|
|
My experience, shared by many other GPs, is that even if someone is on a single medication, patients will often have some health concern raised, either by the patient or myself during a face-to-face consultation and this increases to every consultation when there is polypharmacy. That unmet need when a repeat prescription is dispensed without a face-to-face consultation doesn't go away so the next face-to-face consultation often has two additional health issues but the same booked time, meaning either the problems are not adequately addressed or other patients are unfairly kept waiting. This concept is well described in the following poem, generated and recently shared by a Dr April Armstrong: One morning brought a little boy, his puffer running low, "Just a script," his mother smiled, "then off again we'll go." But I heard a wheeze beneath his words and saw his tired eyes, So we searched beyond the obvious and found the hidden why. A woman came to start the pill, "A simple script today, Just contraception, nothing more, then I'll be on my way." But heavy bleeds and migraines hinted all was not as it seemed, So we found a safer path to take than the one she'd first conceived. Then came a weary mother with her baby on her chest, "Just help me get some sleep, doctor; I'll manage all the rest." But the light had left her smile and the colour left her face, So we named the dark that followed birth and helped her find her place. A tradie wanted stronger pills for headaches growing worse, "They wake me up most mornings now, and work just makes them curse." But coughing made them thunder and blurred the edge of sight, So we sent him for a scan that day and not another night. A teenager felt tired and flat. "It's iron, that's the bet. I'm busy, stressed and run-down, doc; there's nothing serious yet." But bruises, pallor, weight loss too, suggested more than chance, So we drew the bloods that afternoon and never missed a glance. For a script is just a doorway, never why a patient comes; The clues are often hidden in the pauses, fears and hums. What looks routine from far away can change with what we know The years, the trust, the history, the things no records show. A decade spent in learning, and often decades more in care, Teach us when a passing symptom needs a deeper question there. Not every illness shouts aloud; some whisper, faint and slight - And medicine is seeing what is there before it's plain in sight. The script was never really it; that's only where we start. The value lies in judgement formed by science, skill and heart. For general practice lives in trust, built quietly over years - And sometimes what saves a patient is what isn't written here. |
|
"Prescribers will decide what prescription length is best for each person's health needs. They may issue a prescription for up to 12 months, or for a shorter time if that's more suitable." However... "People will still collect up to three months' worth of medicine at a time from the pharmacy or up to six months of an oral contraceptive." However...
See "Decision on changes to support increased prescription lengths"
Feedback from GPs around the country about prescribing longer than 3 months:
While I share many similar feelings to my colleagues, there is often a greater motivation in a non-PHO practice to obtain a repeat prescription or next year, a longer prescription without being seen for financial reasons. As our practice is not producing sufficient income to pay the GP, any expectation of lower prescription costs will result in either the practice closing or much higher fees for anyone demanding longer prescriptions, as the reduced cost of the policy is borne entirely by the General Practice and not the government. Our research has revealed the longer a patient isn't seen, the greater the number of problems that accumulate and the more severe and advanced any illness becomes (if they haven't already needed a trip to the ED). It is also our experience that many patients who ask for a repeat prescription actually have significant health problems not addressed and when "required" to come for a review are poorly controlled (especially diabetics, asthmatics/bronchitics, and those with Heart Disease or major risk factors for heart disease). As such, it is far better to have more frequent short appointments than to try to squeeze serious issues into a single consultation, even if time was allowed for an extended consult. Therefore our new practice in-house policy may well see more patients restricted to 3 months (or less) before being seen than allowed more than 3 months. As we are only continuing in practice to improve or maintain the health of our loyal patients, the same principle to our fees applies, namely, if you want cheap medical care, you are free to try a highly funded practice that gives 12-month prescriptions, but it may not be timely or high quality. (See Venn diagram below). Unfortunately, we cannot accept patients back who leave (unless they had moved away from South Taranaki and have returned). However, if cost is an issue, see the How you can afford quality Medical Care page, where options for low income or high needs patients are described, including a full refund option for those with long-standing (chronic) illness or disability.
|
| | Back to Start Page | Back to Practice Page | Search the site | |