An increasing number of doctors are turning away people with complex problems in order to see enough patients to maintain a profitable practice and meet any loan repayments.
The problem is stagnating Medicare rebates that failed to keep pace with cost-of-living rises after they were frozen in 2014. Indexation resumed in July but, according to Australian Medical Association president Dr Tony Bartone, the damage has already been done.
He says it is not a case of doctors crying poor, arguing that if Medicare rates had kept up with the Consumer Price Index, they would be more than double the current rate.
The Royal Australian College of General Practitioners (RACGP) is calling for all Medicare rebates for GP consultations to be increased by 18.5 per cent and for a new payment of $163 for consultations lasting an hour or more.
RACGP president Dr Bastian Seidel says he is hearing about more instances of longer appointments being refused because they are not financially viable.
“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’.
“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.”
GPs can receive $37.60 from Medicare for a consultation of less than 20 minutes, $71.70 for a long consultation and $105.55 for a prolonged consultation.
Dr Seidel says that GPs want to spend more time with their patients to talk through health issues and potentially prevent longer-term problems.
“Medicare should support and not punish comprehensive and compassionate care,” he says. “It’s what our patients deserve. It’s time for politicians to act.”
In addition to more patients heading to hospital emergency departments for minor issues, Dr Seidel warns that it is becoming increasingly difficult for practices, particularly rural practices, to make ends meet.
The Tasmanian-based GP said three doctors recently announced they were leaving the small town of St Helens on the Tasmanian coast.
“Why are they leaving?” he said. “Let’s be realistic about it. It’s a rural community. 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.”
A Health Department spokesman said the request for an 18.5 per cent rise in the rebate had been referred to the Medicare Benefits Schedule taskforce.
Do you prefer to go to a bulk-billing practice to avoid out-of-pocket expenses? Do you find the doctor clock-watching?