Community-Based Specialist Dr Richard Everts Infectious Diseases Specialist
What is a Specialist? Inpatient care (ward rounds) Surgery/procedures Advice/consultation Primary care (GPs, nurses, Pharmacists) Hospital doctors Outpatient care (clinics) Face-to-face Virtual H H Committees and meetings System development Guidelines Audit Education of others Primary care Hospital staff Education of self Research H H H H
The Problem with Hospitals The fortress Ambulance at bottom of cliff KPI illogical ‘80% clinical’ Limited space and resources Patients don’t like hospitals Parking Bad things happen in hospital Long wait for appointments, Doctor
The Advantages of Being Community-Based Focus on prevention and early intervention More available to 10 care by phone Rapid-access face-to-face clinics Guidelines, audit and education for 10 care Research in 10 care More virtual outpatient care Patients attend clinic in community Co-location with other community teams (e.g. District Nurses, HPO)
The Advantages of Being Community-Based Supportive Managers Nourishing work environment
Which Specialists could be Community-Based? Infectious Diseases is ideal 90% of antibiotics prescribed in the community 90% of consults require urgent action 90% of work does not require location in hospital Others Hepatitis C Rheumatology Diabetes Skin Heart failure Respiratory