Application to become a patient


Because this practice is already bigger than ideal (both in terms of patient access and staff stress), a policy of tightly restricted access has been adopted, essentially "closing the books". This means the only "casual" patients we can see are visiting family of currently registered patients. We will however consider some exceptions to registering new patients on a number of grounds.

Policy

Those likely to be accepted as registered patients are:

  1. Family of existing registered patients;
  2. Previous patients "in good standing" who had been away from the district and have returned.
    • "Good Standing" means didn't leave with a bad debt or ill feelings!
    • "away from the district" means did not move to a local General Practice.
  3. New to the district applicants are also considered if they ask nicely! See below.
ALL applicants without exception must ask politely, in writing...

Send to:
Dr K T Blayney PO Box 447 Hāwera 4640 or to
k.blayney2@orcon.net.nz or
preferably deliver in person to 24 High St. Hāwera

  • What do I say? -whatever you like, but it MUST include three essential items:
    1. Your name/s, a return address and phone number, not just a signature.
    2. That you understand and accept the fact that this is a private non-PHO practice.
      [as we are independent of the government Primary Health Organisation (PHO) system, you will NOT be enrolled in a PHO and will NOT receive any of the government's additional funding for "all" New Zealanders]
    3. That you are willing to pay your unsubsidised fees without complaint. [Unless you arrange an automatic bank payment, you will be expected to pay at the time of the service, we no longer run accounts and cannot afford bad debts -see FEES and how to afford our fees].
  • Do I have to write? -only if you want to become a patient. If you can't be bothered, neither can I. This has proven to be a very effective control on numbers so there are no exceptions to this requirement.
  • But I am free to select any doctor -yes, and as we are a private practice, I am free to not accept anyone, which is primarily anyone who can't be polite enough to ask. It is very simple.
  • Can I apply by e-mail? -of course. Please use the practice e-mail at k.blayney2[at]orcon.net.nz, as only personal messages should be sent to my GMAIL address. Please also include a "snail mail" address to allow us to send practice information and transfer of notes request. Please do not use our email to request medical advice, we do not offer a "Patient Portal" nor remote "Telemedicine" except for COVID-19 patients - see Important New Practice Policy.

  • What happens next? -if you are needing to be seen quickly, you will be given an appointment as a "casual patient". You will then be given (or posted) a standard reply outlining how the practice is run and how to obtain your old notes (or give permission for us to request them). If you don't like the way the practice is run, feel free to go elsewhere.

  • Are there people we won't accept?

    I cannot accept anyone:

    • who as a patient of another local GP has been:
      1. referred to me (say for minor surgery), or
      2. seen by me as a supervisor at another practice
        3. for at least 6 months after being seen (for medico-ethical reasons);
      3. a previous patient who moved to another local GP Practice.
    • who won't ask in writing;
    • who has no confidence in me;
    • who wants a GP to provide drugs or certificates but not medical advice;
    • who wants to remain enrolled in a PHO under another GP;
    • who complains about having to be seen for medical care, there are subsidised on-line practices if you don't want face to face (Kanohi ki te kanohi) care;
    • who doesn't intend to pay for our medical services (see Fees page), if you expect Government subsidies (other than GMS), there are subsidised practices available for you.
    • who complains about our fees. If you want subsidised fees, go to a subsidised clinic. However, you need to understand that our unsubsidised fees are similar to what PHO practices receive (on average) with Capitation BEFORE they charge patient fees see here and even lower than many city practices' patient fees (who also get substantial Capitation and other subsidies), so our GP income is VERY low. The fees we charge now are still much lower than other unsubsidised professionals with far less training and qualifications such as vets, dentists, optometrists, hairdressers and lawyers who arn't expected to subsidise their clients.
       
      Comparison with capitated practices: The easiest way to make a comparison is to see what a capitated practice receives on average for a young (say a 4 year old) child which is $178 [$495 p.a. plus GST divided by the average yearly utilisation rate of 3.2 for this age -see MoH listed capitation-rates.
      [This amount does not include the extra funding for "Practice Component", Management Services, Health Promotion, Services to increase access (SIA), Primary Options for Acute Care (POAC), CarePlus, Long Term Conditions funding, Palliative Care Visits funding etc. received by PHO practices but not by those practices independent of PHOs]
      Our PHO independent practice can claim a General Medical Services (GMS) benefit of $35.78 (GST incl) for a 4 year old. Added to the 10 minute fee of $40 the total our practice recieves is $75.78 (over $l00 less than capitated practices recieve) to run a full practice (including three salaries) and pay GST.

  • Can I have you as my GP but go other providers (Nurse Practitioner, Iwi Clinic, Telemedicine etc) when I wish?
    • If you don't have confidence in our care for the "easy bits", and/or not be prepared to pay for it, why would I want to take on the "difficult bits" without charging proper specialist rates?
    • How can I offer holistic care if I am excluded from aspects of your health care?
    • If something needs care or expertise not available in this Practice, it is better to be referred from our Practice to a service that can provide it (such as an appropriate specialist), so we then remain aware of overall health needs.
    • The main exceptions are:
      1. Emergencies (chest pain, stoke, major trauma, difficulty breathing etc) - call an ambulance and/or go directly to ED
      2. Mental Health Emergencies - contact the Crisis Team, now called the
        "Assessment & Brief Care (ABC) Team" Free Phone 0508 292 467
      3. After-hours urgent care that cannot wait - use ED, an A&M or telehealth clinic see after hours arrangements
      4. Maternity care is no longer offered so find a Lead Maternity Carer (LMC) as soon as you find you are pregnant. For medico-legal reasons we will only deal with unfunded non-maternity medical problems in pregnancy. See Maternity (Obstetric) Care
    • In short, the answer is "this situation fragments care and is incompatible with our preferred practise, so if you want this, you may be better with a "health professional" who doesn't specialise in family medicine." [actually that was the medium answer, the short answer is "no"].

  • Does that include a Midwife, Physiotherapist, Pharmacist, Chiropractor, Osteopath, Naturopath, Herbalist, Homeopath, Acupuncturist, Reiki therapist or Rongoā (traditional Māori) healer?
    • Midwife: Absolutely, provided it is only about your pregnancy care. Most midwives are now "direct access" and are not registered nurses. As such they should not offer any health advice outside pregnancy care. Their options are to refer you to an Obstetrician (if the health problem is maternity related), which can be public (free) or private (fees may apply) or ask you to see me (fees apply). In general they should not send you directly to another medical practitioner.
    • Physiotherapist: We often refer to a Physiotherapist as they are (usually) evidence based and stay within their defined scope of practice. If you choose to see a Physiotherapist without referral, whether or not you are referred on to another specialist (eg Orthopaedic Surgeon, Radiologist) and whether or not I am included in any correspondence, I cannot offer any advice, provide any treatment or certification or take any responsibility unless you attend for a face-to-face consultation where we have time to review the problem, results and conduct any necessary examination or test.
    • Pharmacist:
      • While we rely on Pharmacists to dispense medicines we prescribe (and be an important additional check for errors, interactions and misunderstandings), they do not have the years of training, qualification and practice in diagnosis that a GP (usually 11 years to become Vocationally Registered) or other doctor will have and so symptomatic treatment (or therapeutic treatment) may not always be safe or effective. Usually they advise seeing the GP if something isn't settling.
    • All other "Alternative" Therapists: You attend these at your own risk as they are not evidence based, although some traditional therapies such as herbalism have emperical support (from what has worked over centuries). However any herbal therapy that seems to work is likely to have been reviewed, analysed and any active ingredient subjected to therapeutic trials by the pharmceutical industry which over the years has made treatments safer and more refined (eg aspirin, digitalis, morphine, colchicine, ephidrine, atropine etc, all of which are dangerous above well defined levels and ineffective below the therapeutic range.)
      The two main concerns we have are:
      1. Misinterpretation and misdiagnosis of symptoms, signs and investigations leading to inappropriate and delayed use of effective treatment and
      2. Symptomatic treatment replacing healing therapy. The classic example is masking pain without addressing the cause of the pain leading to maintenance of the problem or increased risk of re-occurance. The three examples of this I see most commonly are sprained ankles, mechanical back pain and iron deficiency, the last sometimes the only clue to a malignancy.
      Finally, if you have been advised to have some test by an alternative therapist, this is NOT my responsibility and will NOT be funded by the public system. If you want my advice, make an appointment (ensure enough time is allowed if a complex issue) and expect me to take a history, do an examination and request relevant investigations based on evidence only.

    Use this to apply to the surgery

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