Hamilton is situated in the Western District of Victoria, 300 km west of Melbourne. Our city offers fine sporting and cultural facilities, excellent schools both private and public and we are within easy reach of the Grampians National Park and the Coast.
The Hamilton Medical Group service not only the population of Hamilton (approx 10,000) but also a large part of the Western District (approx 25,000).
Our consulting rooms (The A D Matheson Clinic) are situated within the grounds of the Hamilton Base Hospital allowing easy access for the doctors and patients to a wide range of services provided by the Hospital. i.e. Pathology, Radiology and Physiotherapy etc. The close proximity to the hospital not only allows our doctors to see their in-patients more easily and quickly, especially in an emergency situation, but it also allows some of our doctors to provide anaesthetic and obstetric services to the Hospital.
The Practice consists of 16 General Practitioners (including 4 GP Registrars) and 1 Consultant Physician. A Practice Manager, Assistant Manager, administration and clerical staff support these Practitioners, as well as 2 Registered Nurses who are rostered on duty each day and Chronic Disease Nurses who assist doctors with GP Management Plans and Team Care Arrangements. Our first GP Registrar commenced at the Practice in January 2000. Since then we have had a number of GP Registrars who have undertaken their Basic, Advanced or subsequent terms at the Practice and some of these Registrars have continued to work at the Practice after obtaining their Fellowship.
In January each year, four Medical Students (third year, Post Graduate) also join the practice for 12 months. Two students from Flinders University commenced this course in our area in January 2002, and now we also have two students from Deakin University who commenced this course in 2012. Medical Students from other Universities, such as Melbourne University, also visit our practice on a regular basis for six week placements.
The Practice has also been involved in many projects over the years. In October 2004, The Practice started working with the Greater Green Triangle – University Department of Rural Health in a “Diabetes Prevention Project”. The study targeted adults over 40 years of age who were at high risk of developing diabetes, (but not yet diagnosed.) The aim was to change the lifestyle of the patients and ultimately postpone/prevent the onset of type 2 diabetes. The project ran from October 2004 until March 2009.
In September 2004, the Practice expressed interest in taking part in the new Federal Government initiative “National Primary Care Collaborative” Program. The aim of this project was for all the participating practices and therefore nationwide “to show sustained improvement to their prevention, management and underpinning clinical and business systems relating to diabetes, cardiovascular disease, and patient waiting times.” We were accepted into the first wave of this program. A GP and the Practice Manager attended an Orientation day and three 2-day workshops throughout the year, completed PDSA cycles to show the changes to the systems to try to improve these areas of medicine and submitted the “measures” to gauge the improvements on a Practice, Division and National level. This in turn helped improve best practice and to deliver better patient care. Dr Dale Ford, a GP at the Practice was the Clinical Director of this National Program. The Improvement Foundation took over from the NPCC Program. Dr Dale Ford was the Inaugural Chair of the Improvement Foundation and he is currently on the Board. A number of the GPs at the Practice were actively involved in the business of the Otway Division of General Practice (Dr Craig de Kievit was the Chairman and Dr Dale Ford was a Board member). Dr Ford is also the current Chief Medical Officer at the Hamilton Base Hospital.
Other GPs in the Practice participate in a number of roles such as “MD Care” (diabetes), “Active Script”, Intern Co-ordinators at the Hospital, Risk Management, “Life! Program” (pre-diabetes), Indigenous Health “Closing the Gap, CVC for Veteran’s Affairs patients, medication reviews for eligible patients, telehealth consultations and many other programs.
Since 2009 we have been working in partnership with Western District Health Services (Hamilton Base Hospital) to deliver a one-stop shop for the treatment and management of Chronic Disease. This program involves our Nurses undertaking GP Management Plans and then referring the patients to the Diabetes Educator and/or the Dietician who work from our clinic for one session per fortnight. A “Men’s Health Clinic” is run by the Men’s Health Educator from the hospital and he conducts these sessions within our clinic (also one session per week). This has fostered important links between the clinic and the allied health professionals and allows better and seamless services to our patients. Pain Management Telehealth Clinics are run at the practice once a month in conjunction with Dr Malcolm Hogg, Pain Specialist from the Royal Melbourne Hospital and Ms Janine Huf, Complex Care/HARP Coordinator from Western District Health Service on behalf of the GP’s. This clinic allows patients who are in need of pain management to be seen locally without having to travel up and down the highway to Geelong and Melbourne.
In the last few years we have also been in involved with the Improvement Foundation and Great South Coast Medicare Local on a Wave 10 Project. This Project looked at chronic cardiovascular disease and chronic kidney disease. This project assisted us in tidying up our clinical database, coding diagnoses within the patient’s clinical files (ICPC coding) and identifying patients who fall within the above diseases. Free texting options were removed from our computer program.
In the last few years we have commenced Nurse Health Assessments. These assessments are undertaken by a Registered Division One Nurse who briefly consults with patients prior to their doctors appointment. The Nurse checks the patients details up to date and are correct (address and phone numbers etc), undertakes measurements such as height, weight and blood pressure recordings, updates allergies, smoking and alcohol status, family and social history. The patient is also asked if they would like to have a shared health summary uploaded to their e-health record and if eligible are offered a medication review with a Community Pharmacist.
Other projects the Practice has been involved with include Improving Patient Safety in Primary Care, A Quality Improvement Project with Deakin University in 2019. Our clinic, along with five other clinics in the region were involved in this pilot project. This project involved a lead doctor, Practice Manager, lead nurse and lead reception staff member from our practice meeting regularly and undertaking PDSA cycles, along with patients completing two surveys (one at the beginning of the project and another at the end of the project) and the practice team attending workshops with the other practices and Deakin University staff. A paper was published at the conclusion of the study which outlined the overall findings and details of the study. The most recent project we have been involved with is a Chronic Obstructive Pulmonary Disease (COPD) Collaborative with Western District Health Service and Safer Care Victoria. The objective of the COPD Collaborative was to improve the outcomes for people with COPD in the Western District. The project involved doctors, nurses, other medical staff and patients within 50km of Hamilton, including Casterton. A number of workshops were held over the 12 months that the project ran with the aim of the collaborative to improve care for patients with COPD. The success of the project was measured by diagnosis by spirometry, time between admissions and length of stay in hospital, smoking cessation, compliance with inhalers, attendance at Pulmonary Rehabilitation and increase in vaccination of people with COPD.
The Clinic is open from 8 am to 6 pm Monday to Friday and from 8 am to 12 noon on Saturdays. As well as routine consultations the following services are available – check-ups, women’s health and family planning, men’s health, pap smears, pregnancy tests, mental health and psychotherapy, GP obstetrics – antenatal care and delivery including caesarean section, ECGs, stroke rehabilitation, paediatrics, rheumatology, spirometries, audiograms, vaccinations (including Q fever, travel vaccinations and children’s vaccinations), blood tests, dressings, iron infusions and glucometers, minor surgery such as stitching cuts, removing moles and skin cancers, anaesthetics, palliative care, liquid nitrogen “freezing” therapy for sunspots and warts, ear syringing, private and commercial pilot medicals, medicals – pre employment, insurance and legal etc, Holter monitors and 24 hour blood pressure monitoring, echocardiograms (available on referral only), pacemaker checks, GP Management Plans for chronic disease, aged 75 and over health assessments, ATSI health assessments, 45-49 year old health assessments, CVC program, Life! Program, nursing home and home visits. Our Group not only offers surgery hours for appointments, but also offers a full after hours service. Doctors are rostered on call to cover these services. For after hours, the practice uses an answering service. Patients still ring a local telephone number, but it is diverted to an answering service where a message is taken and forwarded to the duty doctor via a pager system. Therefore patients have access to medical assistance 24 hours per day, 7 days a week. GP Registrars always work oncall with a senior doctor.