• This is an EMPLOYER/EMPLOYEE relationship and the usual arrangements for PAYG, Superannuation, holiday and sick leave provisions are required.
   
• Be familiar with and comply with the Registrar Terms and Conditions and Accommodation Standards.
   
• Coordinate with the GP supervisor to ensure the new registrar has access to local and general information required in a general practice, such as specialist contacts, item numbers, billing policy, government documents etc. (These are usually maintained in a practice manual). Medicare Australia produces a booklet MEDIGUIDE, which is an excellent resource for registrars and also practice staff. It may be worth providing the registrar with a copy before they start their basic term. This is available here or by contacting Medicare Australia directly for a hard copy.
   
• Patients need some assistance too: they may be wary of a 'new' doctor or one they perceive to be 'inexperienced'. It can help if the incoming doctor is promoted within the practice, on the clinic newsletter or with a photo and introduction on display at the front desk. Emphasise that the new doctor comes with recent education and insights, that they add to the 'team', and that they will appreciate being welcomed into the community. After all, if this is a good experience, they may end up staying and helping relieve our rural doctor shortage.
   
• Patient load should be arranged as far as possible to provide a broad range of age and case mix and:
  • 60-80 patient contacts per week for GPT1 (Basic) Term registrars
  • 70-90 for GPT2 (Advanced) Term
  • 80-110 for GPT3/4 (Subsequent) Term
     
• BUT NOTE that registrar patient loads are less flexible than other GPs in your practice:                                                        
• they can't be OVER-booked because of their terms and conditions                                                                                   
• they shouldn't be UNDER-booked because of their required load for learning purposes

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TASKS RELATED TO SCHEDULING OF REGISTRAR AND SUPERVISOR

Registrars in GPT1 (BASIC) AND GPT2 (ADVANCED) terms are required to attend:

• Total of three hours (GPT1) or two hours (GPT2) weekly teaching by supervisor, or sometimes another doctor in the practice - teaching can be a combination of face-to-face (at least one hour of the specified time) and corridor consultations
• Peer Learning Workshops - nine days per semester
• Monthly regional cluster group meetings at times mutually convenient to the group, usually evenings
• External Clinical Teaching Visits (also involving the supervisor), two each semester
• Note supervisor will be providing informal assistance, teaching and demonstrations over and above this.

Registrars in their GPT3/4 (SUBSEQUENT) terms are required to attend:

• One hour weekly teaching by supervisor - this must be face-to-face
• Peer Learning Workshops - two days per semester
• Monthly regional cluster group meetings
• External Clinical Teaching Visits once each semester
• Informal supervision by supervisor

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THREE YEARLY REVIEW OF STATUS AS A TRAINING PRACTICE (RE-ACCREDITATION)

This is carried out by getGP staff and involves:

• Practice visit
• Interview of supervisor, registrar and practice staff
• Review of the previous three years of registrar feed-back
• Review of video of GP supervisor engaged in a teaching session

This process aims to assess:

• The fulfilment of performance indicators
• Registrar satisfaction with teaching, support, feedback and compliance with National Terms and Conditions
• The Practice learning environment including the physical set-up, Practice support and Practice staff

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SOME FURTHER COMMENTS ON THE REALITIES OF HAVING A REGISTRAR

GPT1 (Basic) Term Registrars

• require a high level of support, with significant onsite supervision
• are particularly dependent in the first two months
• need a reduced consulting rate often starting at two patients per hour
• require a significant extra teaching time commitment

GPT3/4 (Subsequent) Term Registrars

• are obviously more confident and have a more 'collegiate' relationship with their supervisors; teaching sessions are more like a clinical meeting

GPT2 (Advanced) Term Registrars

• are somewhere in-between

Some registrars are a delight to have, some find settling in a trial. Bear in mind that this is a new stage in their careers and they may feel nervous and a little out of their depth. Some are relatively young and 'free'; others are older and may have partners and children to accommodate in their new lifestyles. Some are originally from a rural region; others may have only lived in large cities and may or may not want the change... Bear with them; it will most likely be well worth it!

Registrars bring far more advantages than problems to the practice. They bring fresh ideas and the latest medical teachings, which can stimulate a more jaded GP. Socially, they add some new blood and can add to the Clinic's tennis team or extended family. Some even meet the partner of their dreams locally and so add romance and intrigue. Registrars who enjoy the challenge and rewards of a country practice, who make new friends and feel part of the community, or even fall in love with the region and lifestyle, may stay for life. And that is a very satisfying outcome.

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AN OVERVIEW OF THE FINANCIAL ASPECTS OF HAVING A GP REGISTRAR IN THE PRACTICE

As mentioned earlier, this is an EMPLOYER/EMPLOYEE relationship and the usual arrangements for PAYG, Superannuation, holiday and sick leave provisions are required.

Be familiar with and comply with the Registrar Terms and Conditions and Accommodation Standards (click here to go to links at the top of this page).

GPT1 (Basic) and GPT2 (advanced) registrars have low consulting rates and tend to under-charge. With subsidies and costs, practices on the whole fare a little better than breaking even.

FINANCIAL SUPPORT FOR PRACTICES (2009)

Reimbursement to the practice during each registrar placement:

• GPT1 - $1,053.00 plus $660 allowance for Release attendance per month  
• GPT2 - $550.00 plus $660 allowance for Release attendance per month
• GPT3/4 - $79.00 plus $80.00 allowance for Release attendance per month

Teaching Allowance to the supervisor for each registrar:

• $100 per hour
• GPT1- three hours per week
• GPT2- two hours per week
• GPT3/4- one hour per week

Accommodation (subsidy paid to the practice):

• up to $165 per week

Payment to the supervisor for ECTV's:

• $300 per ECTV visit (3 hours), paid upon receipt of ECTV Report

Payment to supervisor for attendance at professional development activities:

• $100 per hour

Reimbursement of travel and accommodation expenses arising from work undertaken in fulfilment of contract activities:

• Travel - 60c per kilometre
• Accommodation - approved cost based on receipts

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