This is the way in which I meet my patients. Having been in private practice for quite some time means that I have many repeat patients – patients who have become part of the practice family over the years, and who have in the meantime referred many of their friends and family. There is no greater support than word of mouth referral, and I appreciate each of these.

 

I do believe in surrounding myself with experts, and to this end have built up relationships with health care practitioners, whom I treasure and respect. They often refer patients to me when they need my assistance, and they are an important part of my new patient referrals.

Trauma is still a part of my life, and I meet many patients under very unfortunate circumstances. Some have sustained devastating injuries at work, others have slammed their fingers in doors, fallen off jungle gyms, bicycles or motorbikes, and others have accidentally spilled hot drinks over themselves or their children.

Administrative processes

Paperwork is an inevitable part of any practice. This consists of a wide array of both internal and external documents that need to be completed.

My admin team collect information about patients for the practice, the hospitals where I operate, anaesthetists and other service providers who are involved with the patient’s treatment.

Internal processes, such as surgery, involves quite many documents to ensure that the patient’s journey is adequately planned, and that everyone understands what needs to happen, who needs to be involved, what is required, and what needs to be arranged.

Non-surgical procedures also require detailed planning, extensive documentation and consideration.

Arranging of appointments require clear thinking, keen minds and careful planning to ensure that everything falls in place at the right time, and that nothing is forgotten. This is an intricate balancing act. Diaries need to be planned at least a year in advance and needs to consider the impact of public holidays and leave dates on patients.

Admin requirements are many, and include writing of detailed motivations to medical aids to explain why surgery should be performed, filling in of reports for insurance companies, compiling medical reports for the road accident fund, lawyers and insurance companies, progress reports for injury on duty patients and progress reports for medical aids for complex cases or extensive wound care.

Behind the scenes

Much of what happens in the practice, from a patient’s first visit to the practice for the excision of a skin cancer, for instance, until the final follow up visit about three months later, happens behind the scenes.

The admin team is responsible for ensuring that this journey is uneventful, timeous and pleasant, and behind the scenes they would ensure that patients receive quotations prior to surgery, that patients are informed of their surgery date, who the anaesthetist and pathologist would be, and obtaining authorization from medical aids. Then follows the process of arranging surgery, planning who is operated when, ensuring that anaesthetists and pathologists have been arranged. Forwarding the necessary information to patients about what to do or not to do prior to surgery, when to arrive for surgery, and finally, when follow up visits are scheduled for. On average, it takes between 60 to 90 minutes to complete this process for each patient scheduled for surgery.

After surgery, the dance to complete the process continues, ensuring that patients are confirmed prior to their follow up visits, while I also try to include a courtesy call after surgery to each patient. My admin team ensures that pathology results are received as soon as possible after surgery and that these results are communicated to patients as quickly as possible.

Now follows the final process of billing for surgery, submitting accounts to medical aids, collecting copayments from patients and ensuring that medical aids process payment of claims correctly. I send off a letter with pathology results to all referring practitioners, to ensure that they are kept up to date with my patients’ medical history.

Certain procedures and processes are easier – arranging non-surgical procedures such as Botox, dermal fillers and thread lifts are easy and less time-consuming, while reconstructive procedures, such as reconstruction after breast cancer, or ear reconstruction, and even some cosmetic surgery procedures are far more complex and time-consuming to organize.

The clinical journey

While the administrative process is time-consuming and important, the clinical journey is why patients visit the practice, and it is therefore imperative that I am well-informed and well-prepared for this journey.

This includes discussing difficult cases with colleagues, constantly staying up to date with new techniques and procedures, and ensuring that I am healthy, well-rested and prepared for every surgery. I expect the same high standards from my support staff in theatre, including the anaesthetist and the theatre staff, and everyone else involved in the clinical journey of my patients.

Then follows ward rounds after surgery, and the journey of post-operative recovery, which includes wound checks, removal of sutures, opening of skin grafts, dressing changes, month-long treatment of chronic and complicated wounds, together with the necessary emotional support of patients and their family during this process.
The availability after surgery to attend to complications and emergencies, and the phone calls to patients or their family members to encourage, to support and to inform.

And then we say goodbye (till next time)

All good things come to an end, or so the saying goes, and often, far too soon, as a team, we wish our patients a final goodbye as they reach the end of their journey with us. Often with a little sadness, as we give our heart and soul to each of our patients, and with each goodbye, they take a little bit of ourselves with them.

We sincerely hope, as a team, that you will have good memories of your journey with us, and if, somehow, we placed a stumbling block in your path, that you would tell us about it, and allow us to change this stumbling block into a stepping stone for the next patient.