GPs refuse care due to cost

Dr Bastian Seidel.

Bulk-billing doctors are leaving rural areas and refusing longer appointments for complex patients, the RACGP says

Dr Bastian Seidel, president of the Royal Australian College of General Practitioners, has told Fairfax media that it is now “common” for longer appointments, and appointments for children or people with mental health conditions, to be refused at bulk-billing clinics.

The reason is financial, the article says.

“They are saying, ‘it’s 10 minutes and the patient goes out’. And people are being told ‘if you have a mental health condition you probably have to go elsewhere’,” Dr Seidel told reporter Aisha Dow.

“I’m concerned that some places are refusing to see children for the same reason.

“So all of a sudden, you don’t have the comprehensive care that patients deserve. If it’s more complicated, you have to go elsewhere.”

The article claims that most bulk-billing surgeries only offer consultations of around 10 to 15 minutes, despite the fact that longer consultations are more beneficial to patients.

“While there are Medicare rebates for consultations longer than 40 minutes, doctors say they make more money by charging for multiple short consultations, creating a ‘perverse’ incentive to avoid difficult patients,” Ms Dow writes.

She cited respondents to the current review into the Medicare Benefits Schedule, one of whom said that the system “allows some GPs to cream the system by seeing 10 patients an hour and earning $380,” while those who take longer on each appointment are financially penalised.

Dr Seidel also said that some GPs were leaving low socio-economic areas and country areas because of expectations around bulk-billing.

These included three GPs who recently said they would leave the small Tasmanian town of St Helens, on the state’s east coast.

“It’s a rural community,” Dr Seidel said. “There is a high rate of disability and unemployment. Everyone expects to be bulk billed.

“Doctors can’t go broke, so before they go broke, they leave – and that’s what happened.”

The RACGP is urging the Government to increase Medicare rebates for GP consultations by 18.5%, and to introduce a payment of $163 for consultations which last for an hour or longer.

The “Medicare freeze” has just been lifted, which means GPs will now receive a 1.5% increase on standard consultations.

The article comes days after another Fairfax piece in which RACGP Victoria chair Dr Cameron Loy attacked pharmacy health checks, saying that “these pharmacies are motivated by money”.

Pharmacy Guild Victorian president Anthony Tassone expressed concern about today’s report.

“This is an alarming admission by the RACGP and one that highlights the potential for pharmacists to help, by taking some of the strain away from doctors’ surgeries,” he said.

“Within our existing scope of practice and acting collaboratively with local doctors, community pharmacies can ease the burden on the doctors, giving them more time to give care for patients they are currently turning away.”

The community pharmacy sector “stands ready to ease the burden on general practitioners to prevent them having to turn away mental health patients and sick children,” the Guild said.

“The acknowledgement by the RACGP that doctors can’t cope creates an opportunity to enhance the way community pharmacies are utilised in the health system.

“Pharmacists can deal with minor ailments that would otherwise create even longer waiting times at the doctor’s surgery.”

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  1. Jarrod McMaugh

    It is very refreshing to see the RACGP and it’s president taking some responsibility for it’s members’ capitulation to conflict of interest.

    Pharmacists are often accused of having a CoI due to selling products. The fact is, all professionals have a CoI when they sell anything, be it product, advice, or reputation.

    In this case, RACGP and Dr Seidel are revealing that GPs are putting their financial needs ahead of their patients – succumbing to their conflict of interest.

    The only problem is, they still don’t seem to recognise that this is what it is…… but it might explain the article from Dr Cameron Loy earlier in the week that took aim at pharmacists without justification.

  2. Amandarose

    Those practices that fail with bulk billing in rural areas need mentoring with business, utilising care plans and nurses and being able to offer quality care and be funded for it. I work in such a practices pharmacy in such an area and the do just fine- more then fine by employing a smart manager.

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