CSC – STAR PROGRAM

City Specialists Clinic
Supervisor Trained Advanced Registrar Program

Advanced Psychiatry Registrar led care, with close supervision by a Consultant Psychiatrist

For all the psychiatrists at our practice, there is now a significant delay before new patients can be seen. Furthermore, some of our psychiatrists have not been able to accept any new referrals for quite some time.

However, in response to increasing demand and very limited availability of specialist psychiatric care, City Specialists Clinic (CSC) are launching a new initiative to improve access to specialist psychiatric care for new patients referred to our practice.

CSC has been granted accreditation by the Royal Australian and New Zealand College of Psychiatrists (RANZCP) to be a private outpatient training facility for Advanced Psychiatry Trainees (Senior Psychiatry Registrars). This new training post has also received backing by the Commonwealth Government.  This Advanced Trainee (Senior Registrar) will have undertaken all of the assessments necessary to proceed into advanced training, have a keen interest in private practice, and will usually be within twelve months of completing their RANZCP Fellowship training.

From August 2022, CSC will have a part-time Advanced Psychiatry Registrar who will be able to assess and manage patients, under the direct supervision and clinical governance of either Dr Matthew Hocking or Dr Peter Devadason.

Frequently Asked Questions

Is the Senior Registrar still being trained? If so, who is providing supervision?

The Senior Registrar is still being trained.  The Senior Registrars will be closely supervised and the supervisors at City Specialist Clinic are Dr Matthew Hocking and Dr Peter Devadason.

In addition, the Senior Registrar will continue to attend half a day of lectures every week as part of the 5 year Formal Education Course run by the Queensland Branch Training Committee, RANZCP, as well as attending half a day a week of additional hospital based training.

What would be the benefit of me seeing a Senior Registrar vs a Consultant/Medical Specialist?

The main benefit would be to have access to a particular medical specialist, who has limited availability to see new patients. 

Dr Hocking is an Adult and Addiction Psychiatrist, who has expertise in Addiction Disorders, Major Depressive Disorder, Bipolar Disorder, Anxiety Disorders and Attention Deficit Hyperactivity Disorder (ADHD). 

Dr Devadason is an Adult and Old Age Psychiatrist, who has expertise in Bipolar Disorder, Major Depressive Disorder, Post Traumatic Stress Disorder, Eye Movement Desensitisation and Reprocessing (EMDR), Attention Deficit Hyperactivity Disorder (ADHD), Psychotic Disorders and Neurocognitive Disorders (i.e. dementia).

Both these medical specialists are well regarded in their fields of interest.  By seeing the Senior Registrar, you would be managed by a psychiatrist in training who has direct access to the knowledge and expertise of these medical specialists.

There is also a significantly lower cost with seeing the registrar, compared to seeing a Consultant/Medical Specialist.

What is the cost?

There will be a $125 out-of-pocket cost for a 60 min appointment and a $75 out-of-pocket cost for a 30 min appointment, after the Medicare rebate.

The current cost of the initial 60 min appointments with a Senior Registrar is $238.45 with a Medicare rebate of $113.45 (Medicare item No: 282, as long as you have not had a GP Mental Health Treatment Plan done before), leaving you $125 out of pocket. If you have had a GP Mental Health Treatment Plan done before, the rebate will be less ($60.65; Medicare Item No:279), but you will still pay the same out of pocket fee of $125.

Follow up 30min appointments are $135.65 with a Medicare rebate of $60.65 (Medicare item No: 279), leaving you $75 out-of-pocket.

Payment in full is required at the time of appointment and we can assist you in claiming your Medicare rebate.

Please note that when the Advanced Trainee (Senior Registrar) attains full specialist qualifications, they will continue to consult with patients under their clinical care, but the fee structure will revert to the Consultant Psychiatrist rates recommended by the Australian Medical Association (AMA).

While Dr Hocking and Dr Devadason will not be available for routine joint appointments with you and the Registrar, they will be available for joint appointments, if any clarification is required. When a joint assessment is conducted, the fee will revert to the usual AMA fee charged by Dr Hocking or Dr Devadason, i.e. $440 for a 60 minute session.  There will not be any additional out of pocket fee charged by the registrar; the registrar’s fee for the joint session will be bulk billed.

Any subsequent joint follow up reviews with the Consultant and Registrar which are shorter in duration e.g. 30min or 45min, ($295 and $395 respectively) will be charged at the lower, recommended AMA rate for that shorter joint review appointment.  Any subsequent joint follow up reviews with the Consultant and Registrar will also be bulk billed by the registrar, with no out of pocket cost for seeing the registrar for that specific joint appointment.

These AMA recommended fees are adjusted on the 1st of November every year to account for inflation and the CPI.

How long could I see the Senior Registrar for?

The Senior Registrar will be with our practice for a minimum of 6 months and depending on their training requirements, they will likely be with our practice for a total 12 months.  In some cases, the Senior Registrar may be with our practice for longer than 12 months.

You will be able to see the Senior Registrar on a regular basis (how often will depend on appointment availability but will only be a maximum of weekly appointments), for as long as they are with our practice.

This model of care will allow the Senior Registrar to see patients for a series of sessions rather than just for one or two.  This allows for greater treatment gains and therefore, higher patient satisfaction.

The first appointment usually lasts for about 60 minutes and patients will receive feedback at the end of that session about what the problems may be, and what might be done about them. Usually, the total period of assessment runs over 2-3 sessions, after which a more detailed discussion about diagnosis and treatment will occur.

The Senior Registrar will generally have limited capacity to provide longer (e.g. 60 minute), regular (eg every 1-2 weeks) psychotherapy, but will have more capacity for less frequent, shorter appointments.

If Dr Matthew Hocking is providing the Clinical Governance, you will see the Senior Registrar on Mondays.

If Dr Peter Devadason is providing the Clinical Governance, you will see the Senior Registrar on Fridays.

Once the Senior Psychiatric Registrar becomes a Consultant Psychiatrist, you may continue to see this same person for continuity of care.

What is clinical governance?

Clinical governance means that Dr Hocking or Dr Devadason will be provided all the information obtained during your initial and subsequent sessions, to develop a working diagnosis and comprehensive management plan, which will be implemented by the Senior Registrar. This means that if your doctor has referred you to either Dr Hocking or Dr Devadason (both of whom have limited availability to take on new patients for the foreseeable future), Dr Hocking or Dr Devadason will still be closely involved in your care.

While Dr Hocking and Dr Devadason will not be available for routine joint appointments with you and the Registrar, they will be available for joint appointments if any clarification is required. When a joint assessment is conducted, the fee will revert to the usual fee charged by Dr Hocking or Dr Devadason, i.e. $440 for a 60 minute session.  There will not be any additional out of pocket fee charged by the registrar; the registrar’s fee for the joint session will be bulkbilled.

Any subsequent joint follow up reviews with the Consultant and Registrar which are shorter in duration e.g. 30min or 45min, ($295 and $395 respectively) will be charged at the lower, recommended AMA rate for that shorter joint review appointment.  Any subsequent joint follow up reviews with the Consultant and Registrar will also be bulk billed by the registrar, with no out of pocket cost for seeing the registrar for that specific joint appointment.

These AMA recommended fees are adjusted on the 1st of November every year to account for inflation and the CPI.

This clinical model of doctors working in teams led by senior medical staff has been tried and tested for well over a century and is the model used in public teaching hospitals throughout Australia and the world, where senior doctors in the process of training to become a medical specialist, directly manage the patients, while a visiting medical specialist “consults” (hence the term “Consultant”), to confirm the diagnosis and management plan, while retaining overall clinical responsibility.

This model of care allows for a greater number of patients to be seen, who would otherwise not have had any access to specialist psychiatric care.

While this model of care is suitable for many patients, it is not appropriate for all patients and will only be utilised if it is safe to do so.

What if the Senior Psychiatry Registrar moves away to a different job after their term at City Specialist Clinic finishes?

You will be offered the opportunity to see the Senior Psychiatry Registrar who will be replacing the current Senior Psychiatry Registrar.

Alternatively, you could be referred back to the original referring doctor for ongoing care, depending on your preference.

Who is the Senior Psychiatry Registrar (Advanced Psychiatry Trainee) currently?

Please click here for a bio of the current Senior Psychiatry Registrar.

Do I need a referral?

Yes, please obtain a referral from your referring doctor, marked “CSC STAR-Program”. You or your doctor may chose to indicate if you would prefer Dr Matthew Hocking or Dr Peter Devadason to supervise your care. All referrals will be triaged promptly and the staff at City Specialists Clinic will communicate with you if the Consultant of your choice does not have the capacity to supervise your care.

The choice of the psychiatrist will depend on various factors including the nature of your condition and whether your referring doctor has previously referred other patients to that specific psychiatrist.

You or your doctor may chose to indicate if you would prefer Dr Matthew Hocking or Dr Peter Devadason to supervise your care. A Mental Health Care Plan is not required by your doctor for this referral.

All referrals will be triaged promptly and the staff at City Specialists Clinic will communicate with you if the Consultant of your choice does not have the capacity to supervise your care. The choice of the psychiatrist will depend on various factors including the nature of your condition and whether your referring doctor has previously referred other patients to that specific psychiatrist.

Can the Senior Registrar diagnose and write reports?

Yes they can, except for medico-legal reports.

What conditions can the Senior Registrar diagnose and treat?

This model of care, with its direct and close supervision, will allow the Senior Registrar to diagnose and treat most of the same conditions that are diagnosed and treated by Dr Matthew Hocking and Dr Peter Devadason:

Mood Disorders

Depression including Major Depressive Disorder and Bipolar Disorder

Anxiety Disorders

Including Generalised Anxiety Disorder, Obsessive Compulsive Disorder, Panic Disorder, Social Phobia

Addiction Disorders

Psychotic Disorders

Including Schizophrenia, Schizoaffective Disorder and Delusional Disorder

Post Traumatic Stress Disorder

Conditions typically associated with Old Age Psychiatry

Attention Deficit Hyperactivity Disorder (ADHD) in Adults

Are there any conditions that the Senior Registrar will not be managing?

In recent times, there has been a significant increase in the number of referrals for ADHD assessments.  Because of our obligation to provide our training registrars with a range of conditions to assess and manage, we will only be able to accept a limited number of referrals in relation to ADHD.

Given the stage of their training, because they are only working part time, and because some conditions are best managed directly by an experienced psychiatrist with the appropriate sub-specialty qualifications, the Senior Registrar will not be taking on cases of:

  • eating disorders, i.e. where the primary concern is that of an eating disorder
  • patients who have already not benefited from seeing another psychiatrist for an extended period of time,
  • patients under the Mental Health Act or other similar patients who lack capacity or have poor insight into their condition

 However, the Senior Registrar may take on the following cases for assessment only and this may involve a joint assessment with either Dr Devadason or Dr Hocking (who will provide a second opinion), if necessary:

  • complex Post Traumatic Stress Disorder (PTSD)
  • treatment resistant PTSD;
  • treatment resistant depression

Furthermore, the Senior Registrar is only offering outpatient care and cannot directly accept referrals for inpatient care.

Address

Level 8, 225 Wickham Terrace,
Spring Hill. 

Call Us

07 3831 1869
Fax: 07 3832 8800

Email Us

reception@citysc.com.au