Doctor That Won't Notify of Abnormal Test Results

abc123z on 09/10/2019 - 13:17

I have never come across a Dr before who won't notify of abnormal test results, until this one, and was only informed of this when I specifically asked the receptionist.

I am not talking about them giving you the actual result over the phone, they won't do that, but calling you to tell you that the Dr needs to see you about the results, is standard where I've been.

Also always have been able to ring up to ask the receptionist if the result is back, if the Dr has looked at it they will tell you something generic like Dr says no need to see him. This Dr's office says you can't even ring for that. In fact whilst I was there last I witnessed a phone conversation that the receptionist was having with a patient and I believe she was saying that they won't even tell you if the results are even back yet so you can come in to discuss them.

Maybe this is standard practice for bulk billing clinics and I just wasn't aware of it because there are so few bulk billing places around here.

I would have thought they would have had a sign on the wall or at least something on their web site indicating this policy otherwise patients may just assume they would be notified of an abnormal result.

I presume they must have some system in place for reporting postive results for notifiable diseases to the relevant authorities as they are required to however the patient themselves would not be notified I presume.

Of course relying purely on the Dr to call you is not a great idea, and just because Dr says no need to see him doesn't mean everything is normal (it probably just means there is nothing life threatening), but it does seem really rough that the patient can't even check if the results are definitely in before they spend hours of their time going to visit the Dr, it seems a tactic to generate more easy medicare bulk bills.

Assuming this is standard practice for a bulk biller, a non bulk billing gp here costs usually $85 business hours $100++ after hours if they are even open. The medicare rebate is about $38 it seems an awful lot extra to have to pay for the ability to cost a couple minutes of the receptionists time on a phone call.

Health & Beauty

Comments

              • [Deactivated] on 10/10/2019 - 22:06

                @syousef: Not quite so literally.

                When the public pushes for greater privacy, they shouldn't do so to a point where it is obstructive for the clinician.

                Similarly, when a clinician is protecting their self interest, they shouldn't let it compromise patient care.

                It's not as if clinicians want to be restrictive. It is a byproduct of living in a litigious society.

                • syousef on 11/10/2019 - 03:20

                  @[Deactivated]: "The public" here is the lowest common denominator. That one guy that pushes. Not everyone is litigious. The legal system should be able to handle it sensibly without punishing everyone. Unfortunately that's not how we've set up society, and we all suffer for it.

                  • [Deactivated] on 13/10/2019 - 18:18

                    @syousef: Due to the size and spread of our society, case by case judicial system doesn't work. The legal system has to be written so it applies equally across the board.

                    It is dreadfully inconvenient to everyone else who can exercise common sense but honestly, that's a small price to pay for the benefits of an undiscriminating legal system.

        • This Guy on 11/10/2019 - 11:21

          Most industries have a duty of care in Australia, which generally mean you can't let a client or employee get injured or sick due to your action/lack of action.

          Imagine if your home had asbestos, I damaged a panel releasing loose asbestos and I didn't inform you or organise professional clean up.

          I am not a doctor (or a builder), but in my field not informing a client of a major health hazzard that results in death is gaol time.

          It's not like privacy is taken seriously in the health sector anyway. I only need a medicare card, the DOB, address and mobile number (the last three are generally public info for most people) to see most bulk billed doctors. Most bulk billed doctors don't recognise me on repeat visits and if I just ask for next available I would significantly reduce the risk of being detected. I don't think gender would be too big an issue now days and you could just say I am on hormones to transition but I don't want anything about that in your notes. It's not like a doctor can just ask to see my genitals to confirm identity.

          • [Deactivated] on 11/10/2019 - 11:40
            +1

            @This Guy: We do have a duty of care and I wholeheartedly agree - negligence that directly contributes to injury or death should be heavily punished.

            There is nothing here to indicate this discussion is about negligence. This has been entirely about patient convenience.

  • [Deactivated] on 09/10/2019 - 19:00

    What if you called back to book a follow up appointment to discuss your test results and expressly say so at time of booking? The receptionist would have to tell you if your results are in or when they are expected to be reviewed by the Dr, wouldn't she?

    • abc123z on 09/10/2019 - 19:13
      -1

      I overheard the receptionist saying to a patient it is impossible for them to see if the results are there, so I guess this is no.

      However I guess the receptionist implied that this is some kind of legal issue where they cannot do this which I do believe is true, at all.

      It may be a policy of the medical centre but I don't believe it is a law that receptionists cannot access information under reasonable circumstances to perform their duties.

      • abc123z on 09/10/2019 - 19:14
        -1

        sorry, i meant do NOT believe is true

        • [Deactivated] on 09/10/2019 - 20:06
          +1

          So they will let you turn up for that appointment and charge you for it even though they may not have your results? That's stupid. Someone didn't put much thought into writing those P&Ps for that practice.

          Just so you know for the future: patients are legally entitled to a copy of their pathology test results. Although, obviously, the treating practitioner is in the best position to understand and interpret them and their potential impact. If you would like a copy of your results, they should be requested from the treating Dr at the time of consultation, or directly from the relevant pathology lab. I've never had a problem doing so.

          That being said, each pathology lab will have their own protocol on how to release pathology test results to patients, and they may inform the treating Dr of this request. This is because reading their own results may be distressing or potentially confusing for some people. The medical jargon may also be hard to understand/interpret by a lay-person.

          All your best with your health :)

          Ps: Test results that fall within the normal range are more common than otherwise.

          • abc123z on 09/10/2019 - 20:45
            -1

            @[Deactivated]: Thanks Jar Jar have been trying to find out how to get these results from the pathology lab so I can bring them in and not have a wasted appointment but they have no info on their site.

            I might try to send them an online enquiry as to what the process is.

            • Riddler2018 on 10/10/2019 - 10:38
              +1

              @abc123z: Next time you can simply ask your doctor to write "SELF" on the "Copy To" section on the pathology form. You will then be sent a copy of the results.

              • VictimEqualsProfit on 12/10/2019 - 10:52

                @Riddler2018: You don't need the doc to do that. Ask the lab person when they take your sample and they will send you a copy.

        • sjobeck on 12/10/2019 - 10:47

          Troll lol lol

  • try2bhelpful on 09/10/2019 - 21:02
    +9

    I have tests, I ring my doctor, they tell me if the results are back. Telling someone results are back is not a violation of privacy if you don’t identify what the tests are for or the outcome. Society has gone mad if this is considered an issue. I would find a new doctor.

    • EnALup on 09/10/2019 - 22:25
      +2

      When I have tests, normally the practice advise me that test will be sent electronically next day to the doc. I book an appt with my doc in coming days. I dont expect a call to tell me that results are back.

      • try2bhelpful on 09/10/2019 - 23:04
        +1

        Generally, I don’t have to go back to see the doctor if my results are clear. However, I’m reasonably sure my doctor would contact me if I didn’t contact them and there was an issue. I get notifications when my skin check, Pap smear, etc are due. My doctor doesn’t bulk bill. He also has gone out of his way to get me treatment when I have had issues.

        • psdillon on 10/10/2019 - 12:30
          +2

          I think it's a dire mistake to assume a GP would chase you up for a bad test result. GP is a volume business which doesn't leave time or headspace for personal attention unless you are sitting in front of them.

          • try2bhelpful on 10/10/2019 - 12:43

            @psdillon: I wouldn’t make the mistake of assuming but my GP is the sort of practice that would, probably, chase us up. We have been going to the same people for years and they know who we are and our history. We often run into my other half’s doctor in the morning, as we go for our morning walk, and she certainly knows his name outside the clinical setting. My GP convinced a specialist to stay back late to checkout my melanoma test results because he didn’t want me waiting months before I could get seen. Choosing the right GP is one of your more important choices in life.

            • psdillon on 10/10/2019 - 12:50

              @try2bhelpful: That makes sense, I think you're saying that you would always follow up yourself, but if somehow you forgot you have the comfort knowing that your doctor would most likely chase you up.

              • try2bhelpful on 10/10/2019 - 12:52

                @psdillon: Yup. My guys are pricey but they do care and know their stuff. However, I do agree that, for some of the bulk bill places, you are just another sick body part.

  • haemolysis on 10/10/2019 - 00:18

    I would just find a better doctor. If they can’t even notify you of a need to come in they have a seriously relaxed opinion of their duty of care.

    • parsimonious one on 10/10/2019 - 08:52

      Exactly.

      In actual fact the doctor has a duty of care to check test results and advise the patient if anything requires further investigation or treatment.

      If any harm came to a patient due to lack of follow up on the part of the doctor that could be considered negligence

  • Punda on 10/10/2019 - 00:34
    +1

    My last two visits from two different places. First one, the nurse rang me and said Dr wanted you to know results are back everything is ok and recall in 5 years. Second place I rang them to book in for blood test results but first I’d asked if the results were back to which she looked up and said yes.

  • ShannonN on 10/10/2019 - 01:05

    My Drs clinic emails or texts me when results come back with a generic msg like your results are back please make an appointment to see your Dr about these results,if you have already booked a return appointment please disregard blah blah

  • VictimEqualsProfit on 10/10/2019 - 07:41

    Whenever I go for tests I always ask if a copy of the tests can be sent to me via mail. Typically with a blood test they will clearly mark if a test is outside the normal range.

    It doesn't completely solve this problem but you can always take your copy of the test in with you when you go for a follow up appointment.

    Btw, I do agree that doctors should have better follow up. The industry is in a mess.

    • uedamasaki on 10/10/2019 - 11:14
      +1

      just be careful because just because the tests are within the "normal range", doesn't mean they are OK. They often are, but the doctor still needs to be checking the results

      • VictimEqualsProfit on 12/10/2019 - 10:33

        Yes that's right but at least you have the test results in hand when you go to the clinic.

        You can easily Google what's on the results to be more informed before you go.

  • funnysht on 10/10/2019 - 08:55

    so you want to blame a doctor that doesn't want to give you bad news without seeing you and telling you in person, which to point out is medicare funded and you don't need to pay cent usually?

    • by chance do you have something against ppl that care?
    • also any out of range results are flagged as abnormal, but may be normal for you or your previous results
    • chriskq on 10/10/2019 - 10:35

      why are you assuming its bad news?

  • uedamasaki on 10/10/2019 - 09:26
    +5

    Haven't had a chance to look at all the responses yet, but yes, doctors are required to recall patients in for abnormal results. Too many patients assume "no news is good news" and fall through the cracks due to poor/non-existant recall procedures. Doctors can he held liable if something is missed due to not recalling the patient. Infact the standard procedure seems to be to recall twice via phone at different times and once in writing sent by registered post.

    Stay far away from this clinic.

  • Riddler2018 on 10/10/2019 - 09:31
    +5

    It is the "duty of care" of the doctor who requested the blood test to notify the patient of any abnormal results. If the abnormality is significant and needs further management, then the patient should be seen in person. If it is a minor issue, the patient still needs to be notified over the phone and asked to see their doctor at their convenience. The bottom line is, as a requesting doctor, the onus is on him/her to manage/ action all abnormal results. This is part of good medical ethics. Unfortunately, bulk billing HAS adversely impacted good medical practice. Some bulk billing doctors (esp working for corporate medial centers) start churning patients for revenues which impacts the quality of care to the patient. Sad truth - but truth!

    • uedamasaki on 10/10/2019 - 09:53

      ^ This

      not checking your own results is just lazy and very risky.

      • Riddler2018 on 10/10/2019 - 10:11

        … and really asking for trouble (possibility of a complain to AHPRA, risk of getting sued etc). Such practice will come under medical negligence. Imagine a surgeon doing a tissue biopsy to rule out/ diagnose a cancer and then not checking/ following up the
        result!

        • uedamasaki on 10/10/2019 - 10:53

          "umm the patient was supposed to come back and discuss these results your honour. I was worried about the patient's privacy so I thought it was inappropriate to call them to tell them they had cancer that needed urgent treatment".

          I've had 2 near misses in the last few months from specialists not following up and checking their own results. Order tests, CC the GP and assume things will work themselves out. Both cases could have been fatal. If your GP won't check his/her own results and recall you, find a different GP.

          • Riddler2018 on 10/10/2019 - 11:05

            @uedamasaki: That excuse will be thrown out of court! As I said, the onus is on the requesting physician to action all results. It is his/her legal responsibility. The doc will have to prove the he tried his best (within reasonable grounds) to notify the patient. This will include proof of multiple phones calls, sms and letters to ask the patient to see the doctor for a follow-up.

        • kasp on 11/10/2019 - 11:16

          I had surgery a few months ago and I couldn't book a post op examination for 3 weeks. Which I was told I needed to be seen 8-10 days later.

          Just before I was to come in they called me and insisted I needed a referral so I couldn't go that date as I just didn't have time to get it.

          I finally was seen today four months after my Surgery and the doctor was like OMG why did you leave it so long you could have had serious issues. Thing is he paid admin staff to handle these things and they just weren't doing their jobs properly.

  • releasethekr4cken on 10/10/2019 - 09:34
    +3

    Hi, I am not sure why ozbargainers aren't being helpful or saying "this is due to privacy", but in my experience the clinic should call you and make an appointment only if there is something to discuss. Alternatively a nurse would call and say everything is fine, I don't know the system they use to ensure that happens but I guess sometimes they could forget, a skincheck place did a biopsy on my girlfriend because a spot looked suss. Then said that an automated text would let her know if she needed to come back if the biopsy revealed abnormal cells or if it was all clear and no follow up was required. Also I have gone for an STD check at a Clinipath and they have called to let me know it was clear. So it's certainly not a privacy issue.

    Making you call and book an appointment (free or otherwise) only to find the results aren't back is insanity. If they charged medicare for an appointment such as that it would be a rort.

    • uedamasaki on 10/10/2019 - 11:06
      +4

      calling the patient on their listed conact number to say they need to return to see the doctor for results should be pretty safe re privacy.

    • syousef on 10/10/2019 - 12:15
      +4

      Hi, I am not sure why ozbargainers aren't being helpful or saying "this is due to privacy"

      Because while some Ozbargainers are great and want to be helpful, others get their kicks out of bullying and belittling others to make themselves feel superior.

  • richmond12 on 10/10/2019 - 10:03

    I get what the OP is saying, basically there are good GPs and bad GPs. Unfortunately the bad ones are (only a few not all) in the bulk billing ones that try maximize patients per hour etc, and to basically hand out scripts or giving basic results is free money.

    I find I usually go to the bulk ones for blood tests/prescriptions/sick leave etc when time/waiting is not a factor. If you want decent good consultation for a problem, then best to go to a non-bulk one.

    Also, I did go one time to test one at a non-bulk, they basically gave me a text saying I did/did not need to see (and if whether it was urgent) the doctor. I thought was pretty good (as they know it would have been ~$50 out of pocket just to see regular test results)

    • c64 on 10/10/2019 - 10:27

      i always go back to get a copy of my test results

  • HeWhoKnows on 10/10/2019 - 10:29

    Firstly - You will always be told at the time of the est when the result will be back to the doctor

    Secondly - Yes you freely can check if the test result is back so you can discuss with the doctor.

    You pay the doctor to provode a medical service, not to advise you if the test results are in. They can be reported to Medicare if they charge you just to say the results in not in yet as they are not providing the service for which they are paid. hence the receptionist should either answer the question or put you through to the doctor to confirm.

  • Hirolol on 10/10/2019 - 10:40

    Change clinic and move on.
    Problem solved
    Close topic.

  • brad1-8tsi on 10/10/2019 - 10:40

    OP: I'm a relatively new patient at a bulk bill clinic and they were diligent in encouraging me to come back to discuss my test results. 4 phone calls and a letter. On the first call i asked "do i need to come back in a hurry?" and they said no.

    OTOH, I'm changing doctor within the practice as we don't seem to connect / have a rapour. Basically, she doesn't seem to listen to what I'm saying.

    I would suggest you find a better practioner.

    • [Deactivated] on 11/10/2019 - 03:10

      *Rapport. It's one of those words that's not spelled the way it's pronounced. :)

      • brad1-8tsi on 11/10/2019 - 08:14

        I knew it looked wrong but couldn't work out the correct spelling and auto-correct wasn't helping. CBF looking further.

        Thanks!

  • zooter on 10/10/2019 - 11:03

    name and shame the practice/doctor?

    • Kapinny on 10/10/2019 - 12:25
      +1

      point of this being?

    • Tehcookiemonsta on 10/10/2019 - 15:06

      Would that not be defamation ?

  • jacross on 10/10/2019 - 12:25
    +1

    Personal experience is that the results will be looked at and a call made to make an appt if one is needed.

    Incidentally you can demand your results without an appointment if you'd like to go down that road. You'd likely have to go in to colle though abd theyll be resistant.

    Also, try whirlpool forums. Ozbargain is for trolling.

  • psdillon on 10/10/2019 - 12:45
    +1

    Why are some people so harsh on the OP? And then switch-and-bait trolling?

    To answer OP's question, yes I think it's reasonable that you can call to check if results are in before making an appointment. Anything beyond that would be gold-class service in my opinion.

  • Adoses on 10/10/2019 - 14:40

    In my experience:

    1. Results come back to doctor

    2. Doctor has a look at them and decides which are urgent and non urgent

    3. Receptionist sees this on the software and notifies patients to come for urgent/non-urgent appointment through sms system or phone call.

    • Repi on 10/10/2019 - 21:24

      That's how mine works, if everything looks good I'll get the results electronically, if the Doc thinks there is a problem they ring for an appointment which is generally a referral to a specialist.

      If I didn't trust my GP or they are trying to hide behind privacy concerns to charge another appointment, I'd go somewhere else. I never had a receptionist refusing to answer my questions, they might ask a few security questions, but they always answer.

      Just have to find a doctor who thinks your health is more important than them covering their ass or squeezing another consultation out of you.

  • uedamasaki on 10/10/2019 - 14:56

    I think the bottom line is that the clinic described by the OP is operating in a way that is not OK.

    If the doctor even checks the results, it's very easy for reception to check if it's "no action" or "Needs review".

    I also agree it's probably an income/patient numbers thing. Patients that come back for normal results are easy consults. I wouldn't be suprised if they spend <1 min with the patient and still bill a standard consult number for this to medicare.

    • CalmLemons on 10/10/2019 - 15:40
      -1

      lol.

      It's not an automatic system.

      Reception does not check the doctor does.

      The doctor has to remember to check, unless there is a software system that does it.

      • uedamasaki on 10/10/2019 - 16:26
        +3

        Ofcourse the reception doens't check the results. They don't have the medical training to interpret results. But they check to see if they doctor has signed off on the results and whether any further action needs to be done.

        Basically, standard practice is:
        1) The doctors have an inbox of results they should be checking on a regular basis. (I check mine 3 times a day (before work, during lunch, after work)
        2) The doctor clicks "no action" or "needs review" or "urgent review" (or something along those lines) for each result
        3) Reception uses the program to look at list of "checked" results and calls patients for review according marked urgency.

        Believe me I do this every day. Not checking your results is like not checking your email/mail.

      • [Deactivated] on 10/10/2019 - 16:44

        Software does it these days.

  • stumo on 10/10/2019 - 15:34
    +1

    Ive had this recently too. Im pretty sure they do it to maximise the appointments. They wont tell you if the results are back, or if the doctor has looked at them, but they are happy to make an appointement so you can check. Waste of everyones time, especially when they constantly overbook and keep you waiting at least half an hour.

    Do what I did and find a smaller bulk bill doctor place, the smaller the better.

    Ours used to be good when it was small. But it has been "upgraded" a year ago and now its shithouse.

  • CalmLemons on 10/10/2019 - 16:18
    -1

    Oh and things are not told over the phone by the receptionist for two reasons:

    They're receptionists - they're not medical practitioners
    When you visit the clinic, they have a record of you actually attending to ensure you actually acknowledge the result, good or bad.

    If they just left it up to phone records, you could easily say later I didn't hear clearly, or I thought. Least in person, it would be very hard to deny.
    You would be surprised how often what people hear may change.

    When people spend 4 hours a day on their phone, what's an hour visiting the doctor?

    • uedamasaki on 10/10/2019 - 16:32
      +1

      fair points re leaving a paper trail of results being given to patients. I agree results (values, positive, negative, etc) should not be given over the phone as neither the reception, nor patient are trained to interpret these results.

      I think the OP is trying to ask if it's okay to get a "does this need to be actioned?" response over the phone, which I feel is reasonable. The medical software is designed in a way that doctors can easily label results for reception to let patients know whether they need to come in or not, and how urgently.

      • CalmLemons on 10/10/2019 - 22:21
        -1

        tbh didn't read past two sentences of ops post, was ultra-extreme on the cool story scale.

        my gp only calls if need to come in, from what i can remember if ok they call anyway.

        maybe gp didn't want to hear the rest of the story.

        actually when i go in for results and it's less than 5 mins he doesn't charge me at all. clinic is super clinic and doesn't bulk bill working age people

  • sasukewa on 10/10/2019 - 19:23

    Just find another GP. I normally ask my GP for a print out of all my results. Never had any problems.

  • DiLs on 10/10/2019 - 19:45

    What do you mean by normal?
    What is normal to a spider is a chaos for fly.
    Everything positive is not good like hiv positive.
    Also depends on how serious the test was? If it was hemoglobin and instead of normal 15, your test was 14.9, it is technically abnormal but not important.
    If you had a skin test and that has come back positive for cancer, doctor should have called you.
    Are you very much by the book?

  • paraneoplastic on 10/10/2019 - 21:38
    +3

    Few things to consider

    1. The clinic is bulk billing. They get paid next to nothing by medicare, so yes, they likely want you to make another appointment so they can bill you again.

    2. Private practices don't have this problem, in essence the gap you pay, covers 2 'bulk billed' appointments, as such the Dr/receptionist can call and tell you whether an appointment is required for the results or not

    3. Privacy and confidentiality are taken very seriously in medicine, as one wrong step could result in deregistration, so expecting more information than a simple yes you need to come in or not, isn't justified.

    From my limited experience in GP land, most practices use a software (best practice) that allows the receptionist/s to see when results have come in and the doctor is able to verifiy if a further appointment is needed (most do this in the morning).

    • CalmLemons on 10/10/2019 - 22:22
      +1

      great post. you get what you pay for. cheap things no good, good things no cheap.

  • kaleidoscope on 10/10/2019 - 23:34

    Are you asking or telling? :-\

  • barozgain on 11/10/2019 - 00:03

    I always request copy to patient on all my tests etc

    So never really had this problem cause I get my results at the same time the doctor gets them

  • stalker878 on 11/10/2019 - 01:30
    +2

    This post seem quite pointless.
    Too many hypotheticals, subjective statements and hearsay.

    Time to move on..

  • statin on 12/10/2019 - 04:21

    Seems like it is just another tactic, amongst many, to screw Medicare for profit. No wonder Medicare is becoming increasingly unsustainable.
    Needs an investigation just like the National Home Doctor Service.

  • MessyG on 12/10/2019 - 09:03
    +1

    The problem is that while costs of running a clinic have risen over time, the Medicare rebate hasn't. General practitioners are expected to do specialist training now but aren't remunerated the same way as the rest of the specialists. The out of pocket costs for the gap fees reflect the risen costs and the rebate reflects how little GPs are paid by the government to see patients, when really, they're the front line for healthcare. The system is incredibly broken. When you leave the room after seeing the GP, they then have to write letters, organise tests, and make and take phone calls on your behalf. They're not paid for any of that work. It gets even worse with nursing homes, in that they're not paid for their travel time to and from, or any of the truckloads of admin associated with that.

    So when they ask you to come back in, even for a normal result (which they are absolutely entitled to do), they are then able to charge Medicare for the time taken to organise that test, review the result, and communicate it to you. They're not remunerated for giving results over the phone, normal or abnormal, and no one is paying for the reception staff to do that either. There's two ways you can earn a decent (decent, not rich!) wage as a GP. You can be a revolving door script generating bulk billing clinic and try in amongst the truckloads of angry patients, try to not to be a burnt out and angry doctor yourself, or you can charge a gap and be a better-rested doctor, but miss out on a whole segment of the population you wish you could help and feel guilt over that. I honestly don't know how they do it, and keep on top of their knowledge across the entire spectrum of humans.

    When you consider the shite people spend their money on, and the amount of whinging having to spend a bit of money on their health here and there, you can see why the Western world has so many avoidable health problems. When you hear about patients asking their GP to bulk bill them because they want to spend 300 hundred bucks at their hairdresser, you really have to wonder how we arrived in this upside down reality.

    TLDR; Your health is important, prioritise your expenditure there. GP's need more support.

  • theonlymatt on 12/10/2019 - 10:58
    +4

    I'm a GP.

    There are probably multiple reasons for the way your GP does things.

    I have seen this issue dealt with different ways in different clinics.

    A few points:

    1. Privacy - as raised above, this is a significant issue - a phone call, SMS, or message could identify someone as a patient if their phone is seen by anyone else at home. For most people this isn't a big issue. But what about a cheating partner who gets an STI check then wife sees the message and gets it out of him, his marriage breaks down then he uses the doctor / practice. It doesn't sound fair but it's a real risk for practices / doctors. This risk can be mitigated somewhat by individualised consent forms for the patient regarding communications, but it can be difficult to ensure the patient completely understands the potential for confidentiality breaches.

    2. Safety and quality care - I tell all my patients to see me after nearly any test I order.
      Safety
      -Our results, like most practices are electronically downloaded and allocated to our names which we check regularly. If there is an error somewhere in the system, from testing company to my "holding file" I might not see that result which means if it is somewhat abnormal it could be missed. There are safeguards in place for very serious abnormal results e.g. heart attack, in which case the testing company will usually call our reception to hand deliver results to us. But for the average patient who has a slightly abnormal blood test, there is a possibility this could be missed. I discuss the reasons for this with my patients.
      Quality
      -We generally order tests for a reason and often the management plan is made after the result is obtained. e.g. pt presents with X problem, we order Y test, if Y is abnormal we treat the abnormal, if it's normal then we do something else e.g. further investigation, reassurance, watch and wait etc.
      -If the result is normal and there isn't much else to follow up on, then this is a great opportunity for preventative health, e.g. I ask about smoking, diet, exercise, status of other health conditions, screening tests (e.g. pap smears, bowel cancer test, mammogram etc.) - In a busy clinic where a patient comes in about specific things that take up the appointment time, these things are otherwise difficult to get time to address or motivate patients to come to discuss just these issues.
      -I am very aware that the quality of GPs varies dramatically - If you have a GP who you don't think you are getting value from, talk to your GP or try someone else.
      Your health is important, find someone who you value and trust then stick with them. Sometimes you will find a great bulk billing GP, sometimes you will have to pay something for that quality. It may take a bit of trial an error to find the doctor / practice for you.

    3. Business / Money
      I don't own my clinic or a share. Most GPs work as contractors and take a percentage of their "billings". In a completely bulk billing clinic nearly all billings come from medicare. You are only able to bill medicare when a patient is in your room / in front of you. I.E. As mentioned above, phone calls, emails etc.
      I probably order about 15-20 tests per day - I'm in about a 9 doctor clinic with 3 receptionists - that would mean they would have about 135-180 phone call per day to answer / call about results. As you can imagine, this would put a significant financial load on a clinic.
      Most GPs would like phone consults to provide a medicare rebate - i.e. a small fee to the practice to account for the time the GP phones you to discuss your results and further plan - if this is something you would also like, I strongly encourage you to contact your local member of parliament and let them know. As time and technology changes, this is something that I believe should be available to patients and doctors. (Find your local member here: https://www.aph.gov.au/senators_and_members/members)
      With non-bulk billing GPs you might have these extra services because the business will have more money coming in to provide these services. In my experience with bulk billing clinics, costs need to be kept at a minimum and everytime the GP does something without a patient there, they are costing the business and themselves money by not being able to see someone else during that time.

    The big issue with a lot of this is, as mentioned above, the medicare rebates for general practice have not risen with inflation and were frozen for many years by governments, despite the cost increasing for running a practice and for GPs ongoing training / education / insurance, costs etc.
    This is despite good quality, thoroughly researched evidence proving that investment in quality general practice improves health outcomes and saves the health system / tax payer money in the long term.
    In my experience, politicians prefer very expensive fancy machines such as MRI scanners they can pose with for photo-ops rather than investing in the health of our nation when the results won't be visible until after the next election.

    Happy to answer any more questions about general practice :)

    (None of this is medical advice, please see your GP if you have any questions)

    • Bront-1800 on 12/10/2019 - 17:26

      I agree with the phone consults.

      As mentioned in my comment my GP took 5-10min out of his day to discuss my x Ray and CT scan results. I’m grateful I didn’t have to hobble back to the clinic to get the results which I’m sure my previous GP would have made me do.

      I like your idea about them being able to charge Medicare for that consult time and will write to my local member.

  • Bront-1800 on 12/10/2019 - 17:22

    The clinics I’ve been at:

    1. Said yes your results are in you have to make a booking as doc won’t discuss over the phone. This GP is always running behind. So a 75 min wait in the waiting room, 2min consult (results were fine…) and $20 later - I don’t see the doctor anymore.

    2. 2x broken ankles and 1 ankle sprain - new doc has always given me results and advice what to do over the phone. Ie go in to get a referral for X-ray, call up a day later - and he goes through on the phone for 5-10 min with results, what I should do, when he wants to see me again. Always apologises if he’s kept me waiting. And he bulk bills.

    Guess it depends on the doctor.

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