Background
Methods
Design
Participants and setting
Measurements
Procedure
Analysis
Results
Participant characteristics
Total responses n = 465 (100%) | Victoria n = 221 (50%) | New South Wales n = 81 (18%) | Queensland n = 58 (13%) | South Australia n = 39 (9%) | NT/TAS/ACT* n = 23 (5%) | Western Australia n = 24 (5%) | |
---|---|---|---|---|---|---|---|
Age (Years) | 36 (30,46), 22–73 | 34 (29,43) 23–62 | 42 (35,49), 23–73 | 37 (29,46), 22–64 | 36 (29,50), 23–61 | 34 (30,43), 23–61 | 46 (31,47.5), 24–62 |
Gender (Female) | 341 (73%) | 151 (68%) | 55 (68%) | 38 (66%) | 29 (74%) | 12 (52%) | 18 (75%) |
Recency | N = 464 | ||||||
0–5 years | 113 (24%) | 42 (19%) | 16 (20%) | 19 (33%) | 6 (15%) | 6 (26%) | 4 (16%) |
6–10 years | 108 (23%) | 71 (32%) | 18 (22%) | 11 (19%) | 9 (23%) | 6 (26%) | 3 (13%) |
>10 years | 243 (53%) | 108 (49%) | 47 (58%) | 28 (48%) | 24 (62%) | 11 (48%) | 17 (71% |
Primary work setting | N = 443 | n = 218 | |||||
Private practice | 299 (67%) | 130 (60%) | 61 (75%) | 45 (78%) | 32 (82%) | 13 (57%) | 18 (75%) |
Public health service | 136 (3%) | 85 (39%) | 16 (20%) | 13 (22%) | 7 (18%) | 10 (43%) | 5 (21%) |
Administration/University | 8 (2%) | 3 (1%) | 4 (5%) | – | – | – | 1 (4%) |
Business relationship | N = 444 | n = 219 | |||||
Owner or partner | 156 (35%) | 64 (29%) | 37 (46%) | 19 (33%) | 20 (51%) | 5 (22%) | 11 (46%) |
Salaried/Contract | 283 (64%) | 153 (70% | 43 (53%) | 39 (67%) | 17 (44%) | 18 (78%) | 13 (54%) |
Locum/Not working | 5 (1%) | 2 (1%) | 1 (1%) | – | 2 (5%) | – | – |
Working locations | N = 428 | n = 216 | n = 23 | ||||
1 | 181 (42%) | 86 (40%) | 35 (44%) | 23 (40%) | 14 (36%) | 10 (43%) | 13 (54%) |
2–3 | 194 (45%) | 95 (44%) | 36 (44%) | 27 (46%) | 20 (51%) | 8 (35%) | 8 (33%) |
> 3 | 53 (12%) | 35 (16%) | 10 (12%) | 8 (14%) | 5 (13%) | 5 (22%) | 2 (13%) |
Medicare caseload | |||||||
0% | 337 (72%) | 164 (74%) | 62 (77%) | 35 (60%) | 24 (62%) | 20 (87%) | 17 (71%) |
1–50% | 42 (10%) | 22 (10%) | 6 (7%) | 7 (12%) | 6 (15%) | – | 1 (4%) |
> 50% | 86 (18%) | 35 (16%) | 13 (16%) | 16 (28%) | 9 (23%) | 3 (13%) | 6 (25%) |
Telehealth caseload | N = 378 | n = 173 | n = 69 | n = 50 | n = 34 | n = 21 | n = 19 |
0% | 279 (74%) | 115 (66%) | 60 (87%) | 43 (86%) | 28 (82%) | 14 (67%) | 15 (79%) |
1–50% | 96 (25%) | 56 (32%) | 9 (13%) | 7 (14%) | 5 (15%) | 7 (33%) | 7 (21%) |
> 50% | 3 (1%) | 2 (1%) | – | – | 1 (3%) | – | – |
NDIS caseload | |||||||
0% | 301 (64%) | 139 (63%) | 55 (68%) | 39 (67%) | 20 (51%) | 14 (61%) | 19 (79%) |
1–50% | 163 (35%) | 79 (36%) | 26 (32%) | 19 (33%) | 18 (46%) | 9 (39%) | 5 (21%) |
> 50% | 1 (1%) | 3 (1%) | – | – | 1 (3%) | – | – |
Home visits | N = 307 | n = 156 | n = 57 | n = 45 | n = 25 | n = 10 | n = 10 |
0–50% | 287 (93%) | 146 (94%) | 53 (93%) | 41 (91%) | 24 (96%) | 10 (100%) | 10 (100%) |
> 50% | 20 (7%) | 10 (6%) | 4 (7%) | 4 (9%) | 1 (4%) |
Availability of personal protection equipment and consumables
Total responses N = 453 | Victoria n = 211 (47%) | New South Wales n = 81 (18%) | Queensland n = 58 (13%) | South Australia n = 39 (9%) | NT/TAS/ACT* n = 23 (5%) | Western Australia n = 24 (5%) | |
---|---|---|---|---|---|---|---|
No PPE or consumable stock supply issues | 223 (49%) | 112 (53%) | 47 (55%) | 26 (45%) | 17 (44%) | 8 (35%) | 12 (50%) |
< 2 months PPE/hand hygiene products | 145 (32%) | 68 (32%) | 19 (23%) | 24 (41%) | 14 (36%) | 8 (35%) | 8 (33% |
Limited stock of some PPE components | 59 (13%) | 27 (13%) | 11 (14%) | 5 (9%) | 4 (10%) | 7 (30%) | 3 (13%) |
No waterless hand hygiene products | 3 (1%) | 1 (1%) | 1 (1%) | – | 1 (3%) | – | – |
No stock of some PPE components | 23 (5%) | 3 (1%) | 3 (4%) | 3 (5%) | 3 (7%) | – | 1 (4%) |
Employment decisions
Total responses N = 464 | Victoria n = 221 (48%) | New South Wales n = 80 (17%) | Queensland n = 58 (13%) | South Australia n = 39 (9%) | NT/TAS/ACT* n = 23 (5%) | Western Australia n = 24 (5%) | |
---|---|---|---|---|---|---|---|
Business as usual (Self-employed, business owners, employees) | 312 (67%) | 145 (66%) | 57 (71%) | 34 (59%) | 35 (90%) | 15 (65%) | 12 (50%) |
Business as usual but with developed plan/s for practice closure | 74 (16%) | 33 (15%) | 13 (16%) | 12 (21%) | 3 (8%) | 5 (22%) | 6 (25%) |
My employer reduced my hours with paid leave | 21 (5%) | 13 (6%) | 2 (3%) | 5 (9%) | – | – | – |
My employer reduced my hours, with no paid leave | 29 (6%) | 14 (6%) | 4 (5%) | 6 (10%) | 1 (2%) | 2 (9%) | 1 (4%) |
I am currently not working | 28 (6%) | 16 (7%) | 4 (5%) | 1 (1%) | – | 1 (4%) | 5 (21%) |
Sources of information and perceived value
Reported use in past 7 days n (%) | Perceived helpfulness Median (IQR) | |
---|---|---|
Department of Health (State/Territory) | 347 (75%) | 3 (3, 4) |
Australian Podiatry Association | 334 (72%) | 3 (3, 4) |
Department of Health (Federal) | 291 (63%) | 3 (3, 4) |
Friends/family (health professionals) | 292 (63%) | 3 (2, 4) |
Facebook (feed or group) | 273 (59%) | 3 (2, 4) |
Local health services (websites, newsletters) | 225 (48%) | 3 (2, 4) |
COVID-19 Government app | 214 (46%) | 3 (2, 4) |
Friends/family (non-health professionals) | 209 (45%) | 2 (1, 3) |
Regulatory bodies | 203 (44%) | 3 (2, 4) |
Twitter | 51 (11%) | 1 (1, 3) |
Open ended responses to question: “Any other comments on the impact of COVID-19 on your practice”.
Theme 1: Commitment to the end game and big picture
“has reduced patient numbers / income but under the social contract I am in a privileged position to be an essential worker but with this privilege comes responsibility to do what is best for society in this time of crisis which means being more selective in who I see and why I see them” (p60).
“Have done up an A4 flyer on “How to wear a mask” as I spent a lot of time helping people understand this, after seeing what they were doing with their masks!” (p403).
Theme 2: It’s all in the plan, but not everything goes to plan
” I am wearing full PPE gear when I conduct my treatments and am spreading out my appointments so I can do a thorough sanitisation” (p373).
“Physical work load has decreased with COVID-19 but arriving home totally exhausted” (p372).
“… staggered appointments, temperature and oxymeter checks, masks and gloves for reception, opening and closing door for patients, hand sanitiser, posters, following guidelines closely, reassuring patients” (p96).
“The infection control guidelines already in place prior to Covid have been entrenched in our clinical behaviour so as a Podiatrist, I feel we were able to adapt to the few extra duties like educating patients to hand sanitise prior to sitting and taking temperatures” (p354).
Theme 3: I need support from my team, but I am also the support crew for others
“We are having a daily zoom meeting with our CEO, board members and several hundred employees at a time, every day. We have been updated on a daily basis, and feel very comfortable with our current working arrangements to continue practising, would we consider an essential health service …” (p13).
“The not knowing what to do and how to plan ahead when things change every day. The rapidly changing work environment has been a big challenge and we have made it through and I feel most staff are happy now, but it has been VERY HARD!” (p452).
“At initial shutdown business was affected with a decrease in clients wanting to attend. As time has gone on clients are wanting to continue their treatment” (p41).
“Patient dissatisfaction at new 6 week DHS [Department of Health Services] restrictions to work. Very stressful to determine urgency of a small portion of my patients. Some patients view their condition as urgent while I may disagree. This brings increased stress in already difficult times. I want to do right by my patients and duty of care and also adhere to DHS guidelines” (p419).
Theme 4: roadblocks happen
“I remain busy, but have had an increase in DNA [did not attend] and last minute cancellations which has put strain on the cashflow. But not 30%, so am considering options to remain financially viable” (p104).
“Devastating. Haven’t taken income since March to try to keep staff employed. Loans on hold, Job Keeper. Limited patients. OR [Operating Room] work very limited” (p23).
“It was stressful at the peak and I had to close and take time out until mentally and physically equipped to provide optimum care” (p16).
“We have been affected by the NSW/Victorian border closure with some of my colleagues living outside the bubble and unable to attend work as usual” (p86).
Theme 5: Nothing is easy, what’s next?
“As a subcontractor in a private clinic my patient load has decreased by approx 50%, however as a sole trader mobile podiatrist travelling to people’s homes who may be self-isolating my business has increased by approx 20%” (p150).
“Conversion to telehealth where appropriate. I have found COVID-19 and restrictions has required patients to improve their self-management skills and take more ownership of their foot health” (p166).