Medical Centre No Longer Bulk Billing - Requiring Copay

random12 on 20/08/2022 - 21:18
Last edited 20/08/2022 - 21:19

I know there have been new articles and doctors whinging about the medicare care rebate not being raised for ever.

My local medical centre just announced that they are moving to a copay system. Now its going to cost $80 for a consult, and medicare rebate is $39.75, so the person pays $40 out of pocket.

The doctors claim they are going broke by just taking the current $39.75. I don't think that is the case. But even if it is, in what world does someone go from claiming to be going broke to doubling their revenue.

Health & Beauty

Comments

      • spydaboi on 21/08/2022 - 12:21
        +2

        Never does anything else except generate the scripts. Maximum 5 minute consultation. No discuss reviewing medications, no bp check, nothing else. I have twice caught the clinic claiming care plans with several referrals being claimed against my medicare number. Never ever had a care plan! Got stuck into him and advised him if it continued id report it to medicare. If I needed a care plan organised I wouldn't qualify because they have claimed fraudulently within the time period. He was shocked someone actually checked their medicare claims history.

        • eldudebrothers on 21/08/2022 - 12:43

          wow, if true, that is quite concerning

          • JaneSong on 21/08/2022 - 14:08
            +2

            @eldudebrothers: Happens all the time. I even know of doctors that put in visits for people that never visited.

            • Pete10001 on 21/08/2022 - 16:51
              +2

              @JaneSong: I noticed the same thing when I obtained my Medicare history. Visits to the Doctor that I never made. I think the current system is broken as there are insufficient checks and balances to ensure that the system is not abused. It's like giving a blank cheque to someone. Nowadays with electronic billing patients are usually not even aware of what they are billed for and do not need to sign anything. Throwing more money at it is not the way to go.

        • AusGP on 21/08/2022 - 13:47
          +5

          That's medicare fraud - literally a crime…

    • Ahyao17 on 22/08/2022 - 11:45

      You are a pensioner and on long term medications yet your GP doesn't ask many question or do any assessment on script renewals. Either he knows you really well and would realise something is wrong by just looking at you and doing small talks, or he is not doing his job properly.

      Chronic disease scripts last 6 months for a reason. A good GP will run a routine panel of tests every 12 months on someone like you to make sure things are going steady. (This is where he could legitimately charge 36 rather than 23, but probably would taking 10 minutes or 5).

      But the medicare freeze in the past 10 years or so really force this on the doctors.

      Consider changing a GP, most places bulk bill pensioners, even the non-bulk billing centres, you just need to ask.

    • randomvis on 22/08/2022 - 20:46

      Just a point, the consult to the doctor doesn't finish when the patient leaves the room. for every 2 hours of consultation there is probably another hour for notes, results and chasing down patients. A lot of jobs also are not paid or poorly remunerated— one time my wife spent 3 hours dealing with a suicidal teen which required handover with ambulance workers, max charge was only $110.

      Note taking is another time tax that has increased thanks to the litigious nature of patients. Also, sometimes if you are a pain in the ass, some doctors bill you at a higher rate.

      • [Deactivated] on 22/08/2022 - 22:35
        -1

        Just a point, the consult to the doctor doesn't finish when the patient leaves the room.

        True, but from a medicare billing point of view, the timing mentioned in the rebates refers only to time the patient is in the consult room.

        • randomvis on 22/08/2022 - 23:31
          -1

          Wrong.

          Level B

          Professional attendance by a general practitioner (not being a service to which any other item in this table applies) lasting less than 20 minutes, including any of the following that are clinically relevant:
          …

          c) arranging any necessary investigation;

          d) implementing a management plan;

          e) providing appropriate preventive health care;

          in relation to 1 or more health-related issues, with appropriate documentation.

          • [Deactivated] on 23/08/2022 - 06:58

            @randomvis: No, you're wrong. I'm a doctor, it's literally my profession to know this shit. You missed this part on the explanatory notes which mention the time only includes time in which the doctor is actively attending to the patient. The time taken is not supposed to include time when the patient has left the room e.g.:

            Recording Clinical Notes

            In relation to the time taken in recording appropriate details of the service, only clinical details recorded at the time of the attendance count towards the time of consultation. It does not include information added at a later time, such as reports of investigations.

            This is why GPs will often write notes with the patient is in the room to avoid getting getting in trouble with overbilling Medicare.

            I'm not sure why you bolded "with appropriate documentation". All that means is that the person billing that itwm number has to be able to substantiate their time based attendence claim with sufficient written clinical notes

  • peterw1 on 21/08/2022 - 10:41
    +11

    people pay more for a haircut or smokes or grog. Paying $40 for your health is worth it.

  • [Deactivated] on 21/08/2022 - 10:47
    -7

    There are going to be major issues with people requiring consultations to get a medical scrip filled.

    Maybe someone needs to lobby for this be changed. The last thing we need is to fill the pockets of ungrateful doctors after what they did to people during the pandemic, including not disclosing adverse effects and more…

    Typical of the medical profession.. lol…………..

    I sure hope no one is paying $80 to get a scrip filled……………….

    • JaneSong on 21/08/2022 - 14:03
      -1

      This is a known scam run by medical doctors.

      It should not take multiple consultations to figure out what is wrong with someone, doing the minimum work each time just to get paid and milking the taxpayer at the same time.

      • avoidfullprice on 21/08/2022 - 16:24
        +5

        It should not take multiple consultations to figure out what is wrong with someone

        Damn straight you’re right. Base on this one comment you are definitely right 100% of the time. In fact who needs GP??? Just ask google!!! /s

  • Sensiekatie on 21/08/2022 - 11:39
    +2

    Our GP practice has been charging around $80 for quite some time. They have an official no bulk billing policy but I often get bulk billed, especially if I have been recalled after tests or just want scripts. A lot of practices here had given up bulk billing years ago and those that still did didn't always give the greatest quality of care.

    Having said that, I used to see a specialist who used a room in a 7 day GP centre on the week-ends to keep his costs down. He was usually running late. I remember counting at least 13 people going in to the 1 GP working that day. 13 people all paying $90 for an after hours consult and most only staying a few minutes. So the GP practice got $1170 that hour (minus overheads) while my specialist received $310 for an hour consult plus he had to spend time prepping for the consult by going through all the pathology, checking back on history for a refresh before seeing people etc.

  • jrvb42 on 21/08/2022 - 11:53
    -3

    Leave that doctor. Vote for a government that will incentivise doctors to bulk bill. That is, one which will pay them more as a carrot or charge them 80%of any out of pocket expenses they charge as a stick.
    People just do what works for them. If the doc finds bulk billing works for them they will do it. Simples.

    • eldudebrothers on 21/08/2022 - 12:14
      +3

      if this happened, expect no more GP's to exist in a decade.

    • downbythecreek on 21/08/2022 - 12:23
      +1

      Do you have this opinion of every good or service though? Apply what is effectively an abitrary price ceiling to stop them from overcharging?
      GPs are private businesses, they should be free to charge what the market will bear just like any other professional service, landlord, tradesperson, etc.

      • slknv on 21/08/2022 - 13:20

        +1. What I love is comments from people like this OP who have never owned a business, never employed people, never had to deal with government regulations, never had to deal with fairwork, workcover, TAC, never had to budget for a business, do a business plan, take out a business loan etc.

      • JaneSong on 21/08/2022 - 14:05
        -1

        The medical field should be socialised. Why do we have police officers and firefighters on a salary, but not doctors.

        This is why we get all the dirty doctors who go into the field just to make money. It is a real problem. Speak to a child and all they want to do is become a doctor, but ask them why and they will state their parents told them to.

        WTF is wrong with the doctors?

        • AusGP on 21/08/2022 - 14:36
          +3

          It's could be a great idea in theory, but there are a few barriers I see:
          1. Cost - Good GPs will expect to be paid the same as hospital specialists - so think base pay + super + annual leave + long service leave + sick leave + maternity leave + CME allowance + conference / study leave, paid admin time etc.

          Estimates amongst specialist colleagues of mine puts this value at Base pay + 40-50% to compare public hospital work vs private specialist clinic work

          Currently the government are only paying $39 x 4 in rebates for good quality medicine (gap fee funded by patients) without having to pay any admin staff, any rent etc.

          A practice has to probably around $300-$350 per hour to pay GPs the same as hospital specialists after accounting for all the above.

          1. Industrial action / people leaving profession if wages don't match expectations

          Doctors notoriously are unwilling to take industrial action (in Aus anyway). The way I see this playing out is over time if salaries are introduced is that salaries will be squeezed, then doctors will either leave the system and go back to the private system, or just quit the profession, or last resort industrial action. (Just like nurses/fire-fighters/ police take industrial action).

          This is one reason why ophthalmologists can continue to demand huge sums of money from Medicare for cataract surgeries, even though the technology has turned a 45 min operation into a 15 min operation (its currently priced like a 45 min surgery compared with other surgeries). They simply threaten to just go private and leave the public system completely screwed.

          • JaneSong on 21/08/2022 - 15:05
            -2

            @AusGP: What the heck? Why are you comparing a GP to a specialist???

            Are you crazy?.

            Furthermore, all those inflated figures look like you just pulled them out of thin air. Notably you seem to be a shill for the GP team.

            Tell your colleagues to stop billing fake consults please.

            • May4th on 21/08/2022 - 15:49
              +4

              @JaneSong: GPs are specialists according to AHPRA. and from the hysterity of your posts i sincerely hope you find a good GP

            • AusGP on 21/08/2022 - 17:01
              +8

              @JaneSong: Hope you're OK Jane.

              1) GPs are specialists. We go through registrar training, fellowship exams etc.

              2) Yes I detest doctors billing fake consults. Couldn't agree more there. It really requires patients to monitor their Medicare billings to report though. Due to privacy reasons I can't look up my patients billings by other doctors.

              3) Those figures aren't out of thin air.

              For every 7 hours of GP consulting time, it takes me around 2 hours of admin time (unpaid). This seems to be quite consistent including with regards some non-GP specialist friends of mine in private practice. So already true hourly rate is only 78% of your consulting hourly rate.

              Then no super (10%) / leave / CME entitlements.
              Every year that's 4 weeks annual leave, 2 weeks sick leave, ~1 week LSL accrual, 20k CME allowance per FTE, 1-2 weeks conference / study leave. (Total about 10% super + 25% of hospital leave and benefits).

              In summary true hourly rate of 78% of consulting hourly rate, plus missing out on 35% of base pay as benefits. This means a hospital specialist average wage of $150 p/h will take 150*(1/0.78 + .35) = $245 p/h. Most clinics will charge 30-35% service fee to pay for admin/rent/nurses so your billing revenue per hour has to be about $350 to be on par (assuming clinic charges only 30% fees to the doctor).

              Now I could be slow / too thorough but I like keeping on top of what's happening with my patients. Even if you adjust the formula to no admin time at all, it's still 150*1.35 = 202.5 p/h to the doctor to be equivalent to a wage meaning needing a total billing per hour of minimum $290 p/h

  • deeeno on 21/08/2022 - 14:24
    -1

    I went to my usual practice to get an annual specialist referral, was a telehealth appointment, total call time was 1 minute 20 seconds (checked phone logs). Was charged $89 with a $39 medicare rebate, zero consultation and just a call to get a letter emailed. Didn't pay the bill happily.

    • Pete10001 on 21/08/2022 - 16:53
      +3

      This is precisely why the current system is broken.

    • randomvis on 22/08/2022 - 20:49
      +5

      How long did the email take to write with your personalised medical history?
      How long did they take to review the results of the specialist?
      How much did the specialist charge?
      Did you know that General Practice is a medical specialty?

      • MessyG on 23/08/2022 - 12:05
        +2

        This. Patients do not appreciate all the work on the backend of the face-to-face time. No concept whatsoever.

      • deeeno on 23/08/2022 - 17:46

        They wrote the email whilst on the phone to me, it was emailed before I had even hung up, so the email took 1 min 20 seconds at most.
        There was nothing to review becuase I hadn't seen the specialist.
        Specialist charged $0, because I haven't made the booking yet.

      • Clear on 23/08/2022 - 19:08

        Takes little time to write letters within clinical software. They have templates for everything that'll prefill with information like current medication. Then it's a case of changing a few lines and if they have your email it can be sent instantly through the clinical software.

    • dangerdanger on 23/08/2022 - 23:04
      +1

      You paid for their years of medical schooling + training + specialist college years. Not the time it took to create the referral

  • Drakesy on 21/08/2022 - 14:35
    +6

    $39.75 isn't a lot of money when you've invested as much time into your profession as GPs have.
    We still have it far better than most other countries when it comes to healthcare access, i wouldn't complain.

    I'm even for a small copay amount to stop people from abusing the system.

  • Ngliansheng on 21/08/2022 - 15:24
    +12

    I will start by saying that the vast majority of GPs are NOT primarily motivated by money, but money is still a motivating factor with work. If practices could properly bulk bill everyone most would.

    Please spend the time to read this, hopefully you can understand the health system better, have a greater appreciation of your local GP, and consider why increasing medicare funding is a good thing. Hopefully you understand if the GP is ripping you off.

    In the majority of healthcare the norm is to pay for your service, and then Medicare (or insurance) reimburses you for the health service provided.
    In the past GP clinics have just "bulk billed" by collecting this rebate from medicare instead of collecting money from the patient.

    By collecting this amount for the patient - this has resulted in free health services provided by GPs. However medicare has not increased in the past 10 years unlike pretty much every other industry. If rebates (revenue) has not increased over the past years but clinic expenditure has definitely increased, most practices find it difficult to absorb increasing costs of running a business and competitively paying GPs. There has been great opposition to medicare rebates increasing, as people feel that GPs make enough money and we need to keep health care cheap, but the reality is that a majority of GP practices can no longer be financially viable if they were to try and bulk bill and give the same level of service.

    The only way for clinics to be viable is it either to charge a gap and provide the same quality of care, or to try and maximise medicare billings, in many ways at the expense of society.
    Also, there is little understanding about the savings that can happen with good, appropriately remunerated health care.
    When a patient comes in requesting for a routine colonoscopy a GP can "just do a referral" as often expected. Or they can sit there and go through your history, medical history. examine and decide if your situation actually warrants a colonoscopy, and if a patient is counselled against having an untimely colonoscopy that is not needed, this couple of minutes of time would save the public hospital system thousands of dollars.

    Spending time examining a patient with a cold and convincing a parent that antibiotics is A LOT harder and more tedious than just giving antibiotics, but the health system as a whole is much better off if it is not overprescribed antibiotics when not required.
    Whether a GP 'just referred' you without taking a proper history, or spent the time to take a history/exam and "didn't actually refer you", the billing for the GP is the same, but the GP who doesn't explain and just refers the patient ends up getting paid better per hour than the GP who does a proper explanation. However the cost to australians is significantly higher if more unnecessary colonscopies/investigations were not done.

    A lot GPs that can be bothered to take the time to properly explain are working in private clinics or mixed billing clinics (private billing people who can afford to except for children/pensioners).
    Also often these private billed clinics are actually owned by doctors who want to provide great quality of care. Whereas the bulk billing practices are often owned by businesses, where the GPs do have KPIs to keep up, ie doctors expected to see a certain volume of patients.
    If a patient comes in with 3 issues, a bulk billing clinic can sort your problem out one at a time and get you to come back again and again and get 3 billings. Whether its 6 minutes or 16 minutes the doctor gets paid one amount.The private billing clinic will tend to try and look at you and sort you out completely, because the doctor has been appropriately remunerated. Whereas the doctor in the bulkbilling practice is under pressure to just sort you one at a time, and if the doctor worked the same way a private billing doctor does they will get about half the income. In the bulk billing practice generally there is a long wait time and there are patients constantly in the wait room. Whereas in the private clinics generally they will try and place your appointment at a booked slot. If someone does not show up the GP does not have spare patients in the waiting room to take his place unlike in a bulk billing clinic.
    Clinics still run behind - if a doctor sees a suicidal patient and spend 45 minutes, all the cold flu patient who comes for a 5min consult can get frustrated over waiting half an hour just to be seen by a patient. This often gets bulkbilled too.

    Not ALL bulk billing clinics are bad or owned by corporates or poorly run, but with how the system is it is getting harder to do so and it is hard to provide the same care to run a business. If someone was as a doctor and wished to provide quality health care, where would you work? Mixed bills allows for doctors to "work slower" which on paper seems less efficient but they are actually usually increasing standard of care. If a gp was looking for a job the options are often to either work for a corporate clinic which often do have KPIs, or a mixed billing practice where you can have greater satisfaction providing better care.
    Bulk billing clinics can generally only have competitive salaries compared with mixed/private billing clinics if they compromise care. There are exceptions (rural areas with greater billings or clinics that have lower rents or owners that are willing to barely break even)

    Another issue of note is that people sometimes feel that doctors earn a lot so money so wages should not increase. But the reality is that it is, and the most financially well off doctors are the specialists- that continue to have income growth several times higher than GPs. if GP income is not matched then more great GPs will end up becoming specialists because GPs are generally underappreciated by society even though they play a vital role in healthcare - a competent GP when incentivised to work properly can save the health system a lot more money than most specialists can by coordinating care and preventing the worsening of disease and giving properly explanation to patients.

    If everyone's expectation is for universal free health care then please lobby for medicare rebates to increase so bulk billing clinics that want to provide quality care can be financially viable.

    Also, as with any profession there are doctors out there who will just rort the system but the vast majority of GPs wish to do the right thing, but also expect to be paid appropriately, and in today's market the only way we can do so is to do mixed billings. If everyone chose bulk billing then do expect more bandaid type medicine rather than preventative medicine, and in the future we will increasingly see more corporates owning large super clinics with churn and burn mentality rather than doctor owned GP clinics and the cost to society to whole will increase.
    One example of preventative medicine is the GP convincing a patient to stop smoking. Would probably do more good in improving health than any surgery but this is not financially compensated.

    A good referral is meant to encompass all relevant issues and the doctor is expected to run through your history and write in the pertinent issues. Whether it’s complex or simple we’d still bill a similar amount.

    Also at the end of the day just as in any profession there is varying quality of doctors so find one that is good and hopefully isn’t financially frauding the system. If you think he is doctors are frauding the system then this can be brought up - as with any profession doctors have a governing body and are subject to AHPRA registration.
    If the quality of your GP isn’t good then find another one. As with any profession there is varying quality and this should not benchmark the entire industry. See if he can explain why things are done a certain way and you might understand the issues with the health system as well.

    Post grad medicine is 4 years with minimum 60k in hecs debt and GP exams cost about 5-10k with courses and require additional unpaid research components. Add on yearly registration and insurance fees. How much is appropriate for a skilled worker with these minimum academic requirements?

    This is another issue with labour providing urgent care bulk billing clinics. The reason clinics don't run after hours bulkbilling practices is because it is not financially viable and this temporary influx of government cash will end up with clinics either closing at the end of reverting to mixed/private billing once the government funding ends.

    Hopefully you find this info useful and have a better understanding about why mixed billing is not necessarily a rip off, why GP charging a fee at this point is not unreasonable. Hopefully there will be better awareness on this matter.

      • JaneSong on 21/08/2022 - 15:34
        -7

        No shit, the math doesn't lie and as a doctor you should be well rehearsed in math…

        100% increase in fees, wtf, you dreaming. The whole fraternity of GPs is corrupt.

        What happened to the Hippocratic Oath? Oh right, you lost that when the pandemic came along. Now you delve into this mess too? What is wrong with you guys? Why are there so many GPs all of a sudden coming into these forums and voting people's comments into oblivion?

        It is like a freaking cartel.

    • JaneSong on 21/08/2022 - 15:41
      -1

      That's really petty to downvote but hey, you can see I'm upvoting your comment. So jokes on you.

    • ensanguined on 22/08/2022 - 13:07
      +2

      So much of this is wrong that's its insane…

  • fleetfeather on 21/08/2022 - 15:47
    +2

    I work as a physio in a superclinic-like setting (GPs, OTs, Psychs, etc.)

    I'm going to have to stop bulk billing next month, too, as my room rent is contractually linked to CPI and increases with inflation. All my consumables also increase with inflation - every piece of stretchy band I hand out, every shoulder pulley I hand out, every disposable face shield I put on the bed, etc.

    These increasing costs were possible to absorb up until a point - and would honestly be possible to continue to absorb too, if people didn't frequently need to cancel appointments due to covid exposures - but alas I'm at a tipping point now where the maths just doesn't add up anymore

    It's honestly kind of scary to have to add in a co-pay: while I'm aware my own fees for service are lower than any competitor in my region, I still worry that I'm going to have to "sell myself" as a physio to get people coming back to me… The benefit of Medicare allowing me to bulk bill clients means that I don't feel an underlying tone of "Mr Physio, what do you think I'm paying you for!?"

    • JaneSong on 21/08/2022 - 15:51
      +4

      I still worry that I'm going to have to "sell myself" as a physio to get people coming back to me… The benefit of Medicare allowing me to bulk bill clients means that I don't feel an underlying tone of "Mr Physio, what do you think I'm paying you for!?"

      Is this a form of narcissism?

      Welcome to the rest of the world where we all have to market ourselves and meritocracy rules.

      What makes you any different to the rest of the Australian workers?

      It seems weird that the people with the highest UAI/ATARs are the ones with the worst forms of common sense. There seems to be some entitlement syndrome there.

      No shit, you guys are just making yourselves look bad. Look at yourselves in the mirror.

      • fleetfeather on 21/08/2022 - 15:57
        +10

        The 11 replies you've written in this topic so far have been an absolute trainwreck

        • JaneSong on 21/08/2022 - 15:58

          I just gave you the rope of the forum. You guys hung yourselves.

          Blatantly ignoring the facts which are mathematical in nature…

          I bet you are going to call more of your friends to downvote and hang themselves in front of us ozbargainers. You do realise a lot of us aren't well off and you guys need to get off your high horses.

          You see, you picked the wrong forum. It's ozbargain where you have people fighting over small discounts…

          Foolish

          Let this be a lesson to any other GP/Medico that wants to come hang themselves in this forum.

          Context Matters!!!

          Plain and simple, 100% fee increase, WTF?

          • May4th on 21/08/2022 - 16:17
            +1

            @JaneSong: don't know about you buddy but the only one here who looks anywhere near a rope and a noose looks to be you

            • JaneSong on 21/08/2022 - 16:20
              +1

              @May4th: Try to stay on topic. Nice try, but you don't get it.

              Reminder this is what the OP asked:

              The doctors claim they are going broke by just taking the current $39.75. I don't think that is the case. But even if it is, in what world does someone go from claiming to be going broke to doubling their revenue.

              • May4th on 21/08/2022 - 16:23

                @JaneSong: you mean you are not going to teach us how to tie knots with ropes?

                • JaneSong on 21/08/2022 - 16:24

                  @May4th: You already hung yourself, sadly.

                  Remind us why the OP's post regarding this was downvoted by your peers?

                  random12 14 hours 49 min ago
                  -3

                  7% raise is quite different to a 100% raise.

                  We just want a frank discussion. What do you have to hide?

                • JaneSong on 21/08/2022 - 16:28

                  @May4th: Furthermore, talk to your friends around you. How many were not told about the adverse effects of the experiment? That is unacceptable… Where is the informed consent?

                  Now for the GPs to take the high horse and ask for our help. I think they lost our trust. Especially with all that articles in the Murdoch newspapers about doctors looking at too many patients per hour. There aren't enough prosecutions regarding that issue. This is not problem with me. I'm just informed. You might not like that, but every patient should be informed.

                  • May4th on 21/08/2022 - 16:33
                    +2

                    @JaneSong: i have no idea what you are talking about. is this 'experiment' about the great vaccine hoax? If so please open another thread for it we have a lot more ropes to go through

              • shaybisc on 21/08/2022 - 16:30
                +1

                @JaneSong: Can you imagine if age pensions were not indexed to inflation but frozen since 2014? There would be blood on the streets - oldie insurrection.

              • MessyG on 23/08/2022 - 12:06

                @JaneSong: They're not doubling their revenue. Their CPI has been frozen for ten years. They're correcting it to standard, not doubling it.

          • eldudebrothers on 21/08/2022 - 16:25
            +6

            @JaneSong: I can see you are upset with the situation, us doctors are upset too. I really wish that my patients didn't have to pay anything as I believe that good healthcare is a fundamental right. However, the government is not supporting your rebate and clinics are forced to charge a fee higher then the rebate in order to function as a business and actually be open to see patients. Clinics are closing down all around Australia. I feel that you dont trust doctors and sense then we are in it just for the money, well for some doctors that is true, but in my experience the majority love what we do and our priority is directed to the best patient we can do. Your anger should not be directed at us, you shouldn't be angry at all but aim to discuss these issues with your local MP.

          • [Deactivated] on 23/08/2022 - 01:50
            +2

            @JaneSong: There’s very few practices that were bulk billing everyone before this, it’s not like they just started and increased every patients fee by 100%, they’ve simply extended private billing to more patients. They were subsiding some patients with others, but now they’re at the point of walking away entirely if they don’t drop bulk billing.

            I think you’ll find if you genuinely can’t afford it, a private discussion with your GP will see then continue to bulk bill you, unless you’re an absolute nightmare in person.

  • victorheaven on 21/08/2022 - 16:53
    +3

    Most of the GP we have seen are useless and are only there to write scripts, or a referral to a more competent specialist.

    If we have to pay the GP, I'd rather have Medicare scheme cancelled so that we don't have to pay thousands of Medicare levy.

    • Pete10001 on 21/08/2022 - 16:58
      +4

      There needs to be a lot more checks and balances (audits) in place to ensure that the service that is provided by GPs is up to scratch. Otherwise people have to visit multiple Doctors to get the care they should have received at the first visit.

    • Jolakot on 21/08/2022 - 19:14
      +2

      I sincerely hope you realize that the reason why GPs are useless is largely due to the price freeze. The best and brightest now have to become specialists to make it worthwhile, when many of them used to stay as GPs. Adjusted for inflation the rebate should be around $85

      • victorheaven on 21/08/2022 - 20:03
        +2

        That's only a very small part of the reasons to be honest.

        Let's say that rebate is increased and some of them become GPs, this will create a shortage of specialist which itself will attract the best doctors to enter that field. We end up with a majority of second tier doctors in the GP system either way, except now they are overpaid.

        • greatlamp on 22/08/2022 - 07:30

          No it won't. The colleges that train specialists decide how many new trainees they get each year. They are private institutions not public universities- so they have not significantly increasd intake - they want to protect their profession.

          Meanwhile new doctors are being trained by universities in higher and higher numbers. Once they finish their training, a large proportion have no hope of entering the more competitive specialities. So they become GPs.

          The colleges can see what happens when you oversupply a niche profession- look at the wages of optometrists and pharmacists over the last 20 years. They earn under the 92k average Australian wage now. Hardly worth the time and effort to train, let alone taking on the personal risks of being a health professional.

          • shaybisc on 22/08/2022 - 09:05

            @greatlamp: That's why these panic stories I keep seeing in the media that nobody wants to be a GP anymore, everybody is becoming a specialist, do not make sense. Have the specialist medical colleges all declared open slather? I rather doubt it. So if it's hard to get into the specialties as ever what else will medicine graduates do if they don't want to be a GP?

            • [Deactivated] on 22/08/2022 - 19:14

              @shaybisc: Apparently 20% used to become GPs now 16% do, so either the number of specialist places did increase or they just didn’t do medicine at all.

              There’s a lot more $$$ being spent on specialists now than 10 years ago, so it’s not necessarily true that more = less pay, especially since they’ve not had their rebates frozen and actually had more added.

  • lddv04 on 21/08/2022 - 19:25
    +2

    Hahahaha, I've been co-paying for over 20 years. Try finding a bulk billing doctor in regional Australia.

    • [Deactivated] on 22/08/2022 - 19:19
      +1

      Try finding a doctor at all in regional Australia, or even outer metropolitan Australia. Not only was the rebate frozen but the coalition followed up the ‘medi scare’ election by immediately (before all the seats were even counted) reclassifying outer metro areas, cutting the rebate paid.

  • whatgift on 21/08/2022 - 19:56
    +1

    Having been to bulk billing and co-pay medical centres, the difference is night and day - from my experience, co-pay is a much better service and well worth the extra expense. I admit I’m in a position where I can afford it, but there is a sacrifice you make to get something for (essentially) nothing.

  • Vanceer on 21/08/2022 - 22:52
    +4

    OP's topic in a few weeks: why do we have GP shortages!

  • LoserScott on 22/08/2022 - 08:04
    +1

    Why do gp's always ask if your working when going to a bulk bill clinic, especially your occupation, but the other clinics never ask if you're working rather why you chose to bulk bill(you seem like you can afford it)

    • fleetfeather on 23/08/2022 - 14:00

      Probably a few reasons why ANY GP should ask this, aside from "do they have money to pay me":

      Not working is a yellow flag and predicts more long-term health consequences

      Not working due to unsupportive workplaces may be a reason for a doctor to write a letter to advocate for you on your behalf

      The nature of your work itself may be contributing to your health issues

  • mavis30551 on 22/08/2022 - 10:46
    +4

    THe government not increasing the medicare payment is digusting, and you just know when they finally do its going to be by $5 - $10. nothing close to what should cover the full cost of a consult.

  • dangerdanger on 22/08/2022 - 12:26
    +7

    1972 : GP visit cost $8.20.
    If you just increased that $8.20 at the rate of CPI (inflation), in 2022 that would now be… $89.

    So if your 2022 GP is charging $80, they're charging UNDER inflation.

    Get over it, op, GP services have been underfunded forever. You don't get free milk at the supermarket, and yet you want free medical care.

    • eldudebrothers on 22/08/2022 - 19:42
      +7

      Nearly half of that $1200 goes to the clinic, then calculate costs of NO sick leave, annual leave, parental leave. Then calculate a massive HECS debt. Then calculate massive costs in equipment, insurance (can approx be $800 a month), education, registration, college fees, CPD, AMA fees. What is left? Then minus accounting fees and then you realise you either go private, bankrupt or see many more patients an hour. $312,000? Why am I driving a a hyundai i30 lol

      • fleetfeather on 24/08/2022 - 21:29

        The thing that I wasn't prepared for while working for myself was the costs associated with finances. I'm now largely self-sufficient when it comes to quarterly BAS and all my income revenue streams (and thus sorting tax returns), but prior to that, each time I had to call the bookkeeper or finance man for a simple question, it was $400-$600

    • magster on 23/08/2022 - 01:29
      +2

      Plus GPs have to pay for their own super out of their pay. That’s another 10% less in actual salary.

  • rawm on 22/08/2022 - 14:02

    Just came here to say A and Y are nowhere near each other on the keyboard?

  • Robz on 22/08/2022 - 15:05
    -2

    A lot of GP's see 10 patients per hr =$ 400 per hour Easily. So say….times 6 hr per day =$2400 per day. Look @ the car they drive & still say cant make ends meet!! Most are in a multi practice scenario each doing $2400 = $12.000 per day At say 5 day week =$60,000 ($240,000 per month) AND still cant make ends meet in their practice ??? That is not including some patients that are being charged a gap. Then the $300 for an insurance letter that takes 5 minutes to write You need a script for medication that lasts 30 days with 1 or 2 repeats then have to go back to them for the next script… I say once a GP is a licence to print money.
    I am so over poor GP's

    • dangerdanger on 22/08/2022 - 16:00
      +3

      That's a new one. GPs making $2,400 a day…

      • infinite on 22/08/2022 - 23:17
        +1

        My sister is a specialist. The GP's at her practice charge a starting price of $84 for a 4 minute consult in person or via video teleheath. The patient gets back just under $40 from medicare. They can easily smash out an 8 hour day averaging 6min a consult with only a 10min morning tea break and a 30minute lunch break.

        You should see how much money they make on the days where they just run a family immunization clinic day, galloping through the crowd at a rate of a family of 4 in & out of the consult rooms every 3 minutes. It takes a crew of 5 admin staff to keep up with the patient billing.

        • AusGP on 22/08/2022 - 23:26

          What area would have patients sustaining paying $84 for essentially 6 minutes?

        • dangerdanger on 23/08/2022 - 07:34
          +1

          It takes a crew of 5 admin staff to keep up with the patient billing

          There disappears your profit right there.

          Those admin staff need to be paid (shock!), they have 10% super and sick leave and maternity leave (shock!).

          Why don't you throw in Rent? Insurance? Power? What about the years of university + advanced specialist gp training, and associated debt?

          People think GPs just do a weekend course and then pump through these pts at vaccination clinics.

          GPs are not indebted to society forever. They are not here to prop up social injustices or inequities. They are not here to work for free. They are not here to sacrifice their business viability so you can have free health care.

          No different to the notion Woolworths will sacrifice viability to help the starving homeless (shock : they won't), or Home builders will help the guy living under a bridge by building him a home for free (shock ; they won't), or farmers giving every school kid free milk (shock : they won't), or even you taking in a homeless guy into your warm home to sleep every night (shock : you won't).

          Regardless of what the typical person thinks, market forces will work out. GPs will refuse to sacrifice their viability : by passing on the cost.

          As other people have said : your fight is with the GOVERNMENT. Once they fund Medicare properly, you'll get the health care you deserve. Until then, Goodluck to finding a bulk billing gp.

          PS. I'm not a gp. I pay for my clinic visits

      • Robz on 24/08/2022 - 17:56

        Obviously U do not know many GP's !!!

        • dangerdanger on 26/08/2022 - 08:01

          I know about 6 on a personal level since university days, and still see them a few times a year socially

    • ensanguined on 22/08/2022 - 16:00
      +1

      I estimated $1,200 a day to be conservative and got downvoted to hell lol. I couldn't agree with you more.

      • May4th on 22/08/2022 - 19:06
        +3

        1200 as a contractor means ~800-900 equivalent salary with leave benefits. there are many public servants/middle managers/IT contractors etc earning much more with much less responsibility and training needed. not sure what's so lucrative about that. if you cherrypick the easiest part of any occupation it always sound so easy doesn't it. not sure how you can see 10 pts in an hr.. when i was last at the drs watching the dr call in some old lady on a walker took 5min just to get into his room.

    • eldudebrothers on 22/08/2022 - 19:45
      +2

      I commented above but will nearly copy paste this. I see MAX 3 patients an hour, wtf 10 patients an hour is absurd. But the guy above pulled $1200 a day and I broke it down: Nearly half of that $1200 goes to the clinic, then calculate costs of NO sick leave, annual leave, parental leave. Then calculate a massive HECS debt. Then calculate massive costs in equipment, insurance (can approx be $800 a month), education, registration, college fees, CPD, AMA fees. What is left? Then minus accounting fees and then you realise you either go private, bankrupt or see many more patients an hour. $312,000? Why am I driving a a hyundai i30 lol

    • randomvis on 22/08/2022 - 20:55
      +3

      10 patients per hour! lol.

      The best ones can manage 5…. maybe 6 if there are no mental health cases or people crying.

      Most are doing between 3 and 5.

    • dangerdanger on 22/08/2022 - 21:47
      +4

      If it's a license to print money, why don't you become a gp then?

      Oh…

  • [Deactivated] on 22/08/2022 - 15:33
    -6

    There are some pretty badass comments from people, but we need to be civil. I guess we need to prepare for a more angry world just like Klaus Schwab said.

    I feel like the medical profession got the raw end of the stick and ended up being the used condoms of the pandemic. They take all the blame and the pharmaceutical companies made all the money. They did not speak up when the public required them to speak up, so they are mostly to blame for their own problems.

    By the way, this was never part of Agenda 2030, but if you conspiracy guys want it to become part of it and I can see you hinting at it in your posts! I guess we can make it part of it where the cost of healthcare is drastically spirals out of control. Where the doctors will own nothing and be happy. lol. But no, this was never part of any Agenda 2030 whitepaper I've read or authored.

    Furthermore, I note that a lot of GPs are avoiding the topic of price increase deliberately and I can see when they are questioned that they all seem to want to dance around the topic hoping no one will pay attention. No one cares that you are anxious, no one cares about your blog post about your life as a Doctor. Frankly, I thought GPs would not sink this low, but that is what happens when they live in their ivory towers. I note that one post seems to be a nasty copy and paste about their life, so don't go thinking that the GPs really wrote something personalised for this forum topic…

    Frankly it is never acceptable to increase your revenue by 100% whilst your costs remain relatively unchanged. Everyone is suffering from inflation, but to inflate something that is essentially an essential service out of the hands of the average citizen is frankly onerous and unacceptable. There is a social contract with the clients. There is also an implied contract that people who were receiving care in the past will continue to receive care for their needs at an affordable price. You cannot just pull the rug out from under people.

    • dangerdanger on 22/08/2022 - 15:59

      That's ok. You'll be able to find a different bulk billing gp to go to. Or perhaps one day all of them will charge gaps. Or worse yet - less and less GPs

      • [Deactivated] on 22/08/2022 - 16:08
        -4

        I will state this and make this very clear. If you have a patient that has started treatment under the impression that they would continue to receive services at a certain price, and they would not have started treatment if those prices were to deviate in such manner as would be onerous. Then it is clear something is wrong and the courts will not look favourably upon any GPs acting in this manner.

        Changing GPs is a time consuming issue. That can mean people starting from scratch again. This is a very onerous process for the patient.

        Put simply the Equity Division of the courts would likely be very interested in knowing why certain GPs are price gouging. This could be future litigation on the horizon. ACCC are you watching?

        This is not legal advice to GPs, as I have not provided any costs estimates or received any monetary payment, but I suggest all GPs seek their own personal advice. Maybe someone is bold enough to become the test case.

        • dangerdanger on 22/08/2022 - 16:39
          +5

          So you mean once a gp has seen you on the old billing price (ie bulk billing), they're obliged to never bill you a gap… forever? Lol. Good luck with that one. Why don't you test that out in the courts for everyone.

          I'm pretty sure no patient goes into a gp clinic, and signs a 'forever contract' to never be billed.

          It's that entitled attitude that makes most GPs want to move to full gap billing for all patients.

          Believe it or not, all private practices have a right to NOT see you. They can and will administer CPR if you are dying in front of them. But routine care - they can refuse. They'll then let you know you can go to the local ED. As most practices do now if you want an urgent appointment and they have no available clinic slots.

          The only mistakes most GPs have done is to not start billing gaps 20 years ago, and increase in line with inflation. Suddenly increasing it now means there are many pts who have been raised on the 'free' mentality for too long and they then demand ongoing free care

          • [Deactivated] on 22/08/2022 - 20:31

            @dangerdanger: Well clearly not forever. lol… There needs to be a reasonable time frame and each case is determined by its merits. If there is price gouging, it should be obvious.

            I guess your sarcasm detector was also broken…

        • May4th on 22/08/2022 - 18:07
          +3

          this is hilariously delusional. are you going to sue your cafe because their flat white is 4.80 instead of 4.30? because basically GPs are charging you 2012 prices in 2022 and only some of them are now catching up that is price gouging? you can throw around all the fancy words you think you know the meaning to but there is zero legal basis to your arguments

          people seem to think the fight is between you and the GP regarding access to healthcare. it's not. it's between you and the government to provide adequate funding. for argument's sake what do you think happens if there are no medicare rebates? do you get angry at greedy doctors because they don't work for free?

          • [Deactivated] on 22/08/2022 - 20:33

            @May4th: I see you are taking my words out of context. There is no contemplation that one will be working for free. There are issues with price gouging and if you can justify the costs then of course that is fine. Prima facie a 100% increase in a fee is reason for suspicion.

            I guess you did not see the sarcasm in the post… Notably where I trolled Jane.

        • [Deactivated] on 22/08/2022 - 19:23
          +1

          I’ve changed GPs twice in the last two years due to one retiring and then moving state. It incredibly easy to change GPs, finding one however, not so easy, if only more people wanted to be GPs….

          • [Deactivated] on 22/08/2022 - 20:34
            -3

            @[Deactivated]: You are one of the lucky ones. Often a doctor will hang onto their medical records citing copyright. That is another story for another time.

            • [Deactivated] on 23/08/2022 - 01:21
              +1

              @[Deactivated]: https://www.oaic.gov.au/privacy/health-information/access-yo…

              It’s exceptionally rare because you’re going to cost them a lot more by complaining and you can be charged a reasonable fee to have them provided, usually these days by their practice which is not really interested in anything but minimizing costs.

              Because you’ve had one bad experience doesn’t mean it’s common.

  • BartholemewH on 22/08/2022 - 15:37
    +1

    Been paying more than $80 for 10+ years. Not new outside of the city.

    • factor on 22/08/2022 - 17:51

      It is great to see less and less bulk-billing in the largest cities - equality! The problem may impact sufficient voters to be improved Australia-wide.

  • Cheap Rich Guy on 22/08/2022 - 20:09
    +1

    As long as they provide me with OxyContin and Valium when I need it, I’m happy to pay.

  • T3J on 22/08/2022 - 20:42
    +4

    Socialism is great, until you run out of other people's money….

  • [Deactivated] on 22/08/2022 - 21:30
    -4

    I am done with this discussion, or should I say lack thereof. There are just too many vested interests lurking in this forum. They need to outright declare their affiliations. This is one of those times where Scotty's affiliated checkbox would work perfectly in the general forums.

    Nevertheless, what happens to the patient who sought help a few weeks before the price increase? I am referring to someone who will likely only require a few more visitations over the year, not some ludicrous perpetual income stream.

    It seems like most doctors seem to look at their patients as a revenue stream that continues into perpetuity and it shows in the language of their responses. The way the responses are crafted really does reveal people's inner thoughts. Are they really wanting to cure that patient or not???

    Did they really think that patient was going to be a perpetual one until death? Maybe they need to look at how they respond to my questions as there is much information that slips subconsciously.

    Further, everyone is dodging the big question and the whole forum has drifted off topic into rants about their own personal issues as a GP… Geee, go pop an antidepressant!

    For God's sake, stop using the extreme circumstances as the starting point for the discussion. We need to be civil. I know you silently know what I was writing about.

    I thought I would throw a bit of sarcasm in the mix to brighten it up, but that clearly backfired.

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