Medicos Brought to Heal?

doctors manyAccording to recent news reports, city-dwelling Australians are now able to benefit from a surplus of general practitioners. Not only can you phone today and get an appointment today with the GP of your choice, but you can even go after you finish work or on a Saturday or a Sunday — or so we are led to infer.

Competition is so severe that, if you phone your GP’s rooms at night, on Sunday or on a public holiday, your GP, or some other doctor from the same practice – who has access to your medical records – will come to your home. This is the after-hours service which all vocationally registered GPs, have stated, in an affidavit, that they provide and which attracts higher Medicare rebates for all the services they perform.

Surpluses breed competition, a wonderful thing in any service profession. Thanks to the current surplus, confidently predicted to continue for some decades with the expansion of medical schools, you will never again hear a recorded message telling you to go to the nearest hospital’s accident and emergency department, or to call an ambulance or dial OOO. Not only that, but the days are over when a strange doctor, who knows nothing about you, is sent by a deputising service whose number is offered to you on your GP’s answering machine.

Now, thanks to the competition which arises naturally in any situation of surplus, you have someone you can truly call “My GP”. He or she is the doctor you always see when you go to the surgery. No longer do your hear the word “The doctor will see you now.” Now you delight in hearing, “Your doctor will see you now.”

Of course, the surplus-induced competition does not only show itself in the quality of the service you receive and in its accessibility, but is also apparent in the fees you are asked to pay. Gone are the days of handing over a credit card, or waiting for your Medicare rebate to appear in your bank account. With a surplus of GPs, competition ensures that your own GP always bulk-bills you.

And you could ask your GP, who is now so keen to keep you as a patient, to ask the same of any specialist to whom you might be referred. Competition is universally recognised as the most efficient way to bring down prices. Your GP, in order to keep your custom in a competitive market, will quickly find the specialists willing to bulk-bill you. That will certainly save you much anxiety.

So let us all rejoice, as patients, in the surplus of urban general practitioners. Our country cousins are not so lucky, but they have other compensations, such as clean air, fresh milk and produce which has not been frozen.

All together now: “Three cheers for the surplus of urban GPs and for all the new medical schools which are training them.” The surplus is the best thing for health care since health insurance first made its way to Australia. Otto Bismarck, its inventor all those years ago, would be a happy man to see his dream realised so fruitfully for patients, even if thousands of km away downunder.

Peter Arnold, whose tongue depressor was jammed firmly in his cheek while writing this, is a retired Sydney GP. He served as chairman of the Federal AMA for four years and, previously, President of the General Practitioners’ Society

  • mags of Queensland

    There may be a glut of GPs but there certainly isn’t one of specialists if my current waiting time for a consult is anything to go by. I was informed that I could wait up to 365 days for an appointment if you please.

    My doctor works Monday to Friday and it is recommended that I use an after hours service for calls outside those days.I have no problem with that as I am loathe to use the public hospital emergency service.

  • ianl

    > ” Your GP, in order to keep your custom in a competitive market, will quickly find the specialists willing to bulk-bill you”

    Hahahahahaha … on to infinity.

    The Aus medical/hospital system is a curate’s egg, of course. Most of us have had both good and indifferent experiences … but a specialist bulk-billing is truly rare. Understandable, as they have larger overheads for a smaller turnover than GP’s.

  • en passant

    Not so many years ago I completely destroyed my knee doing something that any 20-year old super-fit Olympic athlete might just manage.
    I could not walk with severe pain. I was told that the waiting time for the corrective surgery for a person of my age was 3-5 years. This could have saved the medical service quite a lot as this could quite possibly have been equal to my life span.

    I paid $22K for the operation to be done privately and immediately. Medicare reimbursed $7K.

  • Jody

    My Newcastle GP bulk bills me in a relatively new practice. For years I waited 2 weeks for an appointment then sat for 2 hours. Though I still wait in the surgery I can generally get an appointment within a day or so. And he generally sends me for additional health checks to places which bulk bill. I must repay him by visiting more regularly!!

  • Geoffrey Luck

    What’s the point of this story? Medical services vary enormously; people who think they’re economising by visiting a medical clinid are fooling themselves; nobody but the indigent should have access to bulk-billing; in my experience some specialists (e.g. a gastro-enterologist and an ENT recently) will charge the most common fee. People who can’t do the shopping without treating themselves to coffee and cakes quibble at paying a trained doctor who holds their life in their hands. The “smashed avocado” generation deserves the desperate medical future it is condemning itself to.

    • ianl

      > ” … some specialists (e.g. a gastro-enterologist and an ENT recently) will charge the most common fee”

      And most will charge what they think the traffic will bear. Several quite recent life-threatening experiences have demonstrated this to me without equivocation. Further, if you have insurance, this information now forms part of your medical record (ie. you have no choice in supplying this information or not, despite public propaganda to the contrary), thus encouraging a “gap” to be charged. So one pays the Medicare levy, the insurance premiums, the common fee and then a “gap”. That should satisfy your ideology, Geoffrey. The Robin Hood myth never dies.

      For the moment, imaging and pathology services from a clinic, itself generally organised as an investment, have reasonable fee controls if the referring GP requests it – but this only exists now because the Senate refused passage to disabling legislation. The centre cannot hold.

      • Geoffrey Luck

        One does not pay the Medicare levy AND insurance premium AND common fee AND gap. I pay my Medibank premium or hospital cover and the gap between my GP’s fee and the Medicare rebate. I get the rebate directly into my bank account, often a month before I have to pay the credit card account. When the family is on the safety net, pharmaceuticals are free and an $80 GP fee becomes $7. We don’t burden the public hospital system except in the rare case of accident, and we decide ourselves whether to allow the hospital to charge against our insurance.There is no evidence that insurance is part of my medical record – where did you get tht idea? I have no ideology in all this, just the observation over eighty years that greed and selfishness have changed Australia for the worse. Common ailments like a sore throat are now taken to a doctor, where a chemist did all that was necessary. Honoraries provided the top specialist servic es for free in public hospitals, now they cost the taxpayer an arm and a leg because of Medicare. The failue to means-test Medicare payments for GPs means people flood bulk-billing practices and public hospitals while they maintain a spendthrift lifestyle. Makes avocadoes look dear!

        • ianl

          A fair amount of B/S to reply to here.

          > “There is no evidence that insurance is part of my medical record – where did you get that idea?”

          The specialist and hospital receptionists – they say it outright, despite your denials. The public hospital admissions even attempt blackmail: “Please use your private insurance to help our budget; this won’t put your premiums up (much)”. Private hospitals along with a range of specialists are rare outside the inner city, Geoffrey, and those that do have presence cannot necessarily deal with urgency (they certainly do not have emergency departments). When I asked them how they knew we had insurance – I certainly did not volunteer that information – the cute answer was: “It’s on your referral form”.

          > “One does not pay the Medicare levy AND insurance premium AND common fee AND gap”

          Yes, one does, depending on the specialist. Eventually a Medicare rebate and part insurance refund may turn up, but there is still an upfront GAP, despite all the tax, premiums and upfront fees one pays at point of service. In the case of one anaesthetist, he charged an upfront fee 6 weeks before scheduled service with the condition that service cancellation for *whatever* reason did not allow for a refund. I’ve endured this now for over 3 continuous years, I know exactly whereof I talk.

          > “Common ailments like a sore throat are now taken to a doctor …”

          No comment of mine indicated I have done that. In fact, only real illnesses, such as PSP, bowel cancer, blocked urethra, severe hypertension and so on have ever seen the light of a medical waiting room. You claim no ideology then pontificate inaccurately about greed and selfishness against people you do not know at all. Once an ABC burbler, always one, it seems. The Robin Hood myth never dies.

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