I saw the post on Reddit and thought to share because I find it interesting.
The Numbers behind Why GP's Can Not Continue to Bulk Bill
Comments
I have not visited GP's in Australia many times, but when I did - I was always advised to "Drink more water and take some panadol".
Even the last time I went to GP with Shortness of Breath, and the advise was "Go for a run". Wtf
Maybe it is just me but I find it so much easier to deal with doctors in Public Hospitals. I truly believe our Doctors should be paid more than GPs as they are doing an amazing job.
It’s just like any other business and you’ve got to step up the game and “shop elsewhere”
If life were so hard for doctors, you wouldn't have near infinite lines of people wanting to get into the profession willing to spends hundreds on the GAMSAT + test prep. There is a reason so many high school kids want to be doctors, because it's probably the best profession to get into to guarantee a comfortable salary after a few years.
Maybe standards for compensation are slipping for physicians compared to years passed, but the average doctor has it a lot better than the average X from any other profession, and it takes a cursory glance to look at average salary data to see this.
Why do people begrudge doctors being wealthy? You're entrusting your health to them yet commentators go all narky about the type of car they drive ?
We also entrust our health and life to uber drivers, bus drivers, engineers, pilots, and a whole host of other people who don't get compensated anywhere near as well as doctors do…
I don't think it's surprising that the average Australian, on a salary far lower than most doctors, doesn't like hearing from doctors about how much they're struggling when they earn far far more than most other people. Yes, they work hard and study a fair bit, but that's *true of many other professions. I think it's just hard to feel sorry for people who, by most accounts, seem to be doing pretty well.
If doctors weren't doing well, it wouldn't be so competitive to get into medicine, but it still is, so it seems most people think it's still a fantastic career path that is well compensated.
lol
I hope your cab driver heals you next time you book a trip.
@[Deactivated]: You could go 10+ years if you’re under 60 without seeing a single doctor and most people would still be alive and well.
You can’t move 2m or do anything without entering a structural building, using roads etc created by engineers and other professions
We also entrust our health and life to uber drivers, bus drivers, engineers, pilots, and a whole host of other people who don't get compensated anywhere near as well as doctors do…
really? experienced pilots are on 300-500k with much better perks and based out of dubai or other tax friendly countries with minimal tax. an engineer with their own firm would be easily half a mil plus, even senior employed engineers would be on a 150-200k+ wicket easily, with all the benefits of a salary which would be at least 35% on that figure as a self employed equivalent
bus drivers and uber drivers are not comparable in terms of the barrier to enter the profession or the amount of time required for training. i don't recall an uber driver needing 10-15 years of training to ferry you around in their camry.
No one begrudges them being wealthy, people simply have an issue with them constantly demanding more money despite being heavily funded by the taxpayer on top of already getting paid comparatively more than almost any other occupation in the nation.
how are they getting funded by the tax payer? it's a common entitlement people feel like because they pay taxes they are entitled to free healthcare.
they aren't getting a salary from anyone, less than 10% of the medicare budget is going towards your rebates for seeing a doctor, and bulkbilling basically means they reduce their fees by over 50%. what other profession will give you a discount because you are doing it tough?how are they getting funded by the tax payer?
Medicare payments can account for anything up to 25% of their income. They then get paid for medical reports and advice from other government agencies on top of that. Those earnings are 100% funded by taxpayers.
it's a common entitlement people feel like because they pay taxes they are entitled to free healthcare.
No one is entitled to free healthcare, no one anywhere receives it either. You always pay one way or the other. No such thing as a free lunch in life unless you are staggeringly ignorant.
What other profession will give you a discount because you are doing it tough?
Half the business in Australia do that for pensioners once a week, the difference being it isn't taxpayer money funding any of those "discounts".
@infinite: Do you actually own a clinic? Because you are misinformed and should know better. Medicare or public services doesn't pay for ANY part of a dr's income. No government agencies pay for reports, only insurance companies do for workcover related claims which is not medicare related. The rebate is the patient's rebate, if they bulkbill they are basically streamlining the process by accepting the MBS rate as your fee. The patient receives the rebate and a GP charges the patient whatever their consult rate is, like any other professional service such as accounting or legal fees. If there wasn't Medicare you would just pay 40-100 each time you see the doctor like in the States. Dentists were smart not to opt into it
Please give me an example of three private business that offer a 50% discount for pensioners, go.
Please give me an example of three private business that offer a 50% discount for pensioners, go.
Sure. These are just a few common examples NSW:
- Peppers Retreats, Resorts, Hotels offer 50% off on a range of locations.
- Church Point Ferry Service offer a 50% concession fare.
- RSPCA offers 50% off adoption fees.
- Coonabarabran Golf Club offers 50% off yearly memberships.
- Tooleybuc Sport & Rec offer 50% off memberships.
- Lucky 7 Coffee shops offer 50% off if your a pensioner on a range of drinks.
- Shoalhaven Heads Bowling & Rec offer 50% off gym and rec usage.
- Poppy's Florist offer 50% off delivery fees.
- Wyong Race Club offers 50% off admission fees.
I mean good grief man, you can find entire state based directories for this stuff, broken down into regions it's so common place for businesses to offer discounts of that type.
No government agencies pay for reports
That would be incorrect. Government agencies can request (with signed permission) and pay for a range of documents on behalf of their employees/contractors or themselves, including copies of transcripts / commercial or heavy licensing documents / translations of medical reports / independent written medical advice / etc……. and a wide range of certifying documents on top of that. Separate to that type of work, GP's can also be requested by government agencies to take part in research projects, advocacy programs and deliver medical education.
Medicare or public services doesn't pay for ANY part of a dr's income.
Why would you make up nonsense like that? Your normal GP is not classified as an employee, they operate as contractors. When a patient visits a GP, the gap part of the fee that the patient pays is collected by the practice and then at the end of the week or fortnight, the GP's percentage of the gap payments agreed too in their contract terms are paid to them. Separate to that, Medicare pays the doctors directly for the "BB" segment of the consult fee. Medicare pays the doctors for all the consults in a single hit usually once a month, hence the term "bulk billing".
@infinite: May I suggest you actually have no idea what you are talking about in terms of the intricacies of the Medicare system, and it's even more unfortunate you seem so utterly convinced of your expertise on the matter considering you actually own a medical business as you say you do.
The rebate is not a payment to the doctor, it's the patient's rebate which the patient can directly assign to the provider, if the provider bulk bills. In this way while the transaction may be processed to the billing doctor directly but the govt does not pay the doctor. This is what direct assignment means.
If a gap is charged, the patient pays the clinic and have the rebate refunded back to them (the patient) which shows the process a bit clearer. The rebate is irrelevant to the GP in this case, Medicare specifically forbids paying a gap and then 'bulkbilling' pt as was the hurrah regarding the copayment scheme
This is fundamentally why the public is mistakenly under the impression that the government pays a GP a salary.
@May4th: Dear god man, how deep are you going to continue digging this hole for yourself?
The term "bulk billing" was literally coined by Medicare to describe how they pay GP's on a monthly basis.
https://www.healthdirect.gov.au/bulk-billing-for-medical-ser…
"Bulk billing is when a doctor bills Medicare directly for the services provided to you, so you have no out-of-pocket expenses. If you are bulk billed, you’ve agreed for Medicare to directly pay your GP for the service provided to you."
@infinite: Perhaps you'd like to read my comment again for some education:
The rebate is not a payment to the doctor, it's the patient's rebate which the patient can directly assign to the provider, if the provider bulk bills.In this way while the transaction may be processed to the billing doctor directly but the govt does not pay the doctor. This is what direct assignment means.
I'm not going to make any further comments as you seem utterly convinced of your knowledge on the matter and I have neither the time nor energy to waste. I suggest you sit down with your GPs who actually work in the system, as it's very clear you don't, to get properly educated given your financial interest in the system
If life were so hard for doctors, you wouldn't have near infinite lines of people wanting to get into the profession willing to spends hundreds on the GAMSAT + test prep. There is a reason so many high school kids want to be doctors, because it's probably the best profession to get into to guarantee a comfortable salary after a few years.
So tell me why there is a massive Dr shortage!
There's a massive doctor shortage because medical degrees are insanely expensive and complicated to run and are generally not profitable for universities without substantial supplementary funding from the government. As a result there are nowhere near enough university places in medicine as there are people who would like to study it.
With the exception of some narrowly targeted alternative pathways (primarily for rural and disadvantaged students) the average tertiary entrance rank (ATAR) for admission into a medical degree in Australia is 99 or more (several are 99.85 or 99.90). What this means is that you have to be in the top 1% (or top 0.1%) of students in the country to even be considered.
ATAR ultimately is a reflection of demand. It is not set by the universities as some kind of minimum quality level. It is purely a reflection of the amount of completion from students for a limited number of places. If student demand for places were to drop then the ATAR would drop too.
I have mates who are doctors, and many friends who are lawyers, accountants or work in finance. The three latter groups of friends would have 100% gone into medicine if their marks were 1 or so marks higher needed to be in that top 1%. The fact they were top 2-3% made them ineligible purely because of what you stated correctly - a reflection of demand vs the university places on offer.
This is what I just don't get. So many people hold up this "shortage" as some kind of proof we don't pay GPs enough, it's as if they've never applied for uni and seen how ATAR works?
If we had more places and the ATAR was only 95, there would be absolutely no shortage of doctors of any kind. And frankly, given i've had multiple wrong diagnosis and even incorrect reading of test results from multiple GPs, i can't imagine dropping the standards slightly is going to do any more damage to their rep.
It's because Universities have an ideological problem with GP practices. They are seen as "private enterprise" by Uni academics and as a result, there is literally no requirement or encouragement to ever spend a single day in a GP practice to get their qualifications. Med students will literally spend 1000 hours working in a hospital under supervision, sometimes assisting in work considered some of the most high risk procedures medically possible & never spend a day in a GP practice at all. It's literally not even a requirement to spend a single day in a GP practice to become a practicing doctor.
It's not an issue of GP work being unrewarding (it's highly lucrative, especially being a partner or part owner), it's that the medical training pathway is intentionally designed to exclude GP work from it, so as a result, it's not even considered as an option by a large number of med students. Which is crazy, because a large chunk of highly successful specialists use being a part time GP as a base to gradually work their way into huge money specialist careers (GP's are the primary source for specialists being referred patients).
The Federal Government should be mandating that all Australian Uni's who deliver medicine pathways must include some form of GP training and experience in the final study years, to allow GP registrars to get out into the field quicker and in bigger numbers.
The Victorian state government's decision to introduce a new Payroll tax on GPs will destroy what little bulk billing we have left in the state as well as kill off GP clinics.
I can't believe there isn't more outrage over this disaster?!?
Who'd have imagined that doctors might have to pay exactly the same state taxes that everyone else does?
Doctors are contractors, not employees. It's literally an additional tax for them on top of the regular taxes they already pay like anyone else who is a contractor.
That cost will be passed on in it's entirety to the patient, exactly like it would be to a customer in any other industry. The Victorian government know that and couldn't give a sheeeet.
The whole sham independent contracting thing has not been acceptable in this country for some time. https://www.fairwork.gov.au/find-help-for/independent-contra…
Also, sure, the cost will be passed onto patients, that's how expenses work. As you say, that's how everyone's expenses work. I'm just unclear why doctors think that the law doesn't apply to them.
And yes, it's "the Victorian Government" in an abstract sense, in the same way that when the ATO makes a determination it's "the Federal Government", but you make it seem as if somebody passed a law or something.
All that's happened is that state revenue offices, in both NSW and Victoria as it happens, have correctly determined that sham independent contracting arrangements used in medical practices are a tax avoidance scheme.
As Revenue NSW notes, "the medical centre has operational or administrative control over the practitioners if it is able to influence matters such as who practices at the centre, the hours and days when they practice, and the space within the centre where that occurs", amongst many other things.
The whole sham independent contracting thing has not been acceptable in this country for some time.
The RACGP oversees the professional requirement for GP's to be contractors except in a few scenarios. The RACGP does that due to the federal government and ATO's requirement for it. GP's didn't just come together as a group one day and decide to structure themselves to work that way.
And yes, it's "the Victorian Government" in an abstract sense, in the same way that when the ATO makes a determination it's "the Federal Government", but you make it seem as if somebody passed a law or something.
The Victorian revenue office is literally applying a state law (Payroll Tax Act 2007, V37) amended on 1/9/2023 to enable them to apply the additional tax.
have correctly determined that sham independent contracting arrangements used in medical practices are a tax avoidance scheme.
Other states have gone out of their way not to do the same thing, clarifying specifically that GP's were not avoiding tax & that an additional payroll tax would just be revenue raising and nothing else at the expense of the sick and poor:
https://thewest.com.au/news/wa/wa-government-confirms-gp-pra…
Looks like a lot of people in this thread are just looking at the job and $$$ they earn.
There wouldn't be a Dr shortage if every nitwit out there were able to make it through the training and into the profession. Supply and demand, not everyone can do the job (even less that can do it very well) and thus they are remunerated appropriately.
lol at people who are tired from their basic job complaining that a GP is out earning them. No sh*t sherlock, you didn't go to university and spend 10's if not 100's of thousands of dollars to be able to enter this vocation and contribute meaningfully to society.
Just to note, there are definitely horrid GPs out there working out of huge clinics just trying to rush every patient through - I'd implore you all to leave negative reviews to prevent other patients from experiencing the same.
A lot of people in this thread seem to not be engaging with reason that this thread exists. This thread exists because well paid doctors are complaining that they are not well paid enough.
In order to determine whether doctors are getting paid enough it is necessary to understand how much they get paid in the first place - it's inherent to the nature of the discussion that doctors appear to want to have.
As others have pointed out, however, doctors would prefer it if the discussion were limited to matters other than their overall annual take home salary, because if the discussion was based on how much they make a year instead of how much they allegedly make per consultation (as 'proven' by some rubbery back of the napkin calculations) the tiny violins being played in this thread would be even tinier.
Nobody would be complaining here if doctors had simply stayed home to enjoy their wealth instead of posting on Reddit or OzBargain telling us all how much they're struggling.
How do you know that the reddit threads have not been posted by trolls pretending to be well-paid doctors crying poor?
No one on Reddit even has a high enough IQ to work as a minimum wage office admin for a GP, let alone actually be a GP.
Given the frequency with which the exact same taking points appear in the media, and indeed given that it's a position that the Royal Australian College of General Practitioners and the AMA have been campaigning on for some time, I think we can be fairly confident that it's not been posted by trolls.
https://www.smh.com.au/healthcare/i-m-a-gp-and-i-m-sorry-but…
https://www1.racgp.org.au/newsgp/professional/gps-can-no-lon…
https://www.ama.com.au/articles/more-trouble-ahead-general-p…
@AngoraFish: The RACGP is just the professional body for GP's and the AMA is just a political lobbying group for doctors in general. It is literally their function to politically and publicly advocate for more money for their members, like any existing industry association group does.
That's in no way or form an indication that their representations are valid, accurate or trustworthy in the context of allocating taxpayer funding. No state or federal government has taken anything either of them have said seriously for years now, outside of anything that may be found to be politically advantageous at the time.
I mean, it can easily be argued that an annual financial health check from a financial advisor is as important to one's overall health in their lifetime as a yearly GP checkup is. No financial advisor is getting subsidized by the government though.
@infinite: Oh, I largely agree.
I was just responding to the comment How do you know that the reddit threads have not been posted by trolls pretending to be well-paid doctors crying poor?.
I can see the source of the confusion though. The comment I was replying to appears to have become disconnected from my reply by the page break between pages 1 and 2.
For anyone coming late to the party, I presume that this break will be rectified as more posts are made on page one and that the original comment will eventually be pushed over to here. *edit: which I see has now happened immediately after I posted this.
@AngoraFish: You just proved my argument. Trolls just love taking inspo from the articles you just linked
@[Deactivated]: I 'proved' your point? Which was what, in fact? I can't comment on hypothetical 'trolls' in this instance, unless you have some additional evidence or inside information that you're not sharing, but in the end your post is meaningless in that every anonymous post on social media anywhere can be dismissed as 'trolling' based on… reasons.
What we have, however, is Occam's razor, which might lead one to conclude that someone who claims to be a doctor and who is parroting the talking points widely being circulated by doctor's organizations is probably a doctor, or at least, associated with those organizations in some way, in the absence of any evidence to the contrary.
Regardless, in the end your whole argument is literally irrelevant as it's the expressed opinions being ridiculed, opinions that are self-evidentially held by a great many doctors and that are being given widespread coverage by and credibility in the media, not the specific individuals who posted these particular contributions to that lobbying campaign.
Supply and demand, not everyone can do the job
Horse-shit. It's a racket - controlled intakes. People can't simply be smart enough to study medicine, they have to compete for X spots.
It's actually the exact opposite of supply and demand, it's regulation and intervention.
This is correct.
Australian Universities have intentionally and dramatically limited the intake numbers for medical students to artificially create an insane demand for it. They've done this while also simultaneously offering unlimited spots to foreign students who are willing to pay cash up-front. We could easily quadruple the annual intake for medicine with nothing but high achieving Australian students going through, but the Universities are refusing to do it because it's a cash-cow for them that allows them to offer a huge amount of arts-based degrees that offer no career paths outside of Academia or at all. Which is absolutely appalling, given that higher education in Australia is funded primarily by taxpayers to the tune of approx $20 Billion a year.
Medical degree is not easy for international students to get into either, unless you are talking about getting into the basic biomedical / science degree (which for some uni is the pre-requisite before the medical degree)?
The proportion of our tax spending on education is also not very high, usually only around 7% annually. Most of these are spent on CSP, and the number of medical students on CSP is the third highest just below Agriculture and Nursing, followed by Science. So funding towards this field from taxpayers money is already pretty high. International students also help fund a lot of our higher education. They contributed $30B to the economy just last year, so I guess there has to be some balance to get funding from both ends.
And I dont think it is as easy as flicking the switch to increase university intake to pump out medical professionals - we still need people to teach / guide these students. Also considering the stress of medical degrees, I wonder what's the drop out rate would be if the entry requirements are lowered?
Nail on the head.
Doctors will complain about the long hours, but they pay their dues to the AMA, and the AMA (just like almost all unions) will fight on their behalf to keep the power concentrated. Just look at the pharmacy guild and the fuss they've kicked up over 60 day scripts. Its hard to make any progress when anything that's good for society gets fought by the powerful minority interests.
The low amount of doctors isn’t a reflection of the quality required, it’s the small amount of places available (supply and demand) likely due to the high pay. It’s artificially created as if the shortage is decreased they won’t earn as much as they currently are.
There are plenty of specialist PhD fields that are harder than medicine, that will never get the respect simply because they won’t earn as much.
Ever wondered why you need top tier ATAR to get into med school? The answer is not that you need to be the best and brightest…
Got a top tier ATAR, UMAT score enough to land an interview, test >2 standard deviations above the norm in psychologist administered IQ test. No, the brightest don't always become doctors because of the admission system.
GPs cannot afford to bulk bill is more accurately GP practices cannot bulk bill.
GPs are generally hired as contractors so a percentage of what they earn goes to the practice and the rest goes to the doctors.
Many practices are owned by GPs and some are owned by private corporations.
Broadly speaking with how Medicare is set up many corporate practices focus purely on maximising Medicare billings
For example if a new patient has a cold, needs a script for 5 different medications, wants to get a skin lesion checked
The rebate would be about 75 dollars for 30min consult.
Or if that is broken down into 3 short consults it’s 40 dollars per item.
A corporate practice would definitely try to “spread out your care” which costs the government more money.($120 over 3visits vs $75)If you were the doctor earning which approach would you follow? 3 separate consults or 1 longer consult that earns less then run behind and make the other patients wait?
Broadly speaking private billing allows for a doctor to be more thorough and be more willing to do longer consults which can “save” money and your time.
The other consideration is that wages need to be competitive. If a GP can earn 50 percent more at a different clinic set up
Better and busier is that better?
The only way a smaller clinic that has longer consults can be competitive is to charge for consults.When there is a GP shortages some of the proposed solutions can be too get more international medical graduates and the medicine is often run differently to australia and expectations are different oversea.
The most common thing is about colds- it takes more work and expertise to tell which baby/child 1 year old does NOT need antibiotics.
That is a skill. Would you be able to see 1000 colds and tell 1000 of them they do not need antibiotics and confidently not end up with any of them dying?
Medicine is made out of people who have medical degrees. Human beings. Most of which try to contribute positively to society but do take into account how much they are earning as well.For the people who say all GPs should bulk bill
if you were a great GP and you found a clinic that private bills and let’s you take your time and do longer consults- which actually saves the government money- would you do that or would you choose to work at half pay knowing a lot of your less competent colleagues are earning more than you?
A great GP could sometimes bulk bill someone who is genuinely in need but there are plenty of patients who spend their money on cosmetic surgery which they see as a luxury and see GP as a basic commodity.If there is currently a shortage of GPs and the public perception of GPs is that GPs are rubbish and we should pay less money-
Less great doctors will choose to become GPs - then the problem will get worse and you can get more international doctors.
In certain Asian countries every cold will be a 2minute consult and get antibiotics. Would our health system be better like this? Many don’t perceive value in not getting antibioticsThe value of GPs come from preventative health - stopping someone from smoking will have a bigger impact than almost any surgery you could have.
Or controlling your blood pressure or diabetes.
There seems to be a preconception that anyone could do a GP’s job but
1. How many people can sort out diabetes
2. Tell 1000 people not to take antibiotics without causing harm
3. Tell when abdo pain needs to go to hospital like testicular torsion or mesenteric adenitis or heart attack or oesophageal varices
4. Tell someone with mentrual bleeding when they need to see a specialist
5. Diagnose and break news of cancer
6. Explain mental health and help someone through a divorce/bereavement when they need stress leave and medicationsAsk the GP how to get diabetes sorted and see if they can- or Google and see if you can try and manage that instead.
Doctors are humans who have done a medical degree and may look up the guidelines that they know some about- but better a doctor that keeps up to date and recognises they need to refresh their memory than one that doesn’t bother to check and gets it wrong (like the dose of a medication that isn’t used often)Doctors are people who have undergone medical training and just as there are good teachers and bad teachers there can be good GPs and bad GPs who have gotten burnt out or just optimising cash. But there are good GPs to be found and the solution isn’t to drop the quality of GPs.
Also consider this scenario-
you did an undergrad degree like business and worked for 10 years
Your finances might look Iike this from the first year of working
1st Yr 50k
2nd Yr 55k
3rd Yr 60k
4th Yr 65k
5th yr 70k
6th yr 75k
7th yr80k
8th yr 85k
9th yr 90k
10th yr 90k
720k after 10 yearsIf you decided that instead of working you did 4 years of medical school this is what your life would look like
- 10k Centrelink med school
- 10k Centrelink
- 10k Centrelink
- 10k centrelink
50k school medical school debt net of centrelink
- 90k based on 8-5 (1st year working)
- 95k
- 100k
- 105k
- 110k
- 115k
615k net after 10 years when you have not
Completed trainingHospital pay is not as much as people think and yes there is a lot of mandatory overtime that doctors don’t actually want to do and result in missed weddings and birthdays.
Financial position is worse off then doing a normal business job after 10 years. GPs take 3 years to specialise in.And when people finish qualifying they do take into account money and life circumstances so employer do need to be competitive.
Also there no wage paid for the time spent studying.If you started a clinic tomorrow wanting to survive and employ good GPs you would need to model and juggle around Medicare, patients, and doctor expectations.
If you started a clinic that bulk bills everyone you would not be able to survive getting enough other doctors to work with you and work ethically and take enough time with each patient.
Even if you got every GP today to agree to bulk bill - you may benefit short term but you will see further drops in the quality of GP as more people will choose to work in other specialties.Hope this gives some perspectives.
To end off broadly speaking if a doctor just wanted to earn money they would choose another specialty like cosmetics.I would encourage you to have a chat with your GP about what they actually do and if your further encounters still support the belief they don’t know much then find another GP.
If after seeing multiple locally trained GPs you still feel that every GP you have ever met has been incompetent then the likelihood is you have a warped unfair view which cannot be changed.Nice flawed calculation, you missed out the fact that business undergrads have no hecs school debt? Same with any other undergrad degree.
Medicine is a post grad so you can add the under grad debt to both calculations.
I mean if you still count it as flawed and that’s all you got out of it then so be it.
Part of the issue is not just GP remuneration but how it compares to other medical specialties. Graduates aren’t picking GP because it’s not as well remunerated. Primary Care is the most efficient way of spending health dollars and it should get more of the pie. There’s a lot of misunderstanding of the system in some of these comments.
For the doctor in the reddit thread that claims to only see 1-3 patients an hour, I will say that is not the norm. All the GP visits in my lifetime have only lasted between only 1-5 minutes MAX. These ranged from sickies to a doctor which i had to go back 3 times because the medicine prescribed wasn't working on my arm infection.
The average is absolutely 5-8 an hour face-to-face, 12-14 an hour via telehealth.
You have different scenarios again for off-site / nursing home visits, then super high rate "pump & dump to the nurses" type stuff like 15+ patients an hour immunization days.
There's definitely the outlier slower paced days though to be fair, like when multiple patients fail to show up for double bookings, psych patients lose their shit in the waiting area and have to get kicked out by one of the admin staff before they come in for the consult, an older patient has a stroke and has to be monitored until the ambo's arrive, there's a bad reaction to a Covid booster, etc…..
you are delusional with those numbers, it's mostly young healthy well people who go in for a medical certificate thinking that's the norm. it takes longer than 5min for an elderly pt to walk in and out of a room and get their shopping list out
GP practices break down the numbers based on consults and types of consult. Older patients can take longer, that's true, however if they take longer it's of no difference ultimately, because that type of consult is registered as a double or triple consult depending on the time the consult lasts for and then a fee charged as such. So there's no difference if it's 3 patients in an hour each with a double appointment and then a 4th with a single for that 60 minute period, or 7 patients in the hour with 7 single appointments.
@infinite: 3 consults on a level C is already minimum 60min by definition - how are you squeezing another 4th appointment in that hour?
of course you are financially better off churning through 6 an hour, medicare is flawed in that it rewards simple/singular issue consults with high turnover, which just rewards bad 5 min medicine.how are you squeezing another 4th appointment in that hour
Because consults can be as low as 3 minutes if it's just for a simple flu jab update or telehealth call to give a negative result. A "double" is not indicative of anything other than two consults. Consults vary in their base time and have different billing codes attached & gap fees charged as such.
Good GPs are very few and far in between in my experience. That tells me that something is broken.
On another note, it pisses me off that I need to pay a gap for a stupid medical certificate. Telehealth medical consultation for trivial stuff should be bulk billed and more common I think. May be there is a gap in the market?
Good GPs are booked out weeks in advanced. You know crappy ones that you can see withing the hour. There needs to be better ways to get medical certificates and scripts. I get annoyed paying $80 for a 5/10 minute visit just getting my scripts renewed.
good to pay for gap if the GP is good and fix what my health issues im in that clinic for.
The good GPs dont charge too much gap or no gaps and helps patients, but still drive luxury cars.Not good to pay if the GP sucks, and have to keep paying gaps for a bad GP that pushes patients in 5 mins out their room.
I had GP that was googling what i ask and saw him driving a Mercedes, but lucky he didnt stay long at the clinic.
I think they get referrals $$ when they refer to specialists and products?
I dont know why people are blaming anyone but the government. GP deserve to be paid well, citizens deserve affordable healthcare. We are heading like America where people put off getting medical help when they need it.
Because even a salary employee GP is taking home upwards of $200k a year after costs. Pretty simple.
A large percentage of what they do could be offloaded to nurses and pharmacists, eg gatekeeping basic prescription medications. Which would allow bulk bill rates to cover those 2 minute consultations.
I don't get why people think GPs cannot set their own rate? As much as I hate paying the gap now, the low rebate was set by the government. It should be the gov's job to do something to address this?
GPs are essentially providing services like any other businesses, and I'd think the rate also comes down to demand/supply. If people think being GP is easy and has such a high income, why don't those people study/train to be one? Increase the supply, and hopefully we'll see the price comes down?
Also considering how expensive tradies are these days to do "simple tasks", GPs-equivalent "simple tasks" should also be compensated accordingly imo.
Why are people comparing doctors wages with tradies?
The comparison can be with any other professions too i guess.
But why not tradies?
The length of task can be quite similar. Both are doing highly specialised tasks for a few mins and charge a significant amount?It's literally in OP's linked post: Is there even a tradie in Australia that would pick up the phone for a job netting them $19?
It's doctors making the comparison with tradies, generally with the self-evidentially false claim that tradies make more money than they do, and also completely missing the point that tradies tend not to sit around in air-conditioned offices while clients are funneled into see them in convenient 15 minute intervals.
As an aside, I've personally never had a tradie try to charge me for a 5 minute phonecall.
Neither do I, but half of the tradies that I called never picked up the calls or call me back.
Many that pick up the call will often say they cant help/diagnose unless they come onsite to check, and that will cost me a call-out fee + 1/2-1 hour rate (which is fair enough, they need to travel).So it is probably fairer to compare my 5 min phonecall to a tradie, to my phone call to a GP clinic to arrange appointment (before I started using online booking). They don't normally charge me either as they don't have my details, and both do not resolve/help in any ways other than getting quotes or appointments.
naieve to think manual work is harder work than an office type work. mental stress is much more insidious than the tolls of physical labour
@May4th: Having worked both in a trade and now an office environment in corporate I can say both have mental stress. Just because someone works with pipes or electrical circuits doesn't mean they don't have mental stress.
@Phlume: that's not what was suggested - quite the opposite - a lot of people seem to make the assumption that sitting in an airconned office all day means it's the easiest job in the world. imagine someone walking into your room every 15min with complaints of aches/pains/anxiety/depression/social issues you can't solve all day every day without a minute down time and see how long you can last
I appy a twitter character limit to OPs/comments so intentionally missed the reference. And now, that you've bought it to my attention, I'm thinking no way would a REAL Dr compare themselves to a tradie.
As an aside, I've personally never had a tradie try to charge me for a 5 minute phonecall.
Tradies charge a call-out fee to inspect & quote.
If patients thought they could get away with calling their GP then why would they make an appointment? And with some chronically ill patients and the elderly, how many do you think would stick to a 5-minute phone call?
If only it were that simple to be accepted into medical degree program.
I actually don't know how difficult. Is it mostly based on luck or academic?
I've never attempted as I don't think I have the capability to get into one, looking at the type of friends / acquaintances that got accepted into medical degree program. They are mostly the smartest (academically) & most hardworking peers in my cohort. Couldn't judge how much luck plays apart in their entries though.
It was the ALP who froze the Medicare rebate. Anyone with 10 functioning neurons can see that the ALP hates the poor. All the ALP cares about is inner-city elites. Put Labour last on a ballot paper.
We're on the brink of an economic meltdown. When you hear a doctor, of all people, lamenting about financial difficulties and struggling to maintain payments for their fifth mansion, it's a clear sign that we're all in deep trouble.
Here’s an idea, since all you a**hats know so much, become a GP. What’s stopping you? Go make that cash, go buy that Porsche, it’s effortless free money right?
Go on, just become a GP already.
Found a GP.
Assumptions make an ass out of you.
Too stupid to become a GP, too poor to drive a Porsche or own a mansion…Satlbae…is that you?
I see you are also making assumptions
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▒▒▒▒▀▀▀▀▀▀▀▒▒▒▒▒▒▒▒▒▒▒▒▒@Spootage: Sorry, didn’t realise you were a fellow GP. Let’s leave the salt throwing to rest of the poor people.
Massive amounts of people would and could, if not for the fact that the Australian Federal Government allows the Universities we fully fund and support with our taxpayer funds to choke the supply and skyrocket the demand by artificially limiting the number of places in medical degrees to Australian students.
The Federal Government should be mandating that all Australian Uni's delivering medicine pathways must include some form of GP training and experience in the final study years, to allow GP registrars to get out into the field quicker and in bigger numbers. They should also be forcing the Uni's to quadruple the annual med degree intakes, or take away a percentage of their tax payer funding.
An associate of mine is a doctor at the hospital. He often brags about how he regularly forges his timesheet in order to get paid more, or hang around the hospital chatting to nurses and getting paid OT. I know this is a case of "hate the game, not the player", but he's told me all of his colleagues do it.
Sounds to me like there is a cultural problem in the medical industry.
Honestly a lot of the health system is taken up by people just getting scripts refreshed (which is a huge cost to the taxpayer and an easy $60 for a 10 minute conversation.
I think most angsty people here misses the point of those posts.
They are merely informing you why they are increasing gaps, since they've absorbed the stagnant rebate cuts for so long.
Much the same way as restaurants or trades increases their prices for the 7th time in a year because of "global supply constraints"
They are not there to make up a sob story to make you feel sorry for them, nor do they need it.
You can pay the fee or you can go elsewhere, I doubt they'll shed a tear either wayI'm sure there's worse things to become but I'd never let my kids become a GP, the amount of work you put in and the payoffs, as well as the public perception of them very evident from posts here are just not worth it.
The amount of work is about the same as a teacher. Society just value teachers alot less and so they get paid alot less. Better tell your kids not to be a teacher too.
Our doctors do a really good job though, unlike our teachers who are miserably failing our children worse than ever before, while still crying for more money.
Rough calculation on a bulk billing doctor earnings -
Patient Rebate: $41.20
Minus Clinic Fee (35%-40%): Let's assume a 40% deduction: 0.4 * $41.20 = $16.48
Minus Personal Tax (38%-40%): Let's assume a 40% deduction: 0.4 * $16.48 = $6.59
Net Earnings per Patient: $41.20 - $16.48 - $6.59 = $18.13
If the doctor sees 4 patients per hour, their total earnings per hour would be:Hourly Earnings per Patient × Number of Patients per Hour: $18.13 × 4 = $72.52
minus 10k per year for insurance, 10% super, 25% for annual leave/personal leave
not looking like a very tall poppy is it
Minus HECS loans through their med schools.
72.52 x 40 hours per week x 52 weeks is over 150K after tax and expenses without considering tax deductions. Thats a pre-tax income of about 280K at least. Doesnt sound average to me.
No way its 4 patients per hour. More like 6-8, and potentially even 10 to 15.
most doctors i know see a patent every 5mins or less…..
they could easily hit 30-40 contacts a day and even fill 2/3rds of their day
and if they see 12 patients an hour?
no issues with a 10-20 dollar gap when GP are hitting the 40-60 dollar region when they spent a total of 3mins with me i start to question if they are simply just 'ripping me off'
I wonder if any trade or industry will come in and cry oh i am earning too much! This is not right !
LOL they are comparing themselves that a lawyer will not read a document for X amount.
Does lawyer has clients who walks in every 10 mins ….. And GP work 80% of the time is very relaxing…
All I can contribute is all my friends and family friends who are GPs would be classed as at least upper middle class or higher. Quite a few of them have single income and their partner is the receptionist. Quite a few of them even have a couple of half days and a couple of full days (2 hour break for lunch) 9-5 hours. I dont know a single one who i would class as being middle class or lower. I dont know if I just happen to know all the lucky GPs but these are people my age (my friends) as well as my parents age…
I dont really think GPs are struggling.
Doctors crying poor and needing to be paid more isnt going to attract much sympathy. At 300K or thereabouts a year (at least), you're not going to convince many that you need more. Not to mention the allowances and tax deductions available to the medical profession in general… but hey everyone has a reason for deserving more, right?
I Say Doctors like any other service provider set rates that reflect their market value and operational costs and stop bulk billing. They should collectively band together and set fees to "What the market will bear" and given the relatively scarce resource that they are they sky is the limit $400 for a standard 15 minute consult should be the norm. Abit high you say ?…well what are you going to do about it ? go to emergency hahahah good luck waiting 16 hours to be triaged to get a script for your blood pressure medication .Why does this profession accept peanuts, are they are charity. The RACGP need grow some balls and act like the CFMEU. Workbans, blockades, thug tactics. You come in with an iPhone and want to get bulk billed , sorry GTFO that will be $500 for the consult . if you can afford a $3000 phone you can afford to pay $500 for your health.
GPs are not competing with the general public on incomes.
They are competing with other medical specialties.When your colleagues with medical degrees can earn 2-6 times your income, and not have to put up with ignorant public commentary about primary health care (good luck if we lose it…it is already happening), why would people choose to do it? We will continue to see the erosion of primary care in this country unless GPs are remunerated at a level closer to other specialties. GP training places go unfilled because there is no demand. GPs are imported from overseas and forced to work in specific areas to prop up the system. Yes, GPs can afford to pay their bills. Yes, ignorant people who think they can do our jobs will whinge about our incomes (maybe they would not if they could see our hourly rate taking into account unpaid work and costs). Clinics however will continue to close and people won't be able to get appointments. Gaps will continue to rise because the medicare rebates are inadequate. Public and preventative health will deteriorate. Hospital costs will increase. If you fail to fund primary care, the health system will fail. GPs cannot be replaced with nurses and pharmacists. If you think that you have no idea what we do.
You are correct
GPs THINK they compete with specialist, it is arrogant to make such comment and Specialist doctors would disagree with you (No matter what the RACGP put on the billboards GP is not seen as a specialty among medicos). Just like all the comments from GPs saying if you want to earn what a GP earns then go study med Blah Blah Blah then I will say to GPs if you are so good then why didn't you become a specialist (You obviously know why)GPs are not competing with general public on incomes. Firstly why do you see it as a compeitition and secondly people in General Public can be CEOs etc as well. Thanks for talking down to us
Lol, this is the problem. I could have been a specialist easily but there are multiple reasons. I have seen many specialists that I often question. I'm not comparing myself to anyone but I charge what I am worth because I am a business.
They 100% just advise you to go see a GP, with the exception of any health condition that you should immediately take to the nearest hospital.
They simply operate as a free triage hotline.