Practice management overview

Safety of self and staff

On rare occasions aggressive and potentially dangerous patients have to be managed. Administrative staff should be trained to recognise signs of agitation and impending patient initiated violence and when and how to initiate verbal de-escalation techniques. Private practice psychiatrists should have safety measures in place for themselves, their staff and other patients.

Supervision of administrative/other staff

Good mental health literacy is an important attribute of high calibre administrative staff and may be an important contributor to a well-functioning private practice. All staff should be carefully selected and trained in issues of confidentiality and safety.

Psychiatrists should give consideration to other training and education that may be appropriate for their administrative staff. The provision of training in mental health literacy and limited clinical patient information for administrative staff, in accordance with their confidentiality bond, may help them to better relate to and support patients.

Policies and procedures for administrative staff, tailored to the practice, should be readily accessible. These documents should include decision-making pathways for how administrative staff should respond to patient telephone and email enquiries, and to patient cancellations and failure to attend appointments.

Referrals from a medical practitioner

In Australia a referral by a general practitioner is the preferable pathway but referral by any medical practitioner will enable a patient to be able to make a claim to Medicare for full or partial funding of consultations. In some circumstances patients will be funded by sources other than Medicare, such Worker’s Compensation Insurance, or privately by temporary residents who do not have access to Medicare.

Wherever possible a psychiatrist should communicate with a patient’s referring medical practitioner. A psychiatrist is under no obligation to accept a new referral. In circumstances where a new referral cannot be accepted or fails to attend their first appointment, wherever possible it is good medical practice for psychiatrists to inform the patient and/or the referring doctor. If enquiry reveals the patient has urgent treatment needs, advice about other avenues for treatment should be provided.

In Aotearoa New Zealand, there is no direct government funding of private psychiatry. Some private health insurance companies provide psychiatric coverage; a psychiatrist should prompt these patients to check the terms of their individual policy.

About this information

For enquiries about this information, contact policy@ranzcp.org.

Disclaimer: This information is intended to provide general guide to practitioners, and should not be relied on as a substitute for proper assessment with respect to the merits of each case and the needs of the patient. The RANZCP endeavours to ensure that information is accurate and current at the time of preparation, but takes no responsibility for matters arising from changed circumstances or information or material that may have become subsequently available.