Doctors Not Accepting New Patients

Ok I've recently moved to the northern suburbs of Melbourne and I'm having trouble finding a GP that is willing to accept new patients. Anyone know why it's the case? They seem to have a few appointments available on healthengine/hotdoc but I can't book any of them.

Edit: looks like I find a couple of appointments for clinics that will accept new patients but the earliest appointment is at least 2 days away. I'm thinking maybe I should sign up to as many clinics as I can before they also stop accepting new patients (only because it is difficult to book an appointment if I only rely on one clinic. At least if I have signed up to multiple clinics there's a better chance of me getting an appointment on short notice). I've also noticed some clinics are charging $50 for a sign up fee…

Comments

  • +20

    If its bulk billed doctor, they are probably at capacity and can’t accept anymore

    • +8

      Ours definitely does not bulk bill but is still not accepting new patients. They are always too busy.

      • +4

        too busy.

        Looks like you found the right doctor.

    • Don’t seem to be many doctors at north shore to bulk bill. It’s mostly paid.

    • +11

      Ok

    • Tried it.
      Didn't work.

      Apparently you also need to wear are red shirt.

  • +14

    There are not enough GPs.
    GP pay is terrible compared to every other specialty, so junior doctors don't opt to train in this specialty anymore.
    And people still expect their GP to discount their fees by 50% by 'bulk billing!
    State governments are implementing or planning to charge GP clinics 5% payroll tax as well!

    • +2

      I would like to know how much GPs earn yearly compared to other specialised trades.
      As much as it is matter of work life balance and money , I dont want to see it the way it has happened in US

      • +1

        Some figures in this article: https://www.abc.net.au/news/2023-06-09/australian-taxation-o…

        I'd think GP would be included in "other medical professionals"

        • Only $250k….no wonder nobody wants the job

      • +8

        Parter is a doc.
        GPs make about 150k or less if they are just clocking in and out.
        Money improves if they own the practice but most don't bother due to the massive hassle. Apparently nurses tend to own more practices which I was surprised to learn.

        Compared to other specialties its trash pay, but most go into it when they burn out of the more demanding options.

        • why massive hassle?

          • +4

            @capslock janitor: It's basically not viable to own run a GP clinic as a sole practitioner, the overheads and cost of reception staff all comes out of your medicare billing.

            Consider also that the time spent organising staff, payroll and general business management isn't going to be as profitable for you per hour as being a GP will.

            That means you must set up a small business and hire other doctors to work alongside you.

            So now your options are work for someone else's clinic, earn around 200k and give them 30%, or setup a small business and spend even more of your free time at work, or cut your time with patients down. In the end you might not make much more money than before unless you practice is very large, and also if you wanted to be a businessman you wouldn't have gone to medical school in the first place.

      • +3

        I’m a GP trainee and I make about $40/hr. My partner graduated med school with me and is doing hospital work making 2-3x more than me. This is after studying/stressing in highschool to get into med school, stressing for 6 years to graduate med school, working terrible hours while still studying for the next 2 to qualify to enrol into GP training. I actually make about 20% less this year compared to when I was just a hospital resident last year.
        To add to all this, the government is cracking down on GPs ‘rorting’ Medicare is leading to gradual reductions in this already diminished field. Next year there’s more than 250 GP positions that are going unfilled (compared to about 50 this year), so I’d expect this problem to get a lot worse.
        Sometimes I really feel like I’ve just wasted my time when most of my patients comment about how expensive everything is while all my high school mates in trades/office jobs are buying their 2nd house and high yield investment cars

        TL;DR: GPs have over 10 years of study and experience with the constant threat of being sued to get just under 2x minimum wage

        • +1

          GPs do not make just under twice minimum wage. First year GP trainees do.

      • +10

        Im pretty sure they earn a lot more than that for the most part. The nature of GP work is that you can earn as little as you like by doing as little work as you like. But typical earnings are probably more around double that.

        • +5

          GPs would likely only earn double that if they work 5-6 days per week and have a mix of private gaps and bulk billing. Keep in mind that every patient they see, 30-40% of the money goes to the clinic as a service fee.

          A $40 medicare rebate that is bulk billed means the GP gets about $24-28 of that. And that's pre-tax, super etc.

          • +12

            @chongsu: You forgot to mention a $40 rebate is for a 20min consultation, and that's before the 35%-40% fee to the clinic, the local haircut place cuts my hair for $37, and that's less than 20min.

            You're not earning much more than a hairdresser as a GP if you think about it like that.

            Two reasons for "restricting" entry. Did you want every Tom Harry or Dick to be a Doctor, where you life is literally in their hands? Also, is there actually enough resources to train more doctors? Medical school is not lectures and tutorials, it's actually real life shadowing teams around hospitals or GP clinics. Medical school and student numbers have at least doubled if not more over the past 20yra (15yra ago they talked about the "Medical Student Tsunami").

            • +3

              @Deridas: I think it hyperbole to say "your life is in their hands". Most GP interactions are for the usual lowrisk consultations. With that I don't want to dilute their importance. It would be more apt to say "your health is in their hands".

              Most of what techno2000 said is true, except the last part. Someone in average IQ cannot fulfil the responsibilities of a GP. It is not THAT easy. It's certainly less involved than Neurosurgery or other highly-specialised positions. But patients can definitely tell the difference between a good GP and a crappy GP (experience, ethics, people-skills, all things that matter but cannot be tracked by an IQ Test).

              With that said, do we need more GPs?
              It seems like so. We aren't training much, because the barrier of entry is so high (cost, time, effort, grades). So perhaps we should focus on that. Maybe lower the barrier, have the students interning and earning younger, and ramp up the theory and difficulty, and make it a worthwhile career pathway for the locals. Importing already trained GPs is good for the government, but does have its downsides for the local populace.

              • +3

                @Kangal: If a GP stuffs up a first line diagnosis it may well be fatal to you. I know from personal experience with a loved one.

              • @Kangal: As some one that deals with both good and shitty GPs. A shit GP can most definitely wreck your life, you might not even know it’s happened either.

      • +25

        Given they spend about 6-7 years to get a medical degree, and then about $360,000 in uni. fees I reckon they deserve to be well paid.

        • +8

          You beat me to it..> ^^^^ This is why and they deserve every $$$ they get + more … same as Nurses for the shit they have to put up with.

          • @pharkurnell: Yeah, but all those other professionals that hate their jobs and contribute to society… (profanity) them, they should be paid 1/4 what a doctor should get paid!

        • +1

          GPs also do specialty training to become a GP, but need to know a bit about a vast field of medical problems (or they should anyway). Just like an ophthalmologist trains specifically on eyes, etc. Medicare payments for the most part will never cover a GP salary, hence the co-payment model. Unlike as a surgeon etc in a public hospital, most of which would be paid a salary, not per patient.

        • +3

          Ahem from 1974 to the mid 80’s a lot of these Drs we’re getting their medical degree for free.

          • +3

            @O K: True, but they made me wait until early 2000's to get mine as they weren't that keen on a toddler in medical school.

        • +7

          Unfortunately Ocker I have to disagree with you there. Only a small amount of students are full fee at 360k (either Bond Uni which is private or Full Fee spots which I'm not sure if they have that anymore, or international students), but I think they're 15-20k a year for 4-6yrs HECS (not sure what the latest figure is).

        • -1

          If you do the analysis to compare a Dean of a Medical School with a plumber, the plumber leaves school at 15 starts earning immediately. The Dean of Medicine gets deeper and deeper into debt for many years and never catches up to the plumber who owns his own business.

      • +1

        Probably because the government profits from importing professionals. Overseas professionals pay the government visa costs, AHPRA fees, assessments (that incur GST) etc.

        Given overseas professionals are qualified by the government's metrics, the government does not need to provide as many CSP/HECS funded places. Medical education is very expensive. Even if a student owes the government 11k a year in a CSP, the government will have to fork out 30-50k a year to subsidise the position. Multiplied by thousands of students in medicine, that would cost hundreds of millions of dollars per year. HECS money takes a long time to be paid back since it's the cheapest loan you could get (except in 2023).

        I do agree with that you're saying. There's multiple factors. I personally think the threshold to get in is way to high. The bottleneck to get into a post-degree training program doesn't help either. 150k pa for a GP is way too low. There's other jobs that pays just as much with less stress.

      • +9

        So many inaccuracies here

        1. $150,000-$300,000 is basically peanuts for the amount of training and sacrifice required to get where they are
        2. Sure, top 10% IQ (without considering that IQ is a shitty measure of basically anything important) may be able do med school. But med school is not the only course demanding smart people.
        3. A smart neurosurgeon with shit emotional intelligence, shit hand skills and a lack of self awareness would perform poorly.
        4. Because even at the current level of restriction, there are many who graduate and are still incompetent. I went to uni with many of these people so I'm not just guessing.
      • +1

        I think you're getting downvote for the IQ comment, but you're not far off. It's ridiculous that the GP, the first port of call for most people who are sick, is a role that takes the better part of a decade to get established.

        It would make more sense to split the role up into a multitude of specialties that could be trained for in 6-12 months. That would take a huge load off the GPs, and allow them to deal with the more difficult cases.

        But you can imagine that if you tried anything like that, the medical union (the AMA) would do everything in their power to prevent it. You can see that here.

        Medical union is very powerful, second only to the police union

        • +1

          I read that in Japan people see specialists directly rather than a General Practicioner first.

          People generally know what type of problem they have eg skin, ear, respiratory infection, joint, mental, and could see a person who is trained for just those issues. Only for complicated or mysterious illnesses (eg tiredness, weight loss) would they need to see a generalist.

        • +5

          I used to think that being a doctor was out of the cards for me. Then I married a GP trainee. She's definitely smarter than me - her memory is leagues better than mine and her mathematics/ logic is comparable, but at least half her uni friends are definitely dumber.

          That being said IDK where people get the figure that GPs are earning $150K. They have a weird pay system but my wife as a GP trainee is effectively capped at about $135K. Most registered GPs at her practice pull at least $225K (not all choose a full 38-40hr work week), and the ones working at a reasonable pace full time are comfortably $300K

          • +1

            @Papa Huggies: There's a big difference between what they bill and what they actually earn. Plus what they earn also needs to cover things like super, leave, insurance, registration….

      • There's people that get paid much, much more than this without having to spend an exorbitant amount of time and money on training. People that fall well below your '90%' IQ threshold. The people we pick from '3rd world countries' have to go through the added pressure of 100x more competition to actually get into medical school and then devote additional time going through a visa system to move into a country treating muppets that consider them subhuman because they're an 'immigrant', directing their frustrations from shitty governments' failed policies and fetish for short-term financial gain on them. It's also funny how people still scrutinise these people's salaries when we're in the middle of a shortage. Supply and demand.

        Anybody who has an IQ more than 90% of the population should be capable of doing a GP's job.

        Be the change you want to see then, go out and get your medical license instead of pissing into the wind with uneducated takes like these. People like you screech every time talks of raising taxes even slightly to train locals or improve our underfunded system comes up, but will happy screech about importing '3rd-worlders' who have paid for their own education out of pocket with 0 help from our taxes.

      • -3

        You've been downvoted for speaking too much truth, sorry techno2000.

        There's no boot dirty enough for this crowd not to lick.

        $300k to write medical certs and prescriptions for amoxicillin sounds pretty sweet.

      • Lol no, being a GP requires an intellect, probably even more than a specialist.

        What is easier, being a civil engineer who knows everything about zoning laws, or being a construction manager who needs to know about zoning laws and project management and carpentey and electrical work and plumbing etc etc etc.

        You can apply this analogy straight across to medicine as well. In the real world salary does not relate to how difficult a job is.

        • Civil engineering is categorically and substantially harder than construction management. Construction management needs great people skills and multi-tasking, but there's a reason why takes 4Y of study to graduate, and one can be a TAFE course.

          Additionally, construction management firms can hire civil engineering graduates. I've never seen an engineering consultancy have a construction management guy doing engineering work.

          The key point you're missing is the fact that specialists are often the end-solution - if they don't know the answer they can only ask their peers. Generalists have a connection to defer to when it's out of their league.

    • All the ads I see for VR GPs that mention money start at 300k. How much money do they want?

      • +15

        Sure. And that poster stuck to a traffic pole says I can earn $100 an hour by working at home and picking my hours. Sounds legit.

      • +2

        If you think they charge too much then you should just stop seeing GPs. That will teach 'em.

      • +1

        whats vr gp ?

    • -1

      Maybe gp clinics that are corporate owned and the gps are employees or subcontractors are not earning as much but gp clinics which are owned by gp’s are raking it in! Heard of the strengthening Medicare grants being given out by the governmen? No? What about the fact that practice nurses wages are mostly subsidised by the government? What about the other extra incentives (ehealth and quality improvement) and the bulk billing incentives (for concession card holders) are going to be tripled for short consults by November? I agree that GPs are overworked and the red tape and hoops that have to be jumped through is ridiculous but the idea that they are not paid enough is bollocks.

    • if they have to pay qld payroll tax it would mean the business is paying more than $25000 wages a week or $1.3mil a year

      sounds quite profitable

    • Increase the medical seats, allow more immigrants skilled in the area, allow RNs to write tests, blood work and prescribe a certain set of medications.

  • +1

    They have too many current patients already. I know of GPs that have a 4-6 wait to see them just because of how many regulars there are.

    There’s also the possibility that some GPs are planning for retirement in a couple or so years, so to take on new patients now is just disruptive for the patient.

    I would recommend joining a local fb “good karma” group and ask in there if anyone has any recs.

    What suburb are you in? I know of a few highly recommended GPs around the Coburg area, but may not be close to you.

  • +1

    I tend to go back to the clinic I went to when I lived out east many years ago. They always take my appt.

  • +7

    thanks to everyone who voted for immigration, you made ailartsua what it is

    • +12

      Pretty sure it was big corporate lobbyists who 'couldn't find "skilled" workers' and now we have a bunch of people with no useful skills despite them having a degree on paper.

      • Some of those degrees could be faked as well.

        • +2

          That's what I was saying without actually saying it. Some are definitely legit but absolutely worthless.

    • Overseas doctors have to sit multiple clinical exams and have to jump through several other hoops to get license to practice their profession in Australia. It takes years before they can work as a GP. It’s not the same as an engineer or accountant for example.

  • +4

    My GP shows what happens when one lets anyone who wants to make an appointment. She is now booked out so far ahead that by the time you get to see her you've gotten far worse, or recovered.

  • +27

    GPs show one again that you can't solve labour shortages in particular areas with immigration.

    It happened with IT a couple of decades ago. Employers said they couldn't get "enough" staff - translation: they didn't want to pay more to get more - and demanded the government open up immigration in that area. That meant a lot of people coming into the profession who were willing to work for less because they came from lower wage countries. Australian kids deciding what career they would invest their tertiary education in saw those competitors from overseas reducing the wages in that occupation, and deserted that area of study, leaving immigrants as the only people coming into that career.

    It happened in IT. As soon as IT was opened up to immigration, enrolments by Australian kids in IT courses fell massively. The numbers are there for anyone who wants to to see.

    It is happening now with GPs. In this case the government is the "employer" determining the wages by deciding how much Medicare rebates are. They have tried to hold them down. Young Australians responded by not studying to become GPs. The number of Australian kids doing Medicine fell from 50% choosing to become GPs to 15%. The government responded by bringing in more overseas GPs who were willing to work for less, instead of raising Medicare rebates.

    So we've seen that immigration doesn't solve labour shortages in occupations. It creates them by allowing those who decide renumeration to pay less than is required to attract enough people. So it not only creates labour shortages that it than claims to be the only solution to, it lowers wages. It distorts the natural economic process of demand and price working together. It perpetuates the problem instead of solving it.

    This is why wage growth has been stalled in this country for decades. Because every time there is a shortage of people in an occupation that would push wages up, the government instead responds to employer demands to increase immigration, rather than telling them to increase wages to attract more. And does the same itself when it is the one deciding renumeration.

    • +10

      Govt creates the problem, the rides in to save the day (in a way beneficial to them) and everyone falls for it. Each govt then just kicks the can down the road for the next govt to deal with. It’s a giant Ponzi scheme and they are becoming successful in getting rid of the middle class.

    • +5

      There will be lots of Australian kids willing to do a job which pays them more than $150k to $200k. But even having a sky high ATAR , they cant get in to Medical colleges.Its artificially restricted for Aussie kids and then anybody from a 3rd world country with a so called "Medical Education" is let in to become a GP instead.

    • +3

      How are we going with hairdresser numbers?

    • +3

      Employers don't want to hire the immigrants either. On the balance they'd much rather hire someone who looks and sounds like them, can participate in footy tipping and will "fit in". Employers just want enough competition & unemployment rates to justify lower wages. That's how you end up with qualified and experienced workers from asia driving Ubers.

      • +1

        Many of the employers are now immigrants themselves - over half the current population are immigrats from the last few decades. Many places i've worked have more immigrants than australian-born people.

        • Leadership is still largely australian and european.

          • @brandt: Not at the places ive worked - managers, execs, the board, and shareholders have been ~50%+ immigrants or working visa or foreigner, but i have no idea if my experience is average.

    • +9

      WA used to accept like 100 students each year to one medical school (UWA). They persisted with this for ages until they eventually opened Notre Dame and Curtin (very recently). This situation was a choice. The fact is from Robodebt to rolling lockdowns: Australians are victims of profoundly mediocre governments.

      There has never ever been a shortage of domestic medical students - it's always been a shortage of medical school places - I guarantee it.

  • +4

    Surely our skills based immigration system is only allowing in demand occupations like GPs in?

    • +8

      Lol.

    • +2

      SPOTY….
      Sarcastic Post of the Year… :)

    • +1

      Everyone with a paper degree from the University of American Samoa (it's a TV reference) gets a visa.

  • +15

    You'll just have to wait for someone to die to get their spot at the doctor's. Then hope it wasn't because of the doctor.

    • +4

      Paging Dr Jayant Patel..

  • +2

    Anyone know why it's the case?

    They are too busy servicing their existing patients.

  • +8

    Demand for GPs is growing far faster than our population is thanks to an aging demographic. It's not a population problem, the number of GPs grows roughly in line with our population (over the past 5 years it has grown by about 1.5% per annum and it has grown in terms of doctors per 100k people), but the number of doctor visits for those over 75 has grown by about 6% per annum.

    And it's only going to get worse. The amount we're visiting the doctor is, on average, (set to grow by almost 40% by 2032)[https://www.cornerstonehealth.com.au/latest-news/general-practitioner-workforce-report-2022]. That has nothing to do with immigration, even if our population stayed flat we'd still need 40% more doctors just to cover our increasing need.

    • -2

      And it's only going to get worse.

      Only if Albo keeps doing nothing about it…

      He's too busy taking overseas holidays to worry about domestic issues.

      • Actually it's better that he does.

        The last time he was home he signed the deal to allow even more students, on longer visas and with other perks to bring family over, who of course will also use the gp services without ever having paid tax here.

        • +3

          who of course will also use the gp services without ever having paid tax here.

          Aren't you required to get private insurance for health if you are not a resident? I don't think medicare pay for it.

        • +5

          Overseas students are required to have medical insurance as part of visa conditions

      • +1

        aging demographic

        Only if Albo keeps doing nothing about it…

        He is though. He's importing 400,000 migrants. This will reduce the median age of the population.

        • +3

          He's importing 400,000 migrants.

          That is awesome.

          That will solve the doctor problem…

          Thread closed.

    • +5

      This is a well-argued response, supported by evidence.

      So, no.

      The correct answer is (blows into dog-whistle labelled "IMMIGRATION")

      • +2

        Immigration and wage suppression is easily supported by the data, too, but why acknowledge that when you can spout shit like "dog whistling".
        There are multiple factors at play here. We aren't just aging, and we don't just have restricted student intakes, and we don't just have wage suppression via immigration, we also have (by some measures) a sicker population controlled for age.

  • +8

    At my bulk billing clinic there are a lot of expenses (shared by 2 doctors) such as receptionist and Registered nurse salaries -not to mention electricity and other supplies such as dressings etc. To become accredited they must pass (another) exam - fee 2k for each try to prove they are competent and are worth some more of the measly rebate from Medicare. Medical Indemnity insurance takes another whack each year and to add insult to injury,
    Medicare restricts the number of patients they see each day. If. they go over this limit they are hit with a 'Please explain' and possible fine.
    So even if you have 'just a cold' or minor ailment, the doctor must still document this in case you sue them at some future date for not finding that Melanoma because you didn't mention that spot that was covered by a shirt.
    Be glad we have Medicare and are not in the States where you will be charged $10 for that bandaid!
    Imagine rocking up at work with already 50+patients booked in and then realise that a new patient takes huge time and energy to diagnose properly.
    Disclaimer-I have a family member who is a doctor and tried my hardest dissuade them from this path, but they still raced down it-HECS and all.

    • +1

      be charged $10 for that bandaid!

      More than that. I saw a receipt a few years ago, where 2 ibuprofen pills were US$60 each.

  • -4

    Maybe they are under investigation and legally can't accept new patients, but have an obligation to keep managing their current ones.

    • +2

      That can't be true, as if the GP is deemed to be too "dangerous" to not be allowed to accept "new" patients, they would also be deemed to be too "dangerous" to treat "old" patients.

  • Maybe try a different suburb the doctor I go to isn't that busy can usually get in on the day or the following day

  • healthengine/hotdoc are only really useful for the medicare factory clinics. You will have better luck contacting clinics directly.

  • +1

    It's unfortunately common that people need to call 5-10 practices to find one that is accepting new patients - and even then getting a timely appointment is difficult. I wish there was a simple fix or a better way.

  • +5

    That's what happens with over immigration and the medicare system

  • +10

    LNP have openly mentioned their idolisation of the US Healthcare System and wanting to privatise healthcare… the system has been under funded to push us in this direction. Not to mention the amount of GPs and nurses that have walked off the job under their leadership during covid. Even now we have a party with no direction that's to afraid to make any genuine improvements to this system for fear of being kicked out again. This is what we voted for as a nation for 30years while prioritising bullshit like keeping investor property owners happy. If you want a GP, keep watching sky news, fondle daddy Murdoch's balls and click your heels 3 times.

    • +2

      Privatisation of the system doesn't even do anything because you're not solving the supply, it just deals with demand. It's not like someone with Private health insurance is somehow able to jump queues.

      It's the same symptoms as the Childcare industry, to think people are being paid $millions in consultation fees to conclude that paying subsidies to parents to afford Childcare is someone able to resolve the lack of spaces and affordability. No, the Government needs to look at more workers and centres.

      • +1

        And that's the faulty Liberal thinking.. there is a huge demand for doctors? Must be because its free and everyone is abusing it.

  • I go to a GP, a Google search Pactitioner.. when asked questions she simply googles and tells me the first thing she sees on the result page. Easy as aey..

  • +1

    Why Would any GP's Bulk Bill is beyond me, specialists don't why would GP's. it completely devalues their service and profession, I get it universal health care blah blah and there is a percentage of the population that genuinely that are on their last dime. I genuinely believe bulk billing should be means tested and not a choice. I see people with 5 kids, living in McMansions with iPhones and late model cars getting going to bulk billing clinics, it's all about priorities. A progressive co-payment system subsidised by the government appears the fairest method to provide health care services which genuinely provisions health care to the vulnerable and ensures those who are fortunate to afford it to contribute to the system. Bulk billing just incentivises quick turn arounds and sucking the public teat.

    • I agree it should be means tested, or something similar. I think part of the reason a clinic might be resistant to changing from bulk billing is that the extra work required for a co-payment system (extra account keeping and admin) is only offset by a significant jump in the price, like more than $30 or so per client. But that big jump may scare off too much business because so many people in cities expect bulk billing.

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