There has been no shortage of patients for Townsville and Suburban Medical Practice (TSMP). Dr Peter Gianoulis, one of three owners of the Practice, says there was a time when it might have taken six to 12 months for a doctor to fill their patient book, now that might take six weeks.
“There’s a lot of people now needing to catch up on treatments and consultations on ailments that they didn’t get around to over the last two or so years,” says Peter. “Also, there are fewer general practitioners.”
TSMP has grown largely through word of mouth, supported by strategies to ensure patients receive a positive experience and want to stay.
Navigating higher running costs
TSMP currently is a mixed billing practice, with a 60/40 split between private and bulk billing. Peter says the practice plans to move to about a 70/30 or less bulk billing within the next 12 months.
While Peter says, the height of the pandemic was a tough time for everyone economically, TSMP had to focus on maintaining staff and ensuring everyone was employed during difficult times.
“We’ve come out of that period, and things were supposed to quiet down, but now we’re heading to this period of higher and higher inflation,” says Peter. “Unfortunately, the Medicare funding model will not miraculously change in the coming years despite higher costs associated with running a practice.”
When TSMP was founded in 1967, the Practice had shorter and more procedural appointments. The Practice has expanded to 14 doctors, servicing a growing population where patients are now more likely to present with multiple conditions.
According to Peter, this has “created a situation where the nature of consultations and care has changed, but how Medicare is managed has not. The Medicare rebate is better suited to shorter appointments over prolonged consultations or those requiring more complex care, including psychosocial support”.
“There is a higher emotional burden on doctors that no one talks about.” he says, “Patients want quality time with the doctor when they have a face-to-face appointment. Billing models need to shift as he believes appointment times will move towards longer and longer timeframes.”
Creating balance for doctors
However, these intensive appointments also create a potential risk for the doctors at the Practice. Currently, TSMP needs 14 doctors to work a roster of seven full-time equivalents because, as Peter states, nobody can work five days, eight hours a day anymore.
“We’re seeing a good proportion of mental health consultations or patients with related social issues, and that requires prolonged consultations, which are more costly to the patient and the practice,” Peter says.
Peter says the Practice needs to be flexible enough to allow a doctor to work hours, enabling their downtime to recharge. This creates the need for enough doctors in the system to cover shifts across the week, which is difficult in an environment where shortages are widespread.
Automating the practice
The Practice provides doctors with access to their files from any location, so they can work from home. This is also helpful for their non-clinical work, usually done outside practice hours, and helps drive overall efficiency.
“We are trying to create systems that will automate repetitive work.
We also have clear operational guidelines to help us reduce the risk of error,” Peter says. “We are also trying to make sure that there is consistency across everything that we do.”
Making the system as streamlined as possible helps the doctors with their own requirements and assists the Practice in facilitating automation within the environment of Medicare billings or compliance requirements.
“I think now is the best time for medical practitioners to implement the right technology plug-ins because repetitive work is increasingly becoming a part of a doctor’s day-to-day activities,” Peter says.
TSMP also has data analytics derived from practice management software, whereas it used Excel spreadsheets previously. This gives Peter and his partners a better understanding of lead and lag measures of practice performance rather than looking back in time.
Supporting wellbeing and careers
Taking the pressure off doctors and staff with smoother workflows, and a focus on wellbeing and professional development, has given TSMP a solid staff retention record for the past number of years.
According to Peter, the Practice has brought on board at least one doctor a year over the last five years and hasn’t lost any. That’s a success rate that the TSMP team aims to keep striving for over time.
“The clinic has started switching to a coaching model for its doctors as well.” he says. “We touch base with them periodically to ensure they get the support they need for their personal and educational growth. We want them to feel fulfilled in work.”
Using differentiated approaches to how the Practice retains and attracts medical staff will help TSMP to “determine any storms” that might be around the corner, says Peter. “However, changes within the surgery must be balanced with providing the best possible patient care.”
