There are generally three models under which GPs work at an RACF – solo practitioner, practice-based practitioner and aged care–specific practitioner – each with its own challenges in maintaining patients’ medical records.
The GP may decide to start working at RACFs of their own accord. Commonly known as ‘working out of the boot of their car’, this method allows for flexibility and self-management.
The advantage of this system is the autonomy of practice, where the GP is free to manage their systems, schedule and work as they wish. However, the main disadvantage is that the GP is responsible for managing the ‘back office’ logistics of their practice. Maintaining accreditation under The Royal Australian College of General Practitioners’ (RACGP’s) Standards of general practices (Standards) is part of these logistics, which can be challenging.
Many GPs visit RACFs via their ‘regular’ bricks-and-mortar general practice, and doing so on an ad hoc basis is common practice. The GP visits their patients in RACFs when required, and usually does so after a ‘standard’ day in their consulting room.
This method can be tiring, and does not lend itself to proactive care of the patient in RACFs; however, it can certainly be done with care.
Allocating specific time (eg an hour, a session or a day) for undertaking aged care work is a better method of managing RACF residents. The RACF is therefore aware that the GP comes at that time, and acute issues are managed accordingly. Chronic care is scheduled in, and the GP is able to attend to proactive care.
The advantage of visiting RACFs as a practice-based practitioner is that all of the GP’s patient notes are in the one place, and they have the support of the back office of their regular practice.
The disadvantage is that the system may not be completely set up to manage RACF residents; for example, the electronic health records may not be accessible remotely.
Aged-care specific practitioner
Aged care–specific general practices have recently been established to support GPs in their aged care work. GPs who want to dedicate time to aged care work but find that their regular practice is not set up to support them can use these services.
The advantage of using an aged care–specific general practice is that they are fully set up to support the GP in aged care work.
The disadvantage is that the GP’s work can be fragmented between two practices.