Your Family Medicine Specialists

Services - Chronic Disease Services

Coordinated Care Planning

We have a dedicated Practice Nurse who manages the ‘Coordinated Veterans’ Care (CVC) Program’ which is designed to increase support for Gold Card holders with one or more targeted chronic conditions or complex care needs; and those who are at risk of unplanned hospitalisation.

The CVC Program focuses on improving the management of chronic conditions and quality of life for eligible Gold Card holders who are most at risk of unplanned hospitalisation. Gold Card holders can include veterans, war widow/widowers and dependants. The CVC Program is aimed at Gold Card holders with the following chronic conditions:

Our Nurse provides ongoing, comprehensive and coordinated care for patients enrolled in this program. She visits the home, maintains phone contact at least monthly and refers her patients to any services or programs that ensure the patient is safe and has optimum quality of life and independence in their home.

Team Care Arrangements with Allied Health Services

People with complex care needs requiring regular care from their GP and two other care providers can access a Team Care Arrangement.

A total of five (5) subsidised health care professional services are available each calendar year.

These are services provided by an Aboriginal Health Worker; Audiologist ; Chiropractor ; Diabetes Educator ; Dietician ; Mental health Worker ; Occupational Therapist ; Physiotherapist ; Podiatrist ; Psychologist; and/or Speech Pathologist.

These services include only “private” providers , not services delivered from within a public hospital.

Health care services under a Team Care Arrangement are not free. A rebate is provided by Medicare but the patient may be required to contribute to the cost of the services.

Regular Clinics for Patients with Diabetes

We offer regular Diabetes specific services in conjunction with a qualified and experienced Diabetes Educator in a clinic setting. Patients are recalled to these clinics to ensure they are receiving the best possible care on an ongoing basis.Through these clinics referrals to other providers such as Podiatrists and Dieticians are coordinated.