What I do for $37: One GP's perspective on impact of Medicare pay freeze.

By Cathy Johnson

When a patient joked that Dr Elizabeth Oliver had just earned “easy money”, it hit a raw nerve.

So the Sydney doctor took to her blog.

In her post What I Do for $37.05,

This was because doctors were “time squeezed” and struggling to provide the quality care that could prevent health problems escalating and needing more costly interventions, such as hospital care.

Some 600,000 hospital admissions a year are thought to be avoidable, and each one costs around $5,000, according to the National Health Performance Authority.

“The point is that GPs are amazing value for money,” Dr Oliver said in an interview on RN’s Health Report.

“I don’t know of any other profession that would accept an eight-year freeze on an increase in their pay.”

The most common consultation for GPs is one that lasts less than 20 minutes. For this they are reimbursed $37.05 from Medicare.

Current and previous governments have failed to increase this amount, which is slated to remain the same until 2020, despite the increase in the cost of delivering services.

This freeze has prompted some medical practices to increase the fees they charge patients and reduce their bulk-billing rates.

But many argue they can only pass so much onto patients and GPs themselves are left unfairly bearing the brunt of the rest of the shortfall.

“GPs are doing amazing work to save the healthcare system money and to save people,” Dr Oliver said.

“[But] the more that GPs get squeezed, the less time they are going to be able to spend with people and healthcare is going to suffer as a result. And so is the budget.

“Sometimes the problem can be solved in, say, eight minutes, and that’s great. But sometimes it requires much more than that.”

The stress toll

Dr Oliver said if the situation does not change, she cannot continue to work as a GP.

“I’m going to stop doing it if it stays like this,” she said.

“I am a good doctor, I have patients tell me that I’m a great doctor, but I’m not going to keep doing it for this amount of pay, and for the drain and the toll that it takes on my life, I can’t.

“I spent a huge amount of time and effort and tears and blood and money to become a doctor.

“I’m really proud to be one and I know that it’s a fantastic privilege and I love my job.

“But I physically and mentally can’t keep doing this under these bulk-billing arrangements and with this Medicare freeze.

“GPs need help.”

Avoiding hospital admissions

Dr Oliver said she sometimes had to send patients to hospital and felt “almost apologetic” for doing so.

“But then at the back of my mind I think, ‘Do you know what? There were five others today that I could have sent and I didn’t because I managed it myself. I did that for $37. That could have been seen in an emergency department and cost hundreds and hundreds of dollars’,” she said.


“We must keep people out of hospital, we must stop people’s chronic disease falling apart, we must prevent people going into psychosis.

“And these are some of the things that GPs do on a daily basis, and we do that in a very short amount of time. We are very efficient.”

Claire Jackson, professor of general practice at the University of Queensland, said Dr Oliver had “nailed” many of the issues that had been a problem for GPs for years.

She told the Health Report there had been a “seismic shift” in the complexity of care GPs delivered and they needed a lot more community health and social care resources.

This was especially the case when they were treating complex chronic diseases like heart failure, diabetes with complications, and chronic obstructive lung disease, she said.

A trial of a new program called Healthcare Home, aimed at addressing this would begin in July 1.

It was hoped Healthcare Home would provide more holistic ongoing continuous care while also strengthening the business model for general practice, Professor Jackson said.

You can hear Professor Jackson talk to Norman Swan about Healthcare Home on RN’s Health Report.

This post originally appeared on ABC News.

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