Why we can’t afford to lose GPS
This week JOHN ANDERSEN talks to a well respected medical professional about the serious challenges facing general practitoners in Australia
GENERAL Practice doctors are the nut and bolt component of medical service delivery in just about every community in Australia, but for a variety of reasons they are struggling to survive in the modern age.
How many of us now say out of hand when stricken with some virus or another, “no sense making a doctor’s appointment because I’ll have shaken this thing before I can get into see one”.
You hear it so often now that it is like a joke, a truly sick joke, that we accept as being part of the travails of modern life. Wait times to see a GP can run into weeks.
Townsville Family Medical Centre GP Alan Wallace says it shouldn’t be like this.
He is keen to talk about the system he says is broken but not to the point where it has become irreparable.
It can be fixed, but only by a government focused on seeing it rebuilt in a way that has the interest of the Australian people at heart and that is profitable for the doctors themselves.
“Remember the days when you could get an appointment to see your GP while you were still sick? Remember how after 15 to 20 unhurried minutes you came out of the room with all your problems managed.
It doesn’t happen now because there are way too few GPS and if your GP does take the time to look after you properly and bulk bills you, he can’t afford to stay open,” he said.
“Old doctors are leaving General Practice in droves and young ones aren’t becoming GPS because they can no longer make a living.”.
Federal Governments from the 1970s onwards have ignored GPS and now in Dr Wallace’s own words “the chooks are coming home to roost”.
He is 68 and says that in his younger days it was nothing to see 220 patients over a week. This came at a cost.
Many of the doctors working back in 60s70s-80s put in the hours and didn’t have what is now called a ‘well rounded life”.
In the 21st century where so much emphasis is placed on a healthy work-life mix, it means work is no longer the be-all and end-all.
Many younger doctors now live what we have come to know as ‘well-rounded lives’.
This means they get to spend quality time with their families and are able to pick the kids up at school and generally be there when
You hear it so often now that it is like a joke, a truly sick joke, that we accept as being part of the travails of modern life
needed instead of being stuck at the practice.
Dr Wallace says this is great and what life is all about, but on Planet GP it comes at a cost and that cost is not being able to see anything like 220 patients a week.
Dr Wallace says that compounding this is the fact Australia is not producing as many medical graduates as it needs and the graduates who do go into General Practice might only see around 120 patients a week.
This impacts on profitability and pushes more patients into public hospital Emergency Departments.
So, is the GP becoming a dying breed? Dr Wallace thinks it will if the problems confronting this branch of medicine are not addressed. And if they are not addressed soon there won’t be the people around who can teach medical students about general practice medicine.
That leaves us staring into the void.
He has another startling fact. Every time someone attends a public hospital emergency department, which is free and open 24/7, it costs the government which means, you, the taxpayer, hundreds of dollars.
So, when Joe Blow has a sniffle and can’t get
in to see a GP and goes to the Townsville University Hospital which is free and open 24/7 and sits in emergency until he sees a doctor, there’s a price to pay.
“But, if you go to the GP it costs the government $39.75 and you get to talk to a doctor who might fix three or four other problems as well.
If the Medicare rebate had increased in line with inflation from when it started in 1984, it would now be $70.
If this had happened there would be fewer presentations at hospital Emergency Departments and being a GP would be financially viable,” Dr Wallace said.
He rejects the oft-heard criticism that governments do not give enough money to health.
He says they do, but it is poorly allocated. Health administration has become an industry in its own right and enormous sums of money go into employing accountants, human resources and IT professionals instead of into core service areas like medical care, aged care and nursing care.
All is not lost. It’s not like an asteroid is about to crash into our medical system.
“The young people who want to do medicine are there. The older ones who can teach them how General Practice ought to be done are still there… but won’t be forever,” Dr Wallace said.
Dr Wallace knows the money is there to turn things around. The trouble is a lot of it is being flushed down the toilet.
“It’s being spent on the wrong things. Every dollar spent on administration is a dollar that does not provide patient care.”