The Numbers behind Why GP's Can Not Continue to Bulk Bill

Comments

    • -3

      Totally agree!

      • Absolutely totally agree.

        To support my argument, by GP bulk bills. I don't think he's living in poverty.

        If I need more than 5 minutes, I make an extended booking, and Medicare generously compensates my doctor accordingly.

        Without bulkbilling, Medicare is dead.

        • Why would no bulkbilling kill Medicare?

          • +1

            @Trance N Dance: Medicare is in a spiral of providing less but costing more. It isn't sustainable.

            • +5

              @SlickMick: It just requires more tax dollars. Taxes will have to increase to ensure that medicare has enough money to keep up with an ageing population. I am ok with this. Everyone should have access to proper medical treatment regardless of their financial circumstances.

              • -1

                @mattyman: or pay doctors less and we can have reasonable taxation instead of ridiculous over-taxation

                • +2

                  @SlickMick: I'd love to hear how much you think your tax would be able to be reduced by simply by "paying doctors less".

                  • @callum9999: I'm just saying we need to stop pouring money into this monster.

                    I don't subscribe to this idea of tax being a bottomless pit.

                    • +1

                      @SlickMick: Maybe just say that then?

                      Though given it's a ridiculous point (no-one does subscribe to that…), I see why you didn't!

                    • +1

                      @SlickMick: The issue is the alternative to Medicare is a disaster. Private system is significantly more expensive.

                      The same treatment in private healthcare cost x5 the public treatment.

                      I also don’t want private business profit being a factor in any treatment I require.

                      In my job I’ve had to deal a lot with all of the major health funds in Australia. Go visit their offices. They’re palatial. The waste of them is crazy. Their motivation is to reduce cost of providing services but they can’t do it via negotiation so they try to do it by pressuring healthcare providers with nebulous claims of ‘over prescribing healthcare’

                      Medicare is not close to being perfect. It’s by far the best option we have. We should scrap the hybrid system we have and go all in on public.

                • +1

                  @SlickMick: The doctors have already been paid less for 6 years when the medicare rebate was frozen.

            • @SlickMick: Just because gap costs are increasing, doesn't mean Medicare will die. It will always be there, subsidising a large and significant portion of essential health care in Australia, it just needs more funding to bring it back to a position in which it can increase rebates so more practitioners can stay bulkbilling only.

              • @Trance N Dance: Yes, but but as it takes an ever-increasing portion of our wages, we'll say enough. We will eventually need a better system. We should want it now.

                Funding isn't a bottomless bucket, though you'd think so if you looked at how it's grown.

                Remember when we were going to move to a consumption=based taxation system? What a joke.

        • I dont think you read the article, maybe learn to read first?

    • +118

      From the first comment:

      "I knew I was going to die reading the comments here but opened anyway

      Just to firstly speak on what is it that a general practitioner does?

      I see three people an hour. Probably have 1 consult a day that is the "cold and flu" people think GP's see - we see vastly less of this then people expected. More commonly they will be a sick child betwen the age of 0-5. Most patients are elderly or children with other issues

      In a day yesterday I saw;

      1 Paronychia (Fingernail infection - drained it)

      1. New patient; painful periods - ?adenmyosis ?endometriosis and talked through options

      2. year old with likely viral wheeze and gastro (Took me more than 15 minutes - I think anyone who sees kids knows to do a hydration assessment, physical exam and explain how to use ondans and a puffer knows it takes ages)

      3. A driving assessment in elderly

      4. A blood pressure review - increased medication

      5/ A chap with high blood pressure and low potassium and interesting test result (Any guesses what this is anyone?)

      1. Acute kidney injury in a man with heart failure and a million medications webster packed - gfr 28 This took me so long to sort out; withholding metformin, frusemide, etc etc - writing a letter to pharmacy, organising urine tests, ultrasounds

      8.Two mental health care plans

      9 One skin biopsy

      10Two "check ups"

      Hope everyone knows that theres been a recent bowel screening change - everyone should be getting screened from 45 -Sent one chap off for a calcium score (family history)

      13 7 year old with 9 weeks of a wet cough at night in the morning - likely protracted bacterial bronchitis - treated with augmentin

      14 Referred an elderly man with bad hip arthritis for a steroid injection of his hip - long talk here

      15 Perioral dermatitis in a child - elidel

      16 A 12 month vaccination and development assessment - vaccines given alongside our lovely nurse

      17 H pylori treatment - +ve breath test

      So much more - I cant even remember -

      During all of this day; I am trying to fit in calls from hsopitals, calls from patients with issues, and review literally every single result from prior tests, every hsopital letter and review what my colleagues are asking me to follow up on (All of this obviously being unpaid)

      The end of it was I was exhausted at the end of the day. I think over half the people in the list there felt they were just something minor, but as anyone who works in health knows theres a 100 ways to absolutely stuff up the care involved in the above cases. By me competently sorting out someones webster pack, recognising perioral dermatitis, treating pprotracted bacterial bronchitis - I think people think I haven't Done anything - because realistically we are trained to think. The guy withthe low potassium and high blood pressure (Hyperaldosteronism) isn't going to remember their GP - they're going to tell their mates about seeing their Endocrinologist / Specialist. Unfortunately, the public opinion is we just do "scripts, referrals, colds" when thats just not true.

      Any doctor leaving University would have absolutely no chance going through the above day, and a doctor who has done a specific specialty training as well wouldn't be able to handle the breadth of consults from above - the same way I couldnt assess someone as comprehensively as a geriatrician, or put a coronary stent in, or order all the tests a renal physician wants, or all the liver tests of a hepatologist (Or know who should have adrenal vein sampling in hyperaldosteronism).

      realistically general practice is 6-7% of total medicare spending. I think most people are unaware of this. I think most people are unaware each GP spends ~$8000 on private insurance every year (mandatory indemnity insurance) and another $1000 to the government each year. I think most people dont realise how strict medicare is with us; for example when I spend an hour having a family meeting about starting palliative care in an end stage patient in a nursing home - technically I'm not allowed to charge anything for this. (As its not with the patient). If i spent 30 minutes on the phone with a psychiatrist about a complex patient I am not allowed to charge for this. We had anaphylaxis come into our clinic a few months ago off the street; I gave them adrenaline, Nebs and a PIVC and got them an ambulance. Obviously, we never saw the patient again, but medicare gives us no funding for this (no patient details as they were too sick when they stumbled through the door)

      The lack of rebate changes have perpetuated an awful nature of churning through patients in a bulk bill clinic, which has ultimately eroded care - particularly for younger people who might be used as an opportunity to get them in and out quickly to catch up after running late for more complex cases.

      I'd love to see a change where I wasn't having to charge people (we hate it), but literally every other speciality does, every other allied health does, and when is all and said and done with my insurance costs and the fact I see 3 people an hour, I would be making less than pretty much anyone in healthcare unless I charged a fee. I'd love to just do my job and go home; but realistically as many australians do, I often spend my evenings doing overtime and reviewing results, completing reports after my work. As with most doing overtime, obviously this isn;t paid. We have spend over a decade as a profession pointing out that withholding rebate rises (and doing 20 cent rise from november 1) is a recipe for disaster, and has totally destroyed our relationship with patients now that we have gaps, but realistically we've started sliding torwards dentistry and other professions who look after themselves.

      The worst feeling however is when someone asks me casually after I've spent time explaining, discussing treatment options, and treating them (such as the parent of the child with proctrated bacterial bronchitis) - "are you ever going to specialise?" - Well yeah, I already have"

        • +30

          I know I should just ignore the trolls. However, I believe this quote has been taken out of context.

          most experienced GPs make up to $296,400 per year

          The exact wording on the talent.com site is:

          The average gp salary in Australia is $175,500 per year or $90 per hour. Entry-level positions start at $94,078 per year, while most experienced workers make up to $296,400 per year.

          The graph has no scale but it indicates that those making 290k are a minority.

          Consider the 6 plus years of study and ongoing personal development. Is 175k unreasonable?

          • +16

            @BrettSh: The median salary of a postgraduate degree qualified person in Australia is $91K a year https://www.abs.gov.au/statistics/labour/earnings-and-workin… ($1750*52). Many if not most of these professions have ongoing Continuing Professional Development requirements.

            Is $175k unreasonable? Maybe, maybe not. Is it unseemly for someone on $175k a year to be crying poor? Absolutely.

            • +2

              @AngoraFish: The 50 hours of CPD you need each year for professional development as a GP can be done entirely for free via online webinars. Providers like HealthEd offer them on a weekly basis and there's an easy 10+ hours in total across the EA, RP and MO needed.

            • +15

              @AngoraFish: I went to Uni for 3 years (accountant), my wife 6 (GP) I did 1 extra year for CA she did 3 years in hospital for intern and residency and another 2 as a GP reg. I spent 4 years, she spent 11 years training. This year I spent $1200 for licencing and training, she spent $14,700. I make $130,000 and she makes $100,000 (previous year $79,000). It's not about crying poor but it's not a job you do for money.

              • +5

                @FreddyMerc: There's literally nothing on the internet or in the salary data linked elsewhere in this thread to support your wife's particular circumstances, suggesting to me that your wife is working part time, working for some kind of charity, is getting massively ripped off, or perhaps you're quoting her after tax income?

                Using the GPRS calculator default assumptions (only 3 appointments an hour, taking appointments 6 1/2 hours a day, working 5 days a week) they estimate an annual GP salary of $142,184.16 https://gpra.org.au/gp-earnings-calculator/

                According to the RACGP, $100,000 is the median income for GPs working part time (three days per week). https://www.medicalrepublic.com.au/racgps-new-fees-means-tes…

                If your wife is only making $100k a year and is working full time then her salary is well outside the typical range, and is therefore not especially relevant to this discussion.

                • @AngoraFish: I think it is relevant because at 30 years old and now working towards being a specialised doctor for 12 years her income is less than that of most of our friends that have tertiary education (inc. teachers, nurses and admin workers). If you consider the opportunity loss during these 12 years the money you make later on is just playing catch-up. GP specialist training extends into 4 years (extension awaiting fellowship). All of the GPs I know in this period are paid according the NCTER which sets the rates for them. It has recently been indexed but last year, working full, her income was just under $100,000 before tax. You can see the rates here: https://gpra.org.au/ntcer/base-rates-pay/

                  • +4

                    @FreddyMerc: The page you have linked is literally for GP trainees (registrars), not fully qualified GPs. This is important information that you left out of your original post, and one reason why attempting to make an argument from anecdote is a bad idea.

                    When your wife finishes qualifying to become a GP the data says that she can expect to receive a nice income boost. In the meantime, $100k isn't a bad salary for someone who still hasn't completed their apprenticeship.

                    Additionally, the implication when someone talks about "11 years in training" and "opportunity loss" is that all of this time 'in training' is unpaid. In fact, registrars start getting paid the minute they graduate from university, generally after 6 years, at a rate of pay that already beats the Australian median full time wage on their first day, and before overtime and allowances.

                    • +1

                      @AngoraFish: Yes, it was just a snapshot of the last 3 years. She was paid significantly more when she worked as an intern and resident. Another downside is having to spend 5 years in a remote area of Australia after she finishes. I won't be able to work, unless I take up hobby farming.

          • +8

            @BrettSh: I don't find it unreasonable as just like most other professions it takes time to start and a lot of time to maintain qualifications. What I do find offensive though is when I see them complaining that it isn't enough due to the education and ongoing training. This is no different to 100's of other professional roles.

          • +10

            @BrettSh:

            6 plus years of study

            Heaps of professions require 6 years or more study to enter into serious roles. Medicine is not even remotely a rarity in that regard.

          • -2

            @BrettSh:

            most experienced workers make up to $296,400 per year.

            The 'workers' are the GPs

          • +4

            @BrettSh: That's including part timers so you can't equate it to $90 per hour. It's also after deductions. Reality is Doctors are very well paid and 290k is a minority because most make more than that.

          • +3

            @BrettSh: You're definitely forgetting about overtime. With overtime maxed out, you're looking at $500k+/year. This is why I regret turning down medicine and pursing my passions so that I can "enjoy my work" which was a huge mistake. Always take the job with the most amount of money for the least amount of time required, the only true passion 99% of people have in life is enjoying life itself by not working. I know GPs that highly value their work life balance and they earn $275k/year working the standard 40hrs a week, not a second over. You can see that this is the average as per the source below:

            https://www.medicalrecruitment.com.au/doctors/gp-salary-guid…

            • +1

              @supersabroso: Surprised you even got an offer. Someone who can get into medicine now should be able to easily earn $200k+ in another career. Must be a while ago.

          • +3

            @BrettSh: {Consider the 6 plus years of study and ongoing personal development. Is 175k unreasonable?}

            That's the problem with our society, duration of you study equate to how much you deserve to be paid?

            Hence we get some crap GPs and Surgeons they are only in it for the $$.
            And really do we need atar of 99.9 for GPs really?
            At 99.9 , the person should be rocket scientist.

            Problem is with 99.9 many of those who becomes medical professionals are not really those really who wants to be doctors etc.. THey lack of empathy etc etc.. All they care is getting their $$ back for all the hard work they did.

            In short 99.9 basically exclude a lot of people who are actually can become better doctors than some bookworms or nerd who can score 99.9.

            • +1

              @ttt888: You know nothing about the medical selection process. Almost all universities have interviews which assess for core qualities. You need to be academically excellent and have the right qualities to be accepted.

              • @[Deactivated]: Of course there is the interview process. But for you to hit the interview process for standard VCE grads entry to meds in top universities you need to be at the very top end.. Hence the medical selection process ends up with "lower quality" pool apart from been really smart nerds.

          • +1

            @BrettSh: I guess those poor doctors still bulkbilling are dragging down that average.

      • +39

        Yeah and how much is your salary?

        Every GP who is ever interviewed on the topic tries to give the impression they are on the brink of destitution, but what you really mean is you don't want rising costs eating into the business profit.

        Stop dancing around the topic like it's not part of the equation. You only quote your practice running costs. What you actually mean is that to maintain an average salary of $350k you need to increase patient charges. It's fine, just say that.

        • +13

          Yeah and how much is your salary?

          My GP drives a Porsche Cayenne… Enough said…

          • +18

            @jv: My GP drives a Hyundai Sonata. Not all GPs are rolling in cash.

            • +8

              @barcer:

              My GP drives a Hyundai Sonata. Not all GPs are rolling in cash.

              Warren Buffett drives a 2014 Cadillac XTS…
              Does that mean that not all billionaires are rolling in cash?

              • @jv: These are literally your exact words:

                My GP drives a Porsche Cayenne… Enough said…

                You use the example of your GP driving a Porsche, "enough said", then you claim Buffett drives a Cadillac as an example as to why the car people drive doesn't indicate their level of wealth lmao

                • -1

                  @Vanceer: It doesn't work the other way around… lmao

                  Logic 101

                  • @jv: How do you know if your GP is not drowning in debt, or made his money from property investment, or is leasing the car lmao

                    Enough said.

                    • -1

                      @Vanceer:

                      How do you know if your GP is not drowning in debt, or made his money from property investment, or is leasing the car lmao

                      They should have used a Financial adviser and better managed their $300K+ salary…

                      • @jv: How do you know they're on $300k? Enough said.

                        • @Vanceer:

                          How do you know they're on $300k? Enough said.

                          I've already provided the proof earlier… Enough said.

                          • @jv: That's not proof.

                            Not enough said.

                            • @Vanceer:

                              That's not proof.

                              Of course it is.

          • +10

            @jv: Most tradies drive expensive cars as well and there skill set wouldn't come close to a gp so pretty dumb comment really. All on loan to offset tax

            • +2

              @Geoff01:

              Most tradies drive expensive cars as well

              They're probably on $200K-$300K, like the the GPs are…

              • +1

                @jv: Firstly a gp should be earning more than a trade who knows how to change a power point but you are quick to shoot down a gp who tries to make a good living but has to jump through govt rules and pay surgery costs and whom we rely upon for health advice etc plus as you cared to ignore has a skill set 100 times higher than a tradie but it's ok for them to charge hundreds to change
                said power point.

                • -7

                  @Geoff01:

                  Firstly a gp should be earning more than a trade

                  Why ?

                  • +7

                    @jv: It's like talking to a 5 year old. Let me dumb it down for you. Firstly one is a university degree not a trade certificate at Tafe. Prerequisites just to get into medical school are in the upper percentile. As to a sparky…well no real prerequisite required..takes literally twice as long to qualify as the skill set is 10 times as much. Based on your contributions to Oz bargain no great thought process occurs in your little world but I'm sure these few facts illustrate that this upper professional category does deserve to earn in an upper percentile

                    • +3

                      @Geoff01: Correction, a 5 year old who has found the bold function in the forum

                      Vanishing when taken to task is another jv special which seems to be in full effect :)

                • @Geoff01: So GP costs will plummet with telehealth, right?

            • -2

              @Geoff01: Most tradies charge significant sums in cash. They earn $180K but pay taxes on $100K. Hence big houses, blond wives and brand new monster trucks. A GP cannot charge a single cent off the tax system. So bulk billing GPs only get brunette wives, sonatas and 3 bedroom apartments.

        • -6

          They have probably the highest skill set to maintain in the upper professional category, the highest loans to pay off to get that knowledge and ongoing learning, govt requirements, high insurance so after all that why wouldn't they want to be very comfortable. It's ok to go and work on a mine site and earn near on 200k but a doctor is just whinging. But hey a dumb arse electrician can charge $200 for 30min work changing a power point. High skill level that.

          • +14

            @Geoff01: Jeez mate, you have a massive chip on your shoulder. If you think you could earn the same or more doing something easier, then go do it. Nobody has a gun to your head.

            I'm not saying GPs shouldn't earn decent coin. I'm saying stop omitting your desire to maintain a decent salary from the conversation. All people talk about , and I note you do it again in your comment, is mention the costs of being a GP but always leave out the one you're really concerned about… rising costs eating into your take home pay. It's ok. Just say that's why you want to charge more. It's fine.

        • Yea it's enough to buy a Bugatti.

        • It really depends on where you live. For example, in Sydney, I can barely afford a decent house on GP's pay. This is why I am sub-specialising so I can charge more. If I lived in a rural area where the house I am living in costs $400k I could live on a GP's pay no problem and enjoy life. Now I have a mortgage of $2 million so I can't afford to bulk bill people without dropping my quality of care. In addition, bulk-billing patients tend to be more entitled than patients paying a gap. The patients I've advised to not come back have all been bulk-billing patients. $90 per hour is actually low pay in my opinion for someone who has studied 11+ years and who continues to be required to study excessively to provide the best payment care. I pay my tutors $60-70 per hour and these tutors are university-level students. You also don't get paid super, annual leave, sick leave etc. so the effective salary of a GP is about 15% less than what is quoted.

          • @[Deactivated]: I actually think a small co-pay is a good thing. Lots of people currently go to a GP when it's not necessary simply because they pay nothing. If there was a small co-pay, there would be far less waste in our medicare budget. Maybe it would give people reason to pause and think whether the visit is necessary.

            Similar thing happened when I was doing my postgrad degree. Colour laser printer was free and everyone used to waste paper and toner printing hundreds of pages they didn't need. The department introduced a swipe card to record use, but it was still free… printer use dropped 2/3 overnight.

      • +3

        believing LARPers on Reddit

        NGMI

      • +19

        The end of it was I was exhausted at the end of the day.

        The difference between you and someone as exhausted doing any other profession is they aren't making hundreds of thousands a year

        • -2

          Let's look at professions in the same category with the same stress levels and knowledge to maintain and insurances to pay. Not tradies or accountants

          • +4

            @Geoff01:

            and insurances to pay

            Even after all this, I see lots of GP's rolling around in Porsches.

            Let's look at professions in the same category

            My partner is a lawyer and doesn't have any of those expenses but their salary is nowhere near what I've seen GP's rake in.

            Not tradies or accountants

            They don't work hard?

            • -1

              @coffeeinmyveins: Seen tradies running around in rams, and at the end of the day they are all tax offsets,not every gp rakes it in so also lots of lawyers are millionaires so horses for courses. Working hard doesn't equate to earnings, it's skill set based and a tradies skill set wouldn't come close to a dr or lawyer as your partner is.

              • +4

                @Geoff01: By brother in law is a bricklayer. Last year his own pay was $384k in Perth. Owns his own business and runs a small crew. Business took in over $600k.

                He lives in a massive house in the coast and his only next door neighbour is a surgeon. Strangly they’re great mates and go fishing together on weekends.

                Not everyone shares your obsession with who deserves $

      • +6

        If most GPs were like you I would bother to see them more often (this is a compliment)

      • +6

        You left out the best part from following comment.

        A chap with high blood pressure and low potassium and interesting test result (Any guesses what this is anyone?)

        I watched House, so it’s either Lupus or Sarcoidosis

        👏

        • +1

          A chap with high blood pressure and low potassium and interesting test result (Any guesses what this is anyone?)

          I watched House, so it’s either Lupus or Sarcoidosis
          

          I had both of those and sorry, but it wasn't either of your diagnosis.

      • +1

        Very enlightening post, I honestly feel the same as a lot of people where GPs are completely useless and merely gate keepers to the specialists so that they don't get overloaded with wrong patients. This makes it seem like they do deserve their $500k/year salaries.

        • -1

          One visit to sign a referral, another visit to get the result. Less than 10 minutes work, 2 payments from our taxes.
          At least we aren't wasting specialist's time doing admin. That's what GPs are paid to do.

      • "5/ A chap with high blood pressure and low potassium and interesting test result (Any guesses what this is anyone?"

        Drinking too much water? I once got into the habit of drinking 7L of water a day. I think it ended up making my body leach minerals because I started getting muscle cramps in my legs. Once I stopped it sorted itself out.

        • 7 liters of water a day?

          How were you not regurgitating water through every orifice and leaking water.

          How did you even consume that much without your body telling you this is too much and feeling sick?

          People tend to forget that our bodies tell us when we are thirsty/need water…

          • @SmoothCactus: Oh yeah I was pissing quite a bit.

            I had a metallic taste in my mouth which I was confusing for thirst.

            I work an active job outdoors and only eat breakfast and dinner so my body was fine except for the leg cramps that started after a few weeks.

      • I just want to take this moment to apologise for my ignorance. Thanks for taking the time to type it out, I learned a lot today.

      • cant low potassium lead to high blood pressure ? (what are other electrolytes up to, low magnsium high salt)

        most people i meet are more upset about not being able to find a GP availability when needed than the price.
        I get upset as most GPs i have met dont bother to listen to my chest or do a blood pressure when i see them.
        Is there a protocol you guys should respect? Your job sounds a lot like mine, lots of unpaid unrecognised overtime.

        If it is so bad i understand even less why the GP i saw as a student would valse out around 1030 to go to the gym with people in the waiting room, and rock back 40mn later (i suppose everyone has different priorities)

        They also ask me what i want but me is stupid and have no idea

      • +2

        No problem paying for all of that expertise in complex consultations.

        What I object to is having to pay $100 to get a sick note to get the day off sick or the 5 mins needed to get a repeat script for my regular medication I have been on for years.

        If there was a special schedule item for these trivial consults that could still be 100% bulk billed by everyone and everything else needs a co-payment, I'd be perfectly happy.

      • +1

        Thanks for what you do

    • +1

      Minimum wage is $23.23/hr.

      • +1

        They do more than 1 consult an hour.

    • +8

      The chances of having 5 min patients line up back to back are pretty minimal. That's why they always run overtime. Don't forget clinics generally have 2 receptionists and a practice nurse as well. Practice staff overheads are pretty high, costs of consumables, collection of hazardous waste have skyrocketed and sterilisation costs. There's also rent of the premise. That's why a lot of gp's are allocating time to cosmetic procedures such as botox and fillers these days.

      • Many practice-based GP's will section off two hours of their day to do just telehealth consults. They'll bang through 10 patients in an hour for each of those two hours with ease. Most of the consults will be script repeats, sick certificates, pathology/scan results or follow-up's from a recent hospital visit.

        The bigger money earner comparatively speaking for a private GP (which is almost all GP's in this context) is nursing home visits. They can blast through those in 10 minutes a pop, charging around $280 a consult. They'll line up 10 patients for a once a week visit at a nursing home half way between the practice and their home, then leave the practice at 3pm to finish off a working day, doing the visit on the way home.

        • Sure some do it but not all. Generally it's one doctor from a larger clinic that will do it. Generally the smaller 1 to 2 person clinics won't do it. Also some superclinics will send the new junior burger to do those nursing home runs, just like the physio clinics send the new grads to the private hospital runs. Clinic will keep a big chunk of that billing. There of course wouldn't be enough nursing homes around for every private practice gp to have one to service every week. So that's only a small percentage of gp's who would get that contract. But just like the trades raking it on weekends and after hours there are "uber" type apps for gp's to log onto and see if there are home call visits near them should they have the spare time or need the extra cash

          • +1

            @Sammyboy:

            Generally the smaller 1 to 2 person clinics won't do it.

            GP Clinics of that small size represent a minute tiny fraction of GP practices, overall. They are the extreme exception to the rule.

            Also some superclinics will send the new junior burger to do those nursing home runs

            They'll never do that ever, as "junior burgers" as you put it (registrars) require a supervised working environment at all times, with the exception of unexpected medical emergencies of course.

            There of course wouldn't be enough nursing homes around for every private practice gp to have one to service every week. So that's only a small percentage of gp's who would get that contract.

            While technically true in one context, there are approx 7000 registered GP practices in Australia and just shy of 3500 nursing homes. However, the average GP practice in Australia has 5.5 doctors, while the average nursing home has 65 residents. Nursing home residents require GP visits at a rate of more than 12x any normal patient who would visit a GP practice. So the volume of work available to GP's via nursing home visits is absolutely huge. You then have to break that number down again, as registrar's typically can't do nursing home visits, only experienced GP's can - so it means the volume of work available is actually even higher again.

            • @infinite: Im referencing a newly fully qualfied GP not a registrar. They are still at the bottom of the food chain so to speak. Just like a newly qualified medical specialist such as an endocrinologist etc…the newly specialised ones get given all the crap work, even called in when not on call, knowing that they cant say no.

              Most of the GP's in my area are small clinics with aging doctors.They leave the nursing home contracts to the super clinics in the area.

              • @Sammyboy:

                Im referencing a newly fully qualfied GP

                The typical work a fully qualified GP does in their first year as a fully qualified GP in a GP practice is no different to that of one in their 10th year. There is no such hazing or rookie treatment of GP's like that. That's the sort of thing that would only happen in a TV show or something.

                The "food chain" as you reference it among GP's is nothing more than the amount of years worked for a GP practice or how much of a percent you've decided to buy into the business. The difference in decision making power is nothing other than simple business structure like any other. All GP's once they have progressed past the registrar stage have the capacity to take on or reject any patient they want, for any reason they want. There is no "you have to do X many of this type and X many of that type"of patient allocation happening. That again would just the a work of TV fiction. Fully registered GP's are contractors and maintain the capacity to accept or decline any patient for any reason within the law, the only concern a GP practice has is that you have enough patients on the books to have a consistent flow of consults through each day.

                newly specialised ones get given all the crap work, even called in when not on call, knowing that they cant say no

                Again, I have no idea what is making you invent this stuff. Specialists work out of specialist centers, hospitals or as specialists for GP practices. Their daily work typically consists of a GP referring a patient to them, then consulting and treating them as needed, with follow-up's set for a time period afterwards usually. There is no such thing as "crap work". It's just a case of getting a referral and being able to consult as a specialist, or not. Any out of hours work they do is is completely up to them, as they are always contractors, not employees, with only a few exceptions. As such they have 100% control over their own capacity. Generally speaking out-of-hours stuff is usually limited only to emergency work anyway & they always charge fees commensurate for that time.

                • +1

                  @infinite: Are you actually in the health industry? I deal with GP's, specialists, practice owners on a weekly basis mate

                  • @Sammyboy: A non GP owner of a clinic who thinks they know it all but actually is very misinformed by the looks

                  • @Sammyboy: I think this is a case of things being slightly different in different places.

                    I've seen both of what you're describing simultaneously be the case in different parts of Victoria.

                    It can depend on the place you work and how they treat you, there are plenty of practices where gp's that's don't have many years of experience will get a lot of the shit work put onto them, and power imbalances exist for "juniors" in every industry regardless of policies that allow for freedom to take on or reject cases.

                    Just optically, a new GP refusing to take on work because it's tedious is going to be problematic for a practice manager/owner and therefore has consequences to it. I'm not sure how Infinite isn't realizing this.

      • all the ones i have been to the path nurse is the receptionist and there is just her, she does look stressed out which is why i am nice to her. I do imagine costs of consumables is insane

        • Almost no pathology or blood collection sites hire nurses, they hire phlebotomist's. A phlebotomist is just someone trained to take blood. Most GP's don't have nurses who take blood as a regular part of their role for the purposes of generic blood testing, they simply lease out a consult room to one of the pathology mob's who just keep a contract/casual phlebotomist there on site.

          Becoming a phlebotomist only involves doing a 6 week course at TAFE and no other medical background or education. You can do it without even having graduated high school. It's considered a minimum wage job. The receptionist at any GP is literally a more highly skilled employee than the phlebotomist is.

          • @infinite: path nurse, phlebotomist potato potata

            i meant phlebotomist, some places do have nurses as receptionnists to do all the hands on stuff, some smaller places have a receptio-phlebotomist

    • +2

      A GP at hurstville go through his patient in 5min. You don't have time to ask question not even catch a breath before he hurry you out the door.

      Obviously if you want a GP that spend time and patient then he is not for you. But he is fine if you are in a hurry and something minor like a cough and need prescription drugs.

    • Therefore, in total for a consult before tax, they are paid a paltry $19.36

      Many people work an hour to earn that…

      2 hours if you worked for this doctor at his shop.

      https://www.abc.net.au/news/2023-10-30/melbourne-doctor-seyy…

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