Chronic Health Management and Care Plan Clinics

All Point Lonsdale Medical Group doctors, in conjunction with our Care Plan Nurses, provide GP Management Plans and Team Care Arrangements for patients with chronic medical conditions. They form a framework for agreeing on management goals with individual patients and identifying actions to be taken by patients. These goals are then reviewed with the patient each 3 to 6 months.

 

When a GP Management Plan and Team Care Arrangement is in place, patients with chronic diseases can then be referred to Allied Health Providers. Eligible services include:

 

  • osteopaths,

  • physiotherapist,

  • podiatrists,

  • dieticians

  • exercise physiologist

  • audiologist

  • occupational therapist

  • chiropractors

  • aboriginal health workers

  • mental health workers

  • psychologist

  • diabetes educators

  • speech therapists

 

 

These Enhanced Primary Care (EPC) referrals entitle patients to five Medicare subsidised sessions per calendar year. They facilitate communication between GPs, specialists and Allied Health professionals, which creates a comprehensive team to manage your condition.

 

Following an initial consultation with your doctor to discuss your medical condition, you will then see the Care Plan nurse to record all the relevant information to finalise your GP Management Plan and provide the government-funded referrals to allied health practitioners and specialists when required.

There is no fee for attending the Care Plan Clinic as part of the preparation of your Management Plan. 

 

 

Our Care Plan Clinic nurses also do Health Assessments for all our patients aged 75 and over either at home or at the clinic.   During the visit the nurses will discuss your general health, any medical concerns, medications you are taking and in particular any health services you may be eligible for, but may not be aware of. Annual Health Assessments are an opportunity for your doctor to explore areas of health that may not be covered in a routine consultation.

Attachment – patient guide


We also have a credentialed Diabetes Educator who works closely with the GP's managing patients with diabetes.


Note: Point Lonsdale Medical Group are able to arrange a government-funded home pharmaceutical review by an accredited Pharmacist to provide safe use of medications for our patients.

 


In the event of a medical emergency

call the ambulance on 000

POINT LONSDALE MEDICAL GROUP WELCOMES YOU AND YOUR FAMILY TO OUR PRACTICE