My first 6 months in Australia Sydney - Working as a GP (General Practitioner / Doctor)

hello everyone so thank you for coming today to today's episode which is the six or seven month review of being in Australia so my name is dr. Luo Tian I'm a GP or general practitioner who has come from the UK so went to med school in the UK did my GP training in Wales and I straightaway went worked as a locum GP you think I probably worked in about 20 plus practices in Wales I didn't go for a salaried or a partnership job as I didn't want to be tied down to one practice so low coming there gave me lots of flexibility I could work whatever hours I wanted the pay was better than that of the salaried doctor there was lots that was positive about it now with this job that I've got here you're treated somewhat like a salaried doctor but without the perks of sick pay and your leave pay things like that you know you get paid for the work that you do rather than anything else but you're contracted to working a certain number of hours per week now I'll be honest with you the first several months was super like stressful for me like I would say the first three to five months I was finding it really difficult to acclimatize to the different system the way in which the pregnant your billing patients although it's free health care but you don't have to do all the Billings so that you can send it to Medicare so you actually get paid the fact that patients have to pay for the medications when you're referring them to certain specialities some of them don't even accept non-private patients like the whole health care system is it's just really different and that took a lot of adjusting to in the UK patients they only are able to access one GP surgery that's located by their postcode and then in Australia a patient can go to whichever GP surgery they want in the UK for example because they're fixed to one GP surgery you're always completely booked to have an a DNA or did not attend is extremely rare and as we know in the UK for some reason it is 10-minute appointments although that's not even specified by the Royal College or by the GMC that has to be ten minutes but it is so that means that you know I was seeing about 18 patients in the morning and about 15 in the afternoon on an average day I'd have maybe a 45-minute break which it wasn't a break you were just catching up with your notes and just trying to quickly eat something when you come to working here you develop your own patient base as you go along because patients can choose to go wherever they want they don't have to come and see you so for example six or seven months down the line I am now building up a patient base that probably started happening at around five months but I'm not fully booked there is maybe one or two days in a week where I am fully booked and even with those fully booked patients so many of them DNA and then when it comes to the number of patients that you see per day this varies on a day-to-day basis because of similar issues where your new doctor you're not going to have a regular patient base yet also the number of DNA's and obviously how busy is the practice that day in relation to walk-ins which is when a patient doesn't have to have an appointment and they can walk in and just see either the next available appointment or specify which doctor they would like to see as long as that doctors happy to do that that's not the case in every single practice so worth checking and some practices are a bit more strict than others when it comes to how many patients you definitely need to see per day mine's a bit more flexible but you know you've also got that ability to then choose how long you want your appointments to be here so it can be five minutes ten minutes up to 20 minutes whatever you feel necessary as long as you can justify the length of time like there's certain cases which I know I'll bring back and I'll say right when to do a double appointment for you or for other certain types of procedures I'll just not the rim for a lot longer slots but it's very variable when it comes to appointments in the same breath you can also block off slots within your day if you fancy a break or when you want your lunch hour to be so that's why it's quite nice and it feels like they kind of trust you with your own time management I'm aware that if for example one were to stay in the same GP practice in Australia for about three years by that point you're gonna have a solid patient base you're gonna be fully booked you'll know them well and things will flow really really well so if it's a long term solution it's gonna be a good sort of choice but if it's a short term you just want to try it out it's not financially stable if I'm absolutely honest at the moment I'm earning less than a salary GP in the UK the working hours are totally different because back home you know that earliest you were gonna start work was at 8 a.m. and the latest that you're going to finish work as far as I'm aware anyways was about 6 p.m. or 6:30 p.m. max and obviously you don't do weekends in general practice you can do them as an optional extra in the out of our service whereas here so the do practice is open between 8 a.m. and 8 p.m. that's my own personal practice there are other practices that they even open till 10 p.m. or some that close a bit earlier maybe six maybe seven so it really varies as to you know just dependent on which practice you choose to work full there's a lot more freedom to practice different fields so you often get asked this weird question whenever you say to someone that you're a general practitioner they're like oh cool so what do you specialize in and you're like well I specialize at G feet I actually was super interested in doing skin stuff when I'm UK I did sort of a skin minor procedures cord then I did another one here and I started doing skin clinic and so it's when you do skin checks for cancer abnormal skin lesions you treat them you know doing excisions so for example one morning I'll just block off like 45 one hour slot for a patient and just do that excision and then go and do my regular patients other than the skin cancer stuff you can do others minor procedures like cysts or boils can whatever you're comfortable with doing and the patient is comfortable with doing also it's really common to get iron infusions done here in the GP practice and they have a very low threshold of giving them actually otherwise you know if you wanted to go into women's health you can do the IU DS or the Implanon it's really quite easily you go into a courser then that's it you know you just get started also if you had an interest in alcohol and drug abuse patients you can also help arrange the detox for them obviously not the inpatient detox is it's more sort of using medication for them with regular reviews there's a lot of sort of occupational health stuff that we also do so WorkCover which is when they are sick because of a thing that happened in work you know you don't see an occupational doctor you go to your GP which is really cool from a guy knee side of things I'm doing loads of smears I remember in the UK genuinely it barely did any because you're all done by the nurses and all things like antenatal care you can have a shared care system where you can actually then take over from week 20 as well doing the regular checks in our practice what's also quite interesting is that we have in-house consultants so we have a geriatrician we have a general surgeon we have things like diabetic clinic as like yeah trick clinic that's been a really great help for your complicated cases where you have them as special and you all have have a case conference with the patient about what's going on a GP has a lot more access to investigations so I can easily request CTS MRIs and the most satisfying thing is is that they're all done like within a couple of days and for example on site and my practice they've got radiology so you can just send them straight off for x-ray and ultrasound and you can see the results immediately on your screen like there's some times that I've actually gone in with my patients for an anti nature ultrasound because we've been worried about a possible miscarriage and I literally just go straight to the radiology area and say hey do you mind seeing her and they'll just spit her in and even with the blood taking our pathology staff will take meds from from children if as long as they're cooperative otherwise they go and toss it all here there was a sexual health clinic that you don't refer anyone to them unless they've got something like syphilis for example so we were diagnosed all sort of sexual health staff and treat it also things like travelling vaccines immunizations baby checks so there's quite a few specialities here as well that are mainly privatized for example dermatology ENT quite a few surgical specialities and that basically means that if patients do go on a bulk filling system they kind of have very similar waiting times to that to the NHS anywhere between six to twelve or more months we're able to prescribe medications that normally only specialists could prescribe in the UK you know we can prescribe biological cream therapies for certain skin conditions I've been treating patients with hepatitis C so doing all of their treatment yeah there's very few things that we can't do like a big major one that for me I really wish we could was rocket aim for acne then what I was just genuinely are the only ones that can prescribe that I was under the impression that in Australia there would be sort of like a shared health system of which it technically is but the amount of information that you get from it is very minimal so if the GP updates it and if the patient allows for the system to be available to other general practices and the hospital system then the only information that you'll see is medical history and medications that's it nothing else so it's not entirely useful so when it comes to continuity of care in relation to patients being able to choose whichever general practice they want to go to there are issues with that system one of the main issues is prescription shopping so for example yesterday I hired a gentleman coming in asking for fentanyl patches so it's practice policy with us that we do not prescribe controlled drugs on first appointments at all and there's some drugs that we just do not prescribe at all and the thing is with prescription shopping is that they tend to go for the new doctor on the block because they are aware that you're not aware of the issues around prescription shopping so just understand that there is something called the prescription shopping line which is the way out of this where you can call them up they're open 24/7 and they'll give you a list of all of those sort of control drugs that this patient has taken over a three-month period I think it is and the next thing is complicated medical cases I've had a couple of patients come to see me and just say right I've had enough with my old GP I'm trying to fish around I've got all of these medical problems and you're like whoa and it's kind of like okay if you're convinced that you want to come to our practice that we can sort of arrange that for you were a transfer of medical records which do take a couple weeks to come through and then start from scratch as it were the other thing is when patients are sort of coming in and saying I want my regular scripts or I want to have these investigations done because the weight from my other GP was a bit too long but what they don't understand that you haven't got any of their medical records and then that result then comes back to you so it's just about educating the patient on if it's a chronic issue if it's an issue that's requiring further investigation you really should go and see your regular GP and then the acute medical issues off which unfortunately that GP will never know about because there's no communication between anyone so at least with out of hours for example you get a letter then when it comes to courses there's loads of courses available to go to free courses and courses that you pay for so that that's not something to be concerned about there's lots of educational stuff going on so if I'm now just sort of reflecting on an emotional side of things despite having less of an income why do I enjoy working here the answer is actually pretty simple it's the fact that I get to manage the amount of time that I spend with patients because ultimately the practice and you are at that understanding that you earn as much as you work so you're not dosing around so I think when I compare that in the UK where you're fixed to a 10-minute system it sometimes can be quite demoralizing because you obviously want to do the best that you can for your patients but you can't always fulfill that and that can be really stressful especially because the patients have often waited so long to see you and so you feel it's your duty of care to try and cover everything although it's really unrealistic to do so in in some cases so for example I would often feel really quite drained at the end of the day psychologically and then have less of a motivation to do things like exercise eating well and so that has a really big impact on your day to day life as it were okay so just looking back this video whilst editing it there are a couple of other things that I think are important to mention when it comes to job satisfaction so for example not only just from a time side of things but also the job variety so the fact that you can do so many different things in addition to your routine sort of GP visits and not only about the skills that you can use but also the fact that you can prescribe more the fact that you can also get investigations very quickly so on the same day or even within a week if you're talking about more detailed scans and you get the scan result the next day the Bloods very quickly and so that helps both the doctor satisfaction of getting those answers more quickly but also the patient satisfaction as well so I think by you being able to use that knowledge and skills that you've learned over the years and having to not refer so many patients as specialists as a result like that's really empowering I think that's also a really important part of this as well so yeah so I think that is everything that I can think of for today when it comes to work like overall I feel that if you're a newly qualified GP because I can only speak from a GP s perspective this is like an ideal place to develop skills to develop knowledge because of the flexibility time I have to say that if it's something whereby you know that you've always wanted to go and try it out and you've got the opportunity to it's worth doing so I think that is everything from me today I hope that you find this useful if you did please give me a little thumbs up so that I know that this is this is the kind of right content for you but yeah any suggestions any comments please leave them down below they were so so so helpful and I wish you all a wonderful day and a wonderful Christmas in New Year and I will see you very very soon take care bye

Channel: Today With Dr Lucia

Views: 19,144

Keywords: Moving to Australia, Working in Australia, Working as a doctor, working in sydney, sydney doctor, sydney GP, general practitioner, GP, VLOG Australia, VLOG sydney, Doctor VLOG, Doctor blogger, Living in Sydney, Living in Australia, Work life balance, Best places to eat Sydney, Best places to visit Sydney, Medical school interviews, working as a GP, CSA revision, CSA cases, Gp training, food in sydney, cafe in sydney, Australia health system, why choose GP

Id: OhqELWPSQ_s

Length: 16min 20sec (980 seconds)

Published: Sun Dec 22 2019