Management of chronic and complex diseases
Chronic Disease Management
Staying healthy is important for all of us and requires attention on a regular basis to reinforce our good behaviours and give a nudge to pay more attention to some of the enjoyable but often not so healthy ones.
Keeping on top of diabetes, blood pressure, heart disease risk factors and asthma reduces the long-term complications and prolongs good health. Making small changes earlier make it easier to get where you want to be and optimize health outcomes. Regular monitoring identifies changes in the right or wrong direction early to give you feedback about how you are doing and allow your doctor to advise on changes to management.
For these reasons, patients with chronic or complex conditions benefit from a structured approach to their care which often requires a multi-disciplinary team to deliver the necessary care. Having a relationship with one practice means your records are all in one place and makes this easier for you to coordinate.
Our doctors and practice nurse work as a team with other health professionals to provide holistic care. Our practice nurse provides valuable assistance with managing chronic conditions and helps with the ongoing monitoring and helping patients access allied health services that they need.
Patients with a chronic condition may benefit from a GP Management Plan (GPMP), and those who have complex care needs and require treatment from two or more health care providers in addition to your GP may benefit from a Team Care Arrangements (TCA). Having a TCA allows patients to access Medicare benefits for certain allied health providers – most typically:
- exercise physiologists
- diabetic educators
Visit the Department of Health’s information page for more detailed information.
Book an appointment with your doctor if you would like a GP Management Plan (GPMP) and Team Care Arrangement (TCA). When booking your appointemnt please let the receptionist know you wish a GPMP and TCA so our practice nurse can start to gather the information to help prepare the plan and the reception can allow the appropriate appointment length. Appointments for a new plan are billed direct to Medicare.