We spend an enormous amount of time asking the government to reduce complexity. The RACGP just went out and found more things for us to accredit.
The RACGP wants me to save the planet. They also want me to use disposable instruments.
When my small suburban general practice is next judged against the new RACGP 6th accreditation standards we will retire our trusty onsite steriliser.
The standards demand a new washer disinfector will need to be purchased and we don’t have $16,000 in the budget.
Ironically, we will also need to appoint a climate officer under a new mandatory environmental sustainability goal who will examine our choice of disposable instruments with great dismay.
Being an accredited practice is a big deal. I doubt any of our customers (or patients to those who refuse to move with the times) particularly care.
It’s technically voluntary … if you consider it voluntary to access the core cashflow that keeps most small practices open (PIPs, WIPs, PHN grants etc).
And accreditation is important. The core idea is to demonstrate your practice can provide safe care – vaccines that are stored safely; robust recall systems with appropriate governance; staff that can do CPR if Norma or Bob keel over in the waiting room.
Under the new standards we now have mandatory accreditation criteria requiring the identification of climate risks and a need to demonstrate climate resilience. Owners need to document strategies to reduce our environmental impact and both our direct and indirect greenhouse gas emissions.
Things like bike racks, EV chargers and power audits are now given equal weight to keeping vaccines at a safe temperature and ensuring the privacy of sensitive health data is maintained.
So how did we get from CPR on Norma to now? When did the gap between a safe practice and an accreditable practice become so wide? Why do we now require my practice to have someone with a designated responsibility for environmental sustainability?
And before you write me off as a climate denier I need to clarify a few things. I believe in the man-made effects of climate change, I don’t read The Australian, I drive a plug-in hybrid and I don’t use the word “woke” as a slur.
But I also don’t believe paying a staff member to audit the emissions from our suppliers is a good thing to force onto medical centres.
The new standards are a demonstration of the tokenism that modern accreditation has become – in one section demands are made to consider the environmental consequences of procurement while elsewhere yet more hurdles are added making disposable instruments the only way for small practices to be able to keep compliant stock.
Related
Honestly, for most GPs accreditation is invisible. You’ll turn up, spin in your chair, tell jokes to some kids then bounce home without another thought about that random QPA/AGPAL certificate on the wall.
But you’re actually paying for someone to maintain the log, update the policies, make up the hypotheticals and fill out the risk registers. Your service fee keeps all these wheels spinning and the more cogs and wheels that keep getting added the more stretched that percentage split becomes.
This is also why it’s so galling that more red tape is coming directly from the RACGP.
We spend an enormous amount of time asking the government to reduce complexity. Accreditation is one of the few areas where we write our own rules. We had an opportunity to ruthlessly ask what actually makes patients safer in the modern primary care world.
We used that opportunity to add a special role in the practice making sure the cans are in the right bin. We just went out and found more things to accredit.
So, when we rally against the barriers, the distractions and the costs that take us away from the core business of providing excellent primary care, we need to remember a good deal of this angst is coming from within our own representative organisation.
The call is coming from inside the house …
Dr Max Mollenkopf is a GP and practice owner in Newcastle, NSW.
