Canberra – where political spin is done with a capital “S”.
It certainly is true that there are more GPs in Canberra but lets look at who they are and where they work:
- Most of the new doctors are not locally trained Graduates coming up through the system – they are overseas trained doctors who are in many cases not yet fully registered and have to work under supervision.
- Most/nearly all of these newcomers have been recruited by large clinics with ten or more doctors – these are entities run by Corporates or businessmen or propped up by very large Government incentives and not to mention some very “unusual” billing systems which Medicare choses to fully ignore. Let us also not forget the $ 17 Million spent on building a Super Clinic.
- At the risk of stereotyping – how do most of these new doctors work? In some of the Corporate Clinics it is all about 6 min bulk-billed rush jobs. Never the same doctor and pretty ordinary quality of work. Some of the other large clinics may have longer consults but they also need to somehow re-coup the costs of importing doctors so how do they do it? Mostly by becoming “Referrologists” – these GPs don’t do much more than write requests for test, Referral letters and prescriptions. Anything that appears a bit more complex and chronic is referred to the Allied Health Worker down the corridor (with the obligatory Careplan to go). If it looks a bit more acute then you get sent down to the local ED with a scribbled note (does not really matter what you write – no-one reads it anyway) So these guys are dumbing themselves down, deskilling themselves but hey, they make good money and the numbers look great for ACT Health’s press releases. The most scary part of this sector is that they are the ones who are now teaching the Registrars and Students – it is a real worry what our next crop of doctors’ attitude towards Medicine and patients will be like – I am sure they will all be nice little bureaucrats who can negotiate and delegate but can they actually put a suture in and take a bloodpressure reading without asking someone else to help/ do it?
Then there is the rest of us – small 1-3 doctor clinics fighting for survival. We cannot afford to Bulkbill like the Bigboys nor do we want to work like them. We still believe in a cradle to grave approach and taking however long it needs to take to see a patient. Unfortunately this is a terrible business model which means that we cannot afford to spend $ 50, 000 or more to import a new doctor or take time away from patients to teach Students. We could certainly play the games others play in using Allied Health workers to do our work for us but personally I believe I should look after my patients myself – and I believe my patients prefer it this way.
I guess mine is an outdated and dying approach – this is why we hear about small practices closing up all over Canberra. They either just give it away or join up with the Bigboys.
Ironically the patients still seem to prefer our model – recently we won a “popularity competition” run by one of the local Radiostations. Strangely enough the comments by the voters did not really tend to say much good about the large clinics – they preferred personal attention by a doctor who knew them and cared about them.
If only we could marry this into a system where that actually translated to bills being paid and us actually seeing our kids when they are awake.