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Capital & Coast DHB General Medicine Service

Public Service

Description

What is General Medicine?
General Medicine is the branch of medicine that deals with the diagnosis and nonsurgical treatment of diseases affecting the internal organs of the body in adults.
 
Specialists in this field are called specialist general physicians. They are doctors who have trained in various specialties such as diseases of the heart, lungs, brain and other organs. Often people have more than one part of the body involved in an illness or the exact cause of symptoms is not clear.  The general physician is an expert in diagnosing what is wrong and managing illnesses that are complex.
 
The General Medicine Team
This consists of the consultant (the specialist general physician), the registrar (a doctor who is training to be a specialist) and a house officer (a doctor in training who is more junior than the registrar but is a qualified doctor). Sometimes, as part of the team, there are trainee interns who are medical students who have yet to pass their final exam but are gaining practical experience. More junior medical students may also be part of this team.  
 
You may be seen by the training doctors who then present your case to the registrar or the consultant.  On the day of admission you will be seen by the registrar but you won’t usually meet the consultant until the next day when the whole team does a “ward round” to see all the patients who were admitted the day before.  The tests that are undertaken and the treatment you receive are always done in consultation with the specialist.

Consultants

Note: Please note below that some people are not available at all locations.

Hours

24 hours a day, seven days a week

Referral Expectations

Hospital Admissions and the General Medicine Team

If you suddenly become unwell and need to be admitted to hospital with a medical rather than a surgical problem, you will most likely be seen by the general medicine team (see above). There is always a doctor from general medicine in the hospital. Medical patients who are referred to hospital by their GP will usually be directed straight around to the Medical Assessment and Planning Unit (MAPU).
 
Some examinations and tests will be undertaken by nurses in the MAPU and these help to prioritise how urgently you need to be seen. If blood tests are taken at this time, an IV (intravenous) line may be inserted and left in your arm.  This is a small plastic sheath with a needle that sits in a vein.  It allows rapid and pain-free access for repeated blood tests and for medication or fluids to be given. Other tests you may have include a urine test and an ECG (electrocardiogram) to check your heart.
 
Patients who come to the Emergency Department without going to their GP will be first seen in the Emergency Department and this often requires a wait for patients not requiring urgent attention.
 
Your First Assessment
The doctor who assesses you will take a detailed history of your symptoms and ask about previous illnesses and what medications you are on.  Part of history-taking includes asking questions about what you do for a living, who you live with or what support you have. You will also be asked about smoking, alcohol etc. There may be other questions about your health designed to add helpful information to diagnose what is causing your current problems. The doctor will then examine you. They will explain to you as they go the reason for the examination and then what tests or treatments are coming. You and your family can ask questions at any time during this assessment.
 
What Happens Next?
You will be admitted to hospital if you: require treatment that cannot be undertaken at home (this may include medication given into a vein “IV drip”); need investigations that are best carried out with you staying in hospital a few days; or if you are too unwell to manage at home. If you are likely to stay in hospital for 24 hours or less you will usually remain in the MAPU but if a longer stay is predicted you are likely to be transferred to 5 South, 6 East or 7 North (for patients who have suffered a stroke) or sometimes to Kenepuru for elderly patients.
 
Often the immediate cause of an illness is not known and the general medical team manages the investigation and subsequent treatment of most illness, although sometimes in consultation with other specialists. In some cases, you may be transferred to another team if your condition could be better managed by other specialists.
 
When you are discharged your GP is notified about what has happened in hospital and any follow-up plans.
 
The Medical Ward
Staff on the ward include: Nurses, Doctors, Physiotherapists, Occupational Therapists, Social Workers and Speech Therapists.
Physiotherapists are experts in movement and function.  They provide equipment if needed as well as exercises aimed to improve movement, pain, weakness or balance. 
Occupational Therapists are experts in function. They look at what you do during the day and what might help to achieve things you are struggling with. 
Social Workers provide support for you and your family.  They are able to provide counselling to get through difficult times as well as advice about your rights as a patient.
Speech Therapists are experts in problems with speech and communication.  They are also experts in swallowing.
Pharmacists are particularly involved in making sure that your medication is correct. They may check with you and your GP or chemist about the pills you are taking.
 
Outpatient Clinic
If your GP wants advice about the diagnosis or management of an illness, they may refer you to this clinic.  We aim to see patients in one to two months. It is important that, if your condition worsens while waiting to be seen, you revisit your GP as we can see you sooner if your situation changes. 
 
At the clinic you will be seen by a consultant or registrar (who will discuss your case with the consultant). The doctor will take a detailed history of your symptoms and ask about previous illnesses and what medication you are on.  Part of history-taking includes asking questions about what you do for a living, who you live with or what support you have.  You will also be asked about smoking, alcohol etc.  There may be other questions about your health designed to add helpful information to diagnose what is causing your current problems.  The doctor will then examine you.  They will explain to you as they go the reason for the examination and then what tests or treatments are coming.
 
You may be started on some medications or asked to undergo further testing before being seen or referred back to your GP. A letter will be sent to your GP with any recommendations as well as the results of any tests that are undertaken.
 
The medical outpatient clinic is also where you may be seen after you have been discharged from hospital to follow up any outstanding investigations or to see how you have improved or tolerated medications.

Charges

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Visiting Hours

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Refreshments

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Public Transport

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Parking

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Accommodation

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Pharmacy

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Security

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Other

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Contact Details

This page was last updated at 1:04PM on October 17, 2017. This information is reviewed and edited by Capital & Coast DHB General Medicine Service.