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Doctor shortage

By plausible 25 March 2010 21

An ongoing subject for Canberra, but when is it ever going to get any better. I found out just yesterday my doctor is drastically cutting back his hours. Where are we all supposed to go??? Not his fault as he is nearing retirement but where are the up and coming doctors to fill the gaps!


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Doctor shortage
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sloppery 8:42 am 30 Mar 10

vg said :

“4) Lack of renumeration”

What absolute bollocks

According to the Australian Taxation Office, the average GP earns a gross income of $212,833 a year

Wish I earnt that little. And don’t throw in the ‘thats before expenses’ drivel. Most if not all are tax deductible expenses

Tax deductibility, even on that income, means you get between 30 and 40 percent of the expenses back. Even assuming the best case scenario, expenses of $100k still hit your pocket to the tune of $60k.

I suspect, though, that the tax office’s figures represent the gross taxable income after expenses.

Leinna 7:21 am 30 Mar 10

Also, the ANU graduates are coming through now – maybe after another couple of years some of them will have finished their training as GPs and set up in Canberra. Of course, you’ll have to wait for them to finish their training program…

Regarding remuneration – compare $200,000 with the typical staff specialist income (at least $300000 – $400,000). For the same amount of training you can make twice as much. Or you could work in private practice and charge $250 per consult as a specialist. Why be a GP?

I think we will end up having nurse practitioners because there aren’t enough incentives for junior doctors to become GPs. Although, when’s the last time you heard of a nurse being sued for missing something?

vg, you didn’t address the other three points, which I did place above remuneration as I think they’re more important.

s-s-a, I’d be pretty sure that the figure is before all of those expenses.

squashee 10:59 pm 29 Mar 10

OpenYourMind is exactly right. Pharmacists should be able to prescribe medications for minor illnesses. Pharmacists are actually the medication experts and generally know more about medicines than the doctors. With this in mind, there should be no problems with pharmacists being able to prescribe medications such as antibiotics for minor infections, including skin and urinary tract and upper respiratory tract infections; plus minor eye infections and a number of other minor ailments for which there is little need for differential diagnosis and there is limited choice in treatment.

Pharmacists are a much better option for this than nurse practitioners, as nurses will only have limited training both in diagnosis and medications.

There are two problems preventing pharmacists from being able to prescribe – the doctors don’t want anybody cutting their grass – Doctors are able to charge $60 for a 10 minute consult. Secondly, the pharmacists have no real representation – unlike the doctors, which have the massively powerful AMA, the pharmacists representing bodies fight between themselves and can’t ever take a unified stance on anything.

Hopefully one day a federal government will realise they do have some use for pharmacists and will treat them with the respect they deserve. Pharmacists thought they might have a chance with the current government considering the Health Minister is the daughter of a pharmacist, but unfortunately for them that was wishful thinking.

s-s-a 10:28 pm 29 Mar 10

earns a gross income of $212,833

Is that before or after they pay insurance, receptionist, rent for the surgery, cleaning, practice nurse, supplies etc?

vg 9:17 pm 29 Mar 10

“4) Lack of renumeration”

What absolute bollocks

According to the Australian Taxation Office, the average GP earns a gross income of $212,833 a year

Wish I earnt that little. And don’t throw in the ‘thats before expenses’ drivel. Most if not all are tax deductible expenses

Leinna 5:47 pm 29 Mar 10

The main problem is a GP shortage.

It exists because medical graduates frequently don’t want to be a GP, for a number of reasons:
1) GPs don’t get to do very much any more. Angina? Better see a cardiologist. Out of breath? Respiratory physician. Skin lesion? Dermatologist or plastic surgeon. It’s dull work for many GPs.
2) You need to do a four year training program before you can practice as a GP. Previously, all you had to do was intern year (the year of on the job experience after you graduate from 4 – 6 years of medical school) and then you could go and become a GP. Another four years of training just to be a GP?
3) Lack of respect from specialist doctors and the community in general
4) Lack of renumeration. How much has the medicare rebate gone up since Medicare was introduced? Compare that with CPI. Or you could spend your four years of extra training doing something like cardiology, where you make 4-5 times as much as a GP, or 6 years doing O+G where you can make millions of dollars a year.

TL;DR – GP is less interesting, takes too long to train for, doesn’t get any respect and they don’t get paid enough. Therefore everyone wants to stay in specialist training. Therefore there are fewer GPs than there were 30 years ago.

I think the AMA’s a pretty useless union tbh, they don’t do anything for GPs or junior doctors. Specialists, who make much more money, only pay a small amount above junior doctors and GPs to be members, and yet are represented by the AMA to a much greater extent.

Anna Key 9:34 pm 26 Mar 10

Danman said :

miz, therein lies the problem.

Doctors want to keep their marketshare and always vote out the action to bring nurse preactitioners to the ACT, and Australia.

All the while, there are less and less doctors available and peopel resort to bulk billed ER’s that are already under a lot of stress through staff (and in turn bed) shortages.

So basiacally, nurse practitioners dont exist because doctors dont want to lose the business.

happy to be corrected by someone in the know (Im just married to someone in the know)

Pretty much spot on. NPs are fine for remote places where doctors don’t want to work, but the AMA are going to push a load of emotional arguments against them in metropolitan areas and will jump on any cases where a NP misdiagnosed (of course, such a thing would never happen with a doctor!). At least the current AMA president seems a bit more sensible than the previous one.

Surely an integrated system of nurses, doctors and other health workers is the best use of resources, not a doctor-centric health system like we have now

sepi 8:38 pm 26 Mar 10

Canberra’s doctor shortage is shocking, and getting worse. We are the only place in Australia where it isn’t possible to see a bulk billing doctor (unless you have a health care card, and have been seeing that dr since forever.)

In other states you can still get locum doctors to visit you at home after hours – imagine trying to do that here.

We are seriously under provided for, and something should be done about it (by the Federal govt.)

54-11 2:21 pm 26 Mar 10

I agree with the comments about nurse practitioners – they will be the way of the future, if the govt has the balls to break the most powerful union of all, the AMA.

In the meantime, you will probably be stuck with a multi-doctor practice, where profits will come before patients.

Danman 12:43 pm 26 Mar 10

miz, therein lies the problem.

Doctors want to keep their marketshare and always vote out the action to bring nurse preactitioners to the ACT, and Australia.

All the while, there are less and less doctors available and peopel resort to bulk billed ER’s that are already under a lot of stress through staff (and in turn bed) shortages.

So basiacally, nurse practitioners dont exist because doctors dont want to lose the business.

happy to be corrected by someone in the know (Im just married to someone in the know)

FWIW, I went to a nurse practitioner in Miami, awesome service, was for a suspected tosillitis.

The NP done a quick result swab which came up negative for strep c, done another swab for the lab, and, even though I said I was going to be offshore on a cruise, still rang my mobile with results (after trying to expidite on my behalf)

She then gave me a script for some drugs, and I was able to (if I wanted) claim it on travel insurance.

In and out in 15/20 minutes for US$50….

I think nurse practitioners are a great ide… If it happens though, who knows.

miz 11:54 am 26 Mar 10

Where are the nurse practitioners, and do they bulk bill? I would like to give them a try as my experience is that nurses (in general) are far more interactive and caring towards patients than docs.

prhhcd 8:42 am 26 Mar 10

If you live in the Belco area I can highly recommend the West Belconnen Health coop. Great doc, easy to get appts and once you pay your membership fee its bulk billed.

screaming banshee 7:26 am 26 Mar 10

Its about time nurses get a bit more recognition and have their responsibilities lifted to a level where they can better serve the community. How many people have been to hospital for minor injuries and barely seen a doctor. The truth is nurses are more than capable with their training and experience to deal with most issues below surgery without the input of a doctor, but the system requires that doctors are involved.

Dont get me wrong, I’m not criticising doctors, with the shortfall they have a great deal of work to do. What we should be doing is re-distributing the workload so the doctors we have can focus on the high-end stuff and nurses can be given more recognition of their skills and abilities.

I’m quite excited about the nurse-practitioner arrangement that is being trialled. My own experience I had my finger crushed and when I went to hospital the nurses inspected, cleaned and x-rayed the finger. I then waited 45 minutes for the doctor. The doctor came in, looked at the x-ray, looked at the finger then told the nurses it was OK to dress it. When asked what sort of dressing the doc replied, ahh you know whats best, as he walked out the door.

As for Chemists issuing scripts and certs, I have to disagree, Chemist services are already a slow process. Could you imagine how long it would take to get a script filled if there were a line of people looking for sickie certificates as well. Aside from that, as a general rule if you categorised the pharmaceutical industry priorities into healthcare, making a profit, and protecting their own interests, healthcare comes a distant 3rd.

Davo111 3:57 am 26 Mar 10
Clown Killer 9:57 pm 25 Mar 10

You and you alone are responsible for your health. Think ahead. talk to your GP about sucession planning if he’s getting old or scaling back. If you’re prepared to be have like a mullet then expect to be treated like a mullet.

bd84 9:30 pm 25 Mar 10

My last 2 doctors have retired on me, the hide of them retiring in their 70s geez. Guess what I have done? Gone to the doctor who replaced them.

OpenYourMind 8:38 pm 25 Mar 10

Start with allowing chemists to issue scripts and sick certificates for minor illnesses.

MrPC 8:27 pm 25 Mar 10

Google your symptoms. Unless it’s serious.

vg 6:14 pm 25 Mar 10

“Where are we all supposed to go???”

To another doctor

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