Orientation to the Practice
Welcoming your registrar
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Welcome the registrar and be sure the practice members know who they are. Remember the basics like telling them where the bathrooms are and where to get lunch.
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Encourage all team members to invite the registrar to ask as many questions as needed.
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Ask the registrar what they think they need to go over, rather than making assumptions. It is also helpful to space out the facts you are giving them. Mental overload can happen early on when everything is new and different. Needs may vary depending on whether they have worked in general practice before. However, systems can be very different in different places.
Taking time in the first week is crucial. When the orientation is done well, many potential problems are avoided.
If registrars do not know the basics of how your practice works they are slowed up in their work, they feel stressed, they need to keep asking questions well into the term; or they feel they can’t ask questions and patients are not cared for as well as they should be.
They need to know information about the people, the systems and the equipment.
- Who their supervisor is
- Who to contact if their supervisor is not there
- What their backup is when on call
- Who the staff are and what their roles are
- How the computer system works
- How the appointment system works
- Referrals - specialists, imaging and pathology
- How your recall systems work
- Where their resources are located (books etc)
- What rooms they will be using
- What to do in an emergency and where equipment is located
- What to do if they are concerned for their own safety
- Safe disposal of sharps and practice policy
- General O H & S information in the practice
Obviously, different staff will be responsible for different parts of this orientation process.
What will help the registrar to provide effective patient care?
- Sitting in - registrars consistently report that being allowed to sit in with their supervisor during the first day is invaluable. Many important bits of information can be imparted informally. Similarly, needs can be identified early if the supervisor sits in with the registrar
- Spending time with the practice manager and at the front desk
- Time on the computer before seeing the first patient is crucial
Encourage your registrar. Ask how they are going - reassure them that they are going well and that the practice is happy to have them as part of their team.
Prior to starting
Interview prospective GP registrar and discuss
- terms and conditions
- on-call, after-hours, hospital, home-visits, nursing home
- pay rate, overtime, annual leave, sick leave
- set aside training times, training release time
- put forward a draft ‘Contract of Employment’ agreement stating the above
- what is expected of them when working as part of your team
Express the importance of receiving the provider number prior to the commencement of the term. Ask to be notified of the provider number as soon as they become aware of it.
Check their medical indemnity cover prior to starting (if possible) and ensure that it will cover GP Registrar in Private Practice.
Ensure you have the contact details of the GP registrar (just in case something changes along the way)
Make it clear what equipment they will need to provide eg stethoscope, auriscope, doctor's bag, etc
Exact start date and time and 1st week’s roster. Term 1 Registrars have a Preparation Workshop on the first Monday and Tuesday of their term.
Find out what are their clinical ‘strengths’ and ‘weaknesses’. Ensure that the ‘weaknesses’ are addressed in their initial training sessions after commencement. Don’t assume they know the basics – Check
Checklist of forms
| Provider No |
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| Prescriber No: |
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Australian Health Practitioner Regulation Agency
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check registration via Internet at www.ahpra.gov.au
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Medical indemnity cover
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check category of cover and expiry date |
| Practice contract/agreement |
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Medclaims/HIC online application
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(register online when provider number is approved)
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| Secure email |
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| Pay Group Link application or other banking forms |
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| Australian Childhood Immunisation Register |
(If not HIC on-line) |
| Payment account bank details |
(If not HIC on-line) |
| Electronic transmission of immunisation activities |
(If not HIC on-line) |
| Privacy form |
(so you can access GPII020A report) |
| 90 Day Pay Dr Cheque Form |
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| PIP registration Part G |
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| Notify PIP of new GP registrar and any other doctor changes |
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| Prohibited Employment Declaration/Working With Children Declaration |
(done by Valley to Coast for GP Registrars in Terms 1, 2 and 3) |
| S8 Drug book |
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| Emergency drug book for ordering supplies for Dr’s Bag |
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| Radiology/pathology codes, electronic download setup/notify providers of new doctors |
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| Notify hospitals, nursing homes etc of new doctor and details and their proposed workload |
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| Super fund |
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| Tax declaration |
(check for HECS debt etc) |
| Bank account details for electronic payment of wages |
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| Roster, after hours, on-call, hospital |
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Passwords for medical/clinical websites and workstation
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| Order door sign for room and any other signs that may be required |
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| Advertise in newspaper or newsletters if required |
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| Security alarm codes and keys |
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| Local area map |
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| ‘Welcome’ booklet |
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Orientation and Induction
Term 1 GP registrars need a lot of time for orientation and induction. GP supervisors
are funded an extra 3 hours of teaching time for orientation in the first week in addition to the
normal teaching time. Advanced GP registrars will still require time for proper orientation and
induction.
- Fill in forms (prior to the starting day) and have them signed
- Check immunisation status
- Introduce to other staff and practitioners
Essential Information for the registrar
A) Items that need to be covered before they see their first patient
• Phone system
• Appointment systems
• List of consultants for referral
• Pathology providers
• Radiology providers
• Other investigations
• Medical records
• Script writing
• Billing system
• Safe disposal of sharps and practice policy
• Practice equipment - what and where
• Emergency equipment
• Who to call in the practice for assistance or advice
Some of these will need to be revisited in more detail during the first two weeks.
B) Other items that need to be worked through over several days
• Practice personnel
o GP supervisor
o other accredited supervisors
o other doctors
o nurses and their role
o other health professionals
o office staff and their roles
• Normal hours
• After hours arrangements
• Roster
• Supervision arrangements
o who to call during consultations
o who to call after hours
o access to other doctors for assistance
o contact numbers
• Teaching arrangements
• Your pricing, billing and appointment policy
• Recall system
• Practice policy re
o emergencies
o squeeze-ins
o house-calls
o Nursing Home visits,
o patient phone-calls etc.
• S8 drugs, storage, practice policy
• Pathology and radiology results and correspondence - procedures for review
• Local health services
o Allied Health
o Community Services
o Hospital services
o Pharmacies
• Special expertise and skills offered by the practice
• Any clinics held within the practice eg Diabetes, Asthma
• Nurses role and scope of duties
• Costs of supplies/dressings etc within the practice, what is sold, pricing
• Discuss research and audits that may take place
• Training on the computer – everything
• Occupation Health and Safety requirements and policy (emergency evacuation, fire procedure, armed hold up, panic buttons, sharps and contaminated waste disposal)
• Doctors bag – supplies and requirements
• Expectations – working as part of a team, branch surgeries, clinical meetings etc
Discuss training needs and requirements
Set aside training time each week, plan time for case reviews, topic discussions, supervisor sit-in sessions etc. First thing of a morning is best for everyone with no interruptions. Modify schedule/appts up to 2 months in advance to ensure time is allocated wisely. Notify supervisor each week of training commitments.
Log hrs done, make up time if necessary.
Compulsory release for training days and 3 day workshops
Organising annual leave
Discuss policy on seeing drug reps, samples, research, audits
Use of practice equipment for personal use
Review GP registrar’s progress throughout the day by supervisor and practice manager. Any hassles, address them.
Arrange time each day in the first week to keep in touch.
Make the effort and life will be easier for everyone.
Check pathology/radiology/secure email are all coming through correctly.