How the health system works

Primary, secondary, and tertiary healthcare

Primary care

Health services directly in touch with the community. These include general practitioners (GPs), community nurses, physiotherapists, dentists, and pharmacists.

Primary healthcare providers cover a wide range of services, and you should contact them for almost all of your health needs.

Graphic: patient with GP

Secondary care

Services provided by medical specialists such as cardiologists, radiologists, urologists, dermatologists, speech therapists, and psychiatrists.

If you need secondary healthcare services, your GP or other primary healthcare provider will refer you to a specialist.

Tertiary care

Specialist services for inpatients (patients who stay in a hospital or health centre). These include treatments for serious illnesses and injuries, cancer management, and complex surgeries such as heart or brain surgery.

Graphic: Patient in hospital bed

 

A typical patient journey

Making an appointment

Phone your GP and ask for an appointment. Tell the receptionist what you want to see a doctor or nurse about. Appointments are usually 15 minutes but you can ask for a longer appointment, which may cost more.

A doctor or nurse will usually be able to see you the next day or the day after. If you need urgent attention, someone will see you on the same day or refer you to an urgent care clinic or hospital.

Visiting your GP

Turn up on time to your appointment. The doctor or nurse may be running late, so allow a little extra time at the end of your appointment.

The doctor or nurse will talk to you about your symptoms or condition, and may physically examine you with your permission. He or she will give advice on what you should do next.

The doctor or nurse may prescribe you medication or other treatments. Doctors and nurses can carry out some minor procedures in the clinic, including dressing wounds and giving vaccinations.

Your doctor or nurse may also refer you to another health service. He or she will write a referral and send it to the recommended health service.

Medication

If your doctor or nurse prescribes you medication, take your prescription to a pharmacy to collect your medicine. There is usually a $5 fee for prescriptions, but for certain medications the fee will be higher.

Referral

If you are referred to a specialist, the specialist service will contact you to let you know about your appointment.

You may be put on waiting list to get a specialist appointment. If you’re not sure what stage your appointment is at, or if your condition changes, talk to your GP.

The specialist may need more than one consultation, and may want you to have scans or tests. Once he or she has enough information for a diagnosis, they will talk to you about a treatment plan.

This may involve medication, rehabilitation, surgery, or other treatments.

Patient stories

Wiremu has a cough that has lasted over a week and is causing him pain. He visits his local health clinic to see a nurse, who prescribes James some medication and asks him to come back if the cough gets worse or doesn’t go away.

Lee has persistent severe knee pain. She visits her GP, who prescribes Lee pain medication, and refers her to an orthopaedic surgeon in Christchurch. The surgeon writes to Lee to confirm her place on a waiting list, and sees her within four months. After an initial assessment, Lee has surgery on her knee, and her surgeon refers her to a rehabilitation specialist for ongoing care on the Coast.

James has been living with osteoarthritis for over five years, but lately his pain has become unmanageable. He visits his GP to discuss pain management. The GP recommends James change his medication plan, and writes a prescription. The GP asks James to come back one month later to renew his prescription, or change his medication plan again if it is not working well.

Manaia has badly injured her arm playing at home. Her mother drives her to the hospital emergency department. She gets an X-ray, and a clinician tells Manaia her arm is broken. She gets a cast and a sling, and is discharged with a prescription for pain medication. Manaia has a follow-up appointment with her local nurse two weeks later to see how her recovery is going.

Sarah is having chest pains and trouble breathing. She calls 111 and asks for an ambulance. Ambulance staff arrive at Sarah’s home and transport her to hospital, where a doctor tells her she has had a minor heart attack. She stays overnight in hospital and is discharged the next day. Later that week, Sarah has a follow-up appointment with her local nurse to talk about how she can maintain her health and avoid future heart attacks.

Five tips to get the most out of your doctor

Bring a pen and paper

Write down questions you have for your doctor or nurse before you arrive. You can also write down any medications or supplements you are taking so you don’t forget when your doctor or nurse asks.

During your appointment, write down things you need to remember. You can also write notes on your smartphone.

Ask questions

There is no such thing as a stupid question when it comes to your health.

This also applies after your visit is finished: if you forget something or think you didn’t understand it well enough, phone your GP’s office for clarification.

Ask for more information

It’s OK to say you don’t understand. Your doctor or nurse can clarify things, give you more information, or tell you how to find out more about your condition or treatment.

Learn about the health system

Ask your doctor or nurse what is going to happen next, what to expect, and how long it will take. Ask who you will see next, what it will cost, whether there are other options, and whether you should plan to take time off work.

Be honest

Don’t leave out any details. Your health professional will not judge you. He or she has probably already treated any condition you have, many times. Your visit to the nurse or doctor is confidential: he or she can’t share your information without your permission.

Enrolling: The easy way to get cheaper doctors’ appointments

You can enrol at your local general practice (GP), which will give you a discount on visits to your family doctor, and free visits for children under 13 years old. It is free to enrol.

It is best to enrol before you need a doctor. This will save you time when you get sick. Many clinics have limited enrolments, so contact your local GP now, or as soon as you move to a new area.

You can enrol at some practices online, and for others you will need to visit the clinic and fill out a form.

Different clinics charge different fees, so you might want to look around to find a clinic that suits you. All GPs publish fees on their website, or you can call them and ask.

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Page last updated: 26 October 2018

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