Types of diabetes health care

Public health system clinics

When you attend appointments for your diabetes management as an outpatient at a hospital or public health service, you are being treated under the public health system. Many public hospitals and health services have diabetes clinics that offer other health services like endocrinology, diabetes education, podiatry, dietetics, social work/psychological support. Don’t know what these terms mean? Go to the who’s who table to find out.

Some public hospitals also have ‘transition clinics’ specifically to support young people during their transfer from paediatric to adult care. Public clinics are usually covered by Medicare and you will not have to pay, but you will need a Medicare card to attend these clinics. It is important to call transition clinics to arrange a referral letter from your doctor before going there.

Transition clinics—it’s important to remember

• You will need a Medicare card to attend.
• Make sure you call the clinics to arrange a referral from your doctor before going.

Need more info on Medicare cards?

Private health system

An alternative to the public health system is to see a health professionals privately. Most health professionals (endocrinologists/Diabetes Nurse Educators (DNE)/dietitians/ podiatrists/psychologists) can be seen privately at their consulting rooms. This is sometimes referred to as seeing a “specialist”. Don’t know what who these specialists are? Go to the who’s who table to find out.

To access one of these appointments you will normally need a Medicare card and a referral letter from your local doctor before you attend. When you see the specialist, the appointment usually needs to be paid in full at the time of the consultation. You can then go to Medicare with your receipt for a partial refund, or if you have private health insurance, you may be able to claim an ‘extras’ rebate (refund) depending on the type of specialist you saw and your type of cover.

Seeing a specialist—it’s important to remember

• you will need a Medicare card and a referral letter from your local doctor before going.
• You will need to pay in full for your appointment and claim for a partial refund afterwards that you may be entitled to.

If you have ‘extras’ with your private health insurance, some other health professionals (dietetics, physio, dental, psychology, chiro etc) have an extras rebate (refund) too. The amount you receive will depend on your type of cover.

Check with your parents or contact your private health insurance provider to explain the rebates (refunds) they offer and anything they don’t cover.

Paediatric vs. adult health care services

Paediatric services

In public hospitals you see all the health professionals you need (endocrinologist, diabetes education, podiatry, dietetics, and social work/psychology) in one location, on the same day. Often, public paediatric services have a nurse or a clinician who will organise your appointments with all the specialists in the clinic. They may even chase you up if you do not turn up when you’re meant to. Young people and families usually find this process helpful and supportive, although it can be a little frustrating due to the time spent waiting to see all the specialists one after another.

In private hospitals, paediatric doctors and health professionals work separately and you are responsible for making times to see each specialist separately. You only see the one specialist at a time, in their own consulting room. If needed, these specialists may talk with each other to support children and parents with diabetes management; however, this will only occur if you have agreed to this.

Health professionals

Adult services

In public health, adult services are usually based at a hospital or community health service. Sometimes, paediatric hospital/health services are linked with an adult hospital or health service, which makes the transfer from the paediatric to the adult service relatively simple.

 What will be different?

Some of the changes you may notice:

• a change in the time the clinic is open
• the location may be different
• the way the clinic is run may be different
• you might be expected to sort out some things prior to attending the clinic such as making sure your pathology (blood) tests are done
• making sure you have the appointments booked in with the specialists you need to see
• making sure you bring along any results, blood glucose readings or referrals you may need.

As an adult, the responsibility for making appointments and remembering to go to them is in your hands.

If you miss an appointment in an adult clinic, chances are they won’t call you and chase you up. This is because they respect you as an adult, and your choices about the sort of health care you receive and how often you go to appointments.

Other times adult services are situated in a different hospital to the paediatric service. This is often the case if your paediatric service has been situated in a children’s hospital/clinic. In this situation, naturally there will be changes to the location and way the clinic is run—because it is run by a completely different organisation!

Hopefully, your paediatric service will assist you to find and contact the adult clinic you will be attending and maybe even attend a few appointments with you to help the transfer of information to occur. If you don’t find the right one the first time round, go back to your paediatric service and get them to refer you to another. There is usually more than one option for you when it comes to adult health care.

The final option for adult health service is the private system. To access a health care specialist privately you will need a referral letter from your GP which may need to be renewed every 6–12 months. To receive a Medicare refund for doctor’s appointments you will need a Medicare card.