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Paediatrician gone AWOL? Here’s what to do.

Has your paediatrician suddenly closed their doors or can't be contacted? Here's what you to do now for medication or a referral.

In the past two years there have been several instances where paediatricians have suddenly closed their doors or not been contactable for extended periods of time.  This can happen to anyone.  Either they, or someone they love, suddenly becomes unwell.  We also have several paediatricians who have announced they are retiring so patients will need to find new paediatriciains.

If this is your situation, then you may find some useful advice in this blog I wrote back in 2022 when Dr Elizabeth Green closed her practice.  

May 2023 update

The Department of Health have provided their advice here on what to do if you are struggling finding a paediatrician.  This includes referring to the government-funded Child Development Service.  You can do this at the same time as seeking a private referral.

If you are trying to transfer to another paediatrician, it may help to be clear if you already have a diagnosis and/or are stable on medication.  If your GP is willing to be a co-prescriber then that is a bonus as it takes some of the administrative burden off the practice who may be considering accepting your referral.

April 2023 update

I no longer recommend ringing around clinics to see if they are accepting referrals.  In most cases you will get a blanket no or asked to get a referral first.  

It is very hard for a practice to tell you on the phone if they are accepting referrals and then by the time you come back to them with a referral that capacity may have gone.  

Their processes also differ but most will need the information contained in your referral to triage your referral and make sure you have been referred to the right place.

Believe and trust in your children. But most of all, be kind.
— Dr Elizabeth Green

Dr Elizabeth Green has closed her practice

A close friend rang me in a panic. Her son’s paediatrician appointment had been cancelled.

She had just opened a letter that read:

“Dr [Elizabeth] Green has had to travel to Melbourne suddenly to care for a family member and will not be able to return for some time. As such she has made the difficult decision to close her practice permanently.”.  I cringed. I knew what was coming.

What the hell do I do now?

“What the hell do I do now? How do I find another paediatrician? I know there are HUGE waitlists. And what about his ADHD medication? We were going to get a new script at our next appointment.”

Okay, so there were a few more words used commonly by sailors but I have edited the conversation so you get the gist.

Dr Elizabeth Green has helped so many Perth families since qualifying as a paediatrician in 1997.

The woman who wrote the book on parenting

Dr Green has been a paediatrician in Perth since 1997.  She literally wrote the book on parenting. [You can buy it here.]

As a much loved, respected and long-serving paediatrician, I knew there would be many Perth families who would have been shocked to receive the same letter.

Who would be panicking. [Maybe not swearing *quite* as much – ha!]

Trying to find a new paediatrician when it seems that *no one* is accepting new referrals.

As in, won’t even let you JOIN the waitlist. Books closed. Sorry.

Running low on medication. Begging their GP to prescribe stimulant medication.  Worried about how this would impact their child, their family.

What you need to do

1. Book an appointment with your GP - stat

Your GP can assist you with continuity of care, prescription of medication and referral to another paediatrician. Most paediatricians won’t add you to their waitlist unless you have a referral. Those waitlists are going to be long. So don’t delay – get a referral today.

2. Get on the phone

Your GP may have some leads on paediatrician availability. Unfortunately, most paeds have closed their books so they can try and manage their current caseloads. 

Waitlists for paediatricians could be anywhere from 6-24+ months so get your name on those waitlists NOW, or else you’re going to add more time to how long you wait. 

I’ve contacted the Child and Adolescent Health Service’s Media Team to confirm the wait times for paediatricians through the public system. As yet they have not been able to provide me with an approximate wait time.

Most likely you are going to have to call around and see who will accept your referral. 

You can use the list of developmental paeds on the Perth Kids Hub website and explain you are one of Dr Green’s patients.  Some clinics are prioritising Dr Green’s patients to ensure continuity of care. For that – thank you! 

Be polite. Medical receptionists are copping the brunt of parents’ stress and frustration. Imagine you were talking to a friend. People do not go to work to be abused.

You can use the list from the Perth Kids Hub website to find all of the paediatricians and child and adolescent psychiatrists in Perth.

3. Ask your GP for a new referral

Did you know that your referral starts from the date the specialist first meets the patient?  NOT from the date that the referral was written or issued. 

So get that referral now even if you can’t get in for months and months.  It won’t expire.

Also, you can ask for a referral that doesn’t include a specialist’s name? As in it can be a referral to a paediatrician – not a particular paediatrician.

Here are the relevant guidelines:

Services Australia’s guide for Referring and requesting Medicare services (1) says that, “referrals don’t need to be made out to a certain specialist or consultant physician”.

The Royal Australian College of GPs (RACGP’s) guide for Referring to other medical specialists (2) 

Did you know that was a thing?  Neither did I.  So much wasted time going back and forth on getting names on referrals.  Ringing around to be told they won’t accept you without a referral.  Trying to get a GP appointment with your usual GP when they’re full. Ughhh the frustration.

Consider my mind BLOWN.

If you want more mind-blowing information on referrals, check out Services Australia’s webpage here. 

Especially the bit on INDEFINITE referrals. I didn’t know I could ask for a referral that would extend beyond 12 months.

It is the GP’s “decision as to whether a specialist’s name is included on a patient’s referral. A specialist or practice asking for a referral to be changed after you have issued it (eg you are asked to add a specific specialist name) causes inconvenience and unnecessary costs.”.

THE ROYAL AUSTRALIAN COLLEGE OF GENERAL PRACTITIONERS (RACGP)

4. Get on several waitlists

It’s not ideal.  It’s not efficient.  And it won’t be a popular thing for me to say.

It means that clinics have no idea how long their waitlists really are, as patients are on multiple waitlists and then forget to remove their names if they get in elsewhere.

But when it’s your child there doesn’t seem to be many other options at the moment. 

You’re probably not going to want to put all of your eggs in one basket just in case someone else gets a cancellation and you could have got in sooner.

But can you just promise me that if you DO get an appointment, you will let the other clinics know and take your name off the waitlist/s?  So that they can help other families, don’t waste time contacting you to offer an appointment when you already have one and they also have a real sense of how long their waitlist is. Thanks for being a good human.

5. Make a plan before your meds run out

In emergency circumstances, where a patient’s approved stimulant prescriber is not available, other GPs may apply for short-term authority to prescribe.

However, it is up to the GP if they are comfortable prescribing stimulant medication.

Some aren’t. Particularly when it comes to paediatric patients.

Have a chat with them about what you will do if your child’s prescription runs out before you can see a new paediatrician.  Don’t leave it until you’re on your last week of meds to find out your GPs comfort level with this.

6. Show your GP this

If your GP is reluctant to become a co-prescriber, then show them this official advice from the WA Department of Health:  “The Department of Health is aware of the closure of Dr Green’s practice.

The advice to patients and parents is to visit their local GP who can apply for a short-term approval while they transition to a new specialist. GP’s can then apply for an interim approval. These are managed as an urgent application to reduce the risk of interrupted treatment,” said a WA Health spokesperson.

“Interim approvals are usually approved for four months while the patient is arranging a new appointment. If an appointment has not been secured the department will review the request to renew.

“Information about applying for interim stimulant approval is available on the Department of Health website.”

Department of Health Spokesperson

7. If they're still not comfortable

If your GP is still reluctant to apply for approval, encourage them to ring the Department of Health’s Schedule 8 Medicines Prescriber Information Service on (08) 9222 2483.

They will walk them through the process and answer any questions that they have.

They are well aware of the closure of Dr Green’s practice and the challenges of finding a new treating pediatrician.

And if your GP won’t get on board – it may be time to find a GP who is willing to provide that continuity of care.

8. Seek other support (if required)

The letter from Dr Green’s room includes a great list of alternative resources. 

I also have listings for therapists who love working with kids & teens with ADHD, Autism and Specific Learning Disorders in the Perth Kids Hub paediatric directory. 

9. Write, don't call

Dr Green’s office is now officially closed.

Medical Secretary Carole is looking forward to her retirement. We hope she gets to enjoy some international travel soon.

But, don’t worry. You don’t need to ring the office to get a copy of medical records or diagnosis.

Dr Green’s practice has been to send a detailed letter to the referring GP after each appointment that summarises results, diagnosis and treatment plan.

You should also have received a copy after your appointments. But if you’ve misplaced them, please speak with your referring GP as they will have them on file.

If you would like to send cards and well wishes, mail is being redirected from the clinic address:

Suite 69, Level 2, Medical Clinic

St John of God Murdoch

100 Murdoch Drive

MURDOCH WA 6150

An open letter to Dr Elizabeth Green

Can we just take a minute to show some gratitude to this amazing woman who has dedicated her career to helping Perth families? Paediatricians are people too. They have their own families who they worry about, care for when they are sick and need to consult specialists for.

Dear Dr Green,

You don’t know me. Our family has never been under your care.

But your 40-year career has touched so many lives.

It has spanned city and rural general practice, work as a flying doctor, as a paediatrician and as a child advocate.

Family has been at the heart of everything you have done.

As a mother, as a GP, as a paediatrician.

Almost 25 years ago you diagnosed a friend of mine with Dyspraxia, or what is now called Developmental Coordination Disorder (DCD). I want to let you know that she’s all grown up. She’s a terrific Aunty. She has the most beautiful, caring heart, a cheeky sense of humour, and cares for the elderly in our community. Thank you for supporting her and her family all those years ago.

More recently you have helped another friend and her son. Your diagnosis and treatment of his ADHD has been life-changing. His thoughts are now focused. He gets positive feedback all the time from his teachers. His confidence has soared.

These are just some of the stories I hope you hear as you look back and reflect on your career as a paediatrician and GP.

Again, you have led by example and shown that family always comes first.

Take the time you need.

From our families to yours, know that our thoughts are with you.

Pia & the Perth Kids Hub community

References

(1) Services Australia. Referring and requesting Medicare services. Canberra: SA, 2021. Available at: www.servicesaustralia.gov.au/referring-and-requesting-medicare-services [Accessed 28 February 2022].

(2) The Royal Australian College of General Practitioners. Referring to other medical specialists. RACGP, 2019. Available at: https://www.racgp.org.au/FSDEDEV/media/documents/Running%20a%20practice/Practice%20resources/Referring-to-other-medical-specialists.pdf [Accessed 28 February 2022].

Picture of Pia

Pia

Perth Kids Hub was created and is run by me, Pia Hazelwood. I'm a Perth Mum of two gorgeous curly haired kiddos, wifey and a communications and marketing professional. Since our first kiddo was diagnosed with a congenital heart defect 10 years ago, our family has been on a mystery-shopping tour of (seemingly) every kind of paediatric specialist and therapist in Perth. Along the way we have met the most amazingly talented and dedicated people who are passionate about helping our little (and big) people to flourish. Whatever that looks like and means to them. Perth Kids Hub has given me a creative outlet and a way of helping families to find their own amazing team, who can help their child or children understand how their brains and bodies work.
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Current patients of Dr Andrew Savery have been notified of his plans to retire in June 2023.  

 

Losing another paediatrician in Perth will put even more pressure on remaining paediatricians to absorb the current case load.   And with most having closed their books, it may leave you wondering what on earth you are supposed to do and where to go?

 

You may find some useful advice in this blog I wrote back in 2022 when Dr Elizabeth Green closed her practice.  

Dr Elizabeth Green has closed her practice

A close friend rang me in a panic. Her son’s paediatrician appointment had been cancelled.

She had just opened a letter that read:

“Dr [Elizabeth] Green has had to travel to Melbourne suddenly to care for a family member and will not be able to return for some time. As such she has made the difficult decision to close her practice permanently.”.  I cringed. I knew what was coming.

What the hell do I do now?

“What the hell do I do now? How do I find another paediatrician? I know there are HUGE waitlists. And what about his ADHD medication? We were going to get a new script at our next appointment.” 

 

Okay, so there were a few more words used commonly by sailors but I have edited the conversation so you get the gist.

Dr Elizabeth Green has helped so many families since qualifying as a paediatrician in 1997.

The woman who wrote the book on parenting

Your GP may have some leads on paediatrician availability. Unfortunately, most paeds have closed their books so they can try and manage their current caseloads. 

 

Waitlists for paediatricians could be anywhere from 6-24+ months so get your name on those waitlists NOW, or else you’re going to add more time to how long you wait. 

 

I’ve contacted the Child and Adolescent Health Service’s Media Team to confirm the wait times for paediatricians through the public system. As yet, they have not been able to provide me with an approximate wait time.

 

Most likely you are going to have to call around and see who will accept your referral. 

 

You can use the list of developmental paeds on the Perth Kids Hub website and explain you are one of Dr Green’s patients.

 

Be polite. Medical receptionists are copping the brunt of parents’ stress and frustration. Imagine you were talking to a friend. People do not go to work to be abused. 

Some clinics are prioritising Dr Green’s patients to ensure continuity of care. For that – thank you!

9 things you need to do now

1. Book an appointment with your GP - stat

Your GP can assist you with continuity of care, prescription of medication and referral to another paediatrician. Most paediatricians won’t add you to their waitlist unless you have a referral. Those waitlists are going to be long. So don’t delay – get a referral today.

2. Get on the phone

Your GP may have some leads on paediatrician availability. Unfortunately, most paeds have closed their books so they can try and manage their current caseloads. 

 

Waitlists for paediatricians could be anywhere from 6-24+ months so get your name on those waitlists NOW, or else you’re going to add more time to how long you wait. 

 

I’ve contacted the Child and Adolescent Health Service’s Media Team to confirm the wait times for paediatricians through the public system. As yet, they have not been able to provide me with an approximate wait time.

 

Most likely you are going to have to call around and see who will accept your referral.  [UPDATE: April 2023: I no longer recommend calling practices to see if they will accept referrals.  They are all full and you may have better success by sending through your referral and then following up once they have reviewed.]

 

You can use the list of developmental paeds on the Perth Kids Hub website and explain you are one of Dr Green’s patients.

 

Be polite. Medical receptionists are copping the brunt of parents’ stress and frustration. Imagine you were talking to a friend. People do not go to work to be abused.

Some clinics are prioritising Dr Green’s patients to ensure continuity of care. For that – thank you!

3. Ask your GP for a new referral

Did you know that your referral starts from the date the specialist first meets the patient?  NOT from the date that the referral was written or issued. 

So get that referral now even if you can’t get in for months and months.  It won’t expire.

Also, you can ask for a referral that doesn’t include a specialist’s name? As in it can be a referral to a paediatrician – not a particular paediatrician.

 

Here are the relevant guidelines:

Services Australia’s guide for Referring and requesting Medicare services (1) says that, “referrals don’t need to be made out to a certain specialist or consultant physician”.

The Royal Australian College of GPs (RACGP’s) guide for Referring to other medical specialists (2) 

Did you know that was a thing?  Neither did I.  So much wasted time going back and forth on getting names on referrals.  Ringing around to be told they won’t accept you without a referral.  Trying to get a GP appointment with your usual GP when they’re full. Ughhh the frustration.

Consider my mind BLOWN.

If you want more mind-blowing information on referrals, check out Services Australia’s webpage here. 

Especially the bit on INDEFINITE referrals. I didn’t know I could ask for a referral that would extend beyond 12 months.

It is the GP’s “decision as to whether a specialist’s name is included on a patient’s referral. A specialist or practice asking for a referral to be changed after you have issued it (eg you are asked to add a specific specialist name) causes inconvenience and unnecessary costs.”.

 

THE ROYAL AUSTRALIAN COLLEGE OF GENERAL PRACTITIONERS (RACGP)

4. Get your child on a few waitlists

It’s not ideal.  It’s not efficient.  And it won’t be a popular thing for me to say.

It means that clinics have no idea how long their waitlists really are, as patients are on multiple waitlists and then forget to remove their names if they get in elsewhere.

But when it’s your child there doesn’t seem to be many other options at the moment. 

You’re probably not going to want to put all of your eggs in one basket just in case someone else gets a cancellation and you could have got in sooner.

But can you just promise me that if you DO get an appointment, you will let the other clinics know? 

So that they can help other families and have a real sense of how long their waitlist is. Thanks for being a good human.

Can you just promise me that if you DO get an appointment, you will let the other clinics know? So that they can help other families and have a real sense of how long their waitlist is. Thanks for being a good human.

5. Chat to your GP about what you'll do if your medication runs out

In emergency circumstances, where a patient’s approved stimulant prescriber is not available, other GPs may apply for short-term authority to prescribe.

However, it is up to the GP if they are comfortable prescribing stimulant medication.

Some aren’t. Particularly when it comes to paediatric patients.

Have a chat with them about what you will do if your child’s prescription runs out before you can see a new paediatrician.  Don’t leave it until you’re on your last week of meds to find out your GPs comfort level with this.

6. If your GP is reluctant to prescribe stimulants, show them this

The official advice from the Department of Health is:

“The Department of Health is aware of the closure of Dr Green’s practice.

 

The advice to patients and parents is to visit their local GP who can apply for a short-term approval while they transition to a new specialist. GP’s can then apply for an interim approval. These are managed as an urgent application to reduce the risk of interrupted treatment,” said a WA Health spokesperson.’

 

“Interim approvals are usually approved for four months while the patient is arranging a new appointment. If an appointment has not been secured the department will review the request to renew.

 

“Information about applying for interim stimulant approval is available on the Department of Health website.”

 

Department of Health Spokesperson

7. If they're still not comfortable ...

If your GP is still reluctant to apply for approval, encourage them to ring the Department of Health’s Schedule 8 Medicines Prescriber Information Service on (08) 9222 2483.

They will walk them through the process and answer any questions that they have.

They are well aware of the closure of Dr Green’s practice and the challenges of finding a new treating pediatrician.

 

And if your GP won’t get on board – it may be time to find a GP who is willing to provide that continuity of care.

8. Seek other support (if required)

The letter from Dr Green’s room includes a great list of alternative resources. 

I also have listings for therapists who love working with kids & teens with ADHD, Autism and Specific Learning Disorders in the Perth Kids Hub paediatric directory. 

References

(1) Services Australia. Referring and requesting Medicare services. Canberra: SA, 2021. Available at: www.servicesaustralia.gov.au/referring-and-requesting-medicare-services [Accessed 28 February 2022].

 

(2) The Royal Australian College of General Practitioners. Referring to other medical specialists. RACGP, 2019. Available at: https://www.racgp.org.au/FSDEDEV/media/documents/Running%20a%20practice/Practice%20resources/Referring-to-other-medical-specialists.pdf [Accessed 28 February 2022].

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Perth Kids Hub is created in Boorloo (Perth) on the land of the Whadjuk Noongar people.  I acknowledge the traditional custodians throughout Western Australia and their continuing connection to the land, waters and culture.   I pay my respects to all Aboriginal peoples; Elders past, present and emerging.

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