25 August 2009

Pay up to see doc

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As sepi has alerted us, Ginnindera and Phillip medical centres are ‘rolling back’ thier bulk billing services. Children and pensioners will still be bulk billed, but everyone else will pay $30 – $40 for a consultation.

Jon, Katy, Kevin, Nicola, anyone – please fix our health system! Doctors – please come and work here!

On the up side, it might decrease the waiting times.

UPDATE
Here’s the story from ABC on the money grabbing medical centres.

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the dr might have been trying to suggest they would get better treatment of ongoing medical issues at a family practice wiyh a regular gp than at a drop=in centre.

“the doc told them that they appeared to be too wealthy to be attending at Phillip”

To which I would have replied, ‘I wasn’t aware that is any of your f*cking concern, now shut your mouth and treat me’

A while back my elderly parents were told by one of the doctors at Phillip medical centre to find another doctor, the doc told them that they appeared to be too wealthy to be attending at Phillip. I now understand why, 14% less for them means that they don’t want to treat you if you are not a pensioner.

But I like not having to make an appointment, if paying $40 bucks gives me 6 minutes instead of 4 minutes I will be happy. That might give me enough time to convince them that a medical certificate is preferable to a prescription for drugs. Oops then the in house pharmacy will miss out, I guess I wont win that one.

Waiting 3 hours can be fun too, I like to get a seat where I can see the doctors wading thru the slips of paper that represent the queue, it is amazing how selective they are.

Speaking of waiting 3 hours perhaps they can now afford to buy a system like the motor registry and banks use, where your number is posted on monitors when your turn comes up.
Currently it is laughable, if you are really sick and don’t get a seat near the counter you can easily miss your turn as some of the doctors don’t speak very loudly and have trouble pronouncing names. If you fall asleep you will miss your turn and be told “you must have left the building”…

why do I keep going back???

In last weeks discussion of this a number of people mentioned that you can get doctors certificates from pharamacists. Has anyone tried any pharmacists in ACT to see if this is true/works? If so where?

Would be really nice to see people with a simple cold not having to block up the GPs waiting rooms.

I was at the Ginninderra medical mentre last night and was handed a letter explaining that from 26th August there would be a co-payment required. If anyone is interested, I have typed up the accompanying ‘Background to our Changes in Billing Policy’, that was attached to the letter and signed by the Medical Director of the centre. It may provide a little more insight as to the reasons behind the co-payment.

Copied verbatim – “The standard GP consultation is the cornerstone of general practice and most of healthcare delivery throughout Australia.

The Medicare bulk bill rebate for standard GP consultation is currently at $33.55 which is approximately 45% discount to the private “common fee”. It is also 14% less than the Medicare rebate for a pensioner or socially disadvantaged patients for the same condition and same condultation!

There have been increases in Medicare rebate for the standard GP consultation which have totalled approximately 8& over the last 4 years compared to a 16% to 20% increase in the main cost of practice (wages and rents). While there has been continued under-funding of the cornerstone GP consultations, there has been increased demands on general practitioners with greater documentation required, greater demands for care, greater and increased Medicare audits and greater direction of GP practices.

The co-payment of $30 [$40 for weekends and public holidays] will provide a net bulk bill fee to your GP that is a discount to the common fee charged for private billed patients in many areas.

The practice considered the introduction of a co-payment for Commonwealth concession card holders. Such a co-payment is justified due to the inadequate Medicare rebate. However, due to the curren economic circumstances the practice has determined to continue bulk billing concession card holders for as long as possible.”

Genie said :

MrPC – I agree… My grandmother is at the Doctors probably once a week.. and usually in there for a half hour appointment.

I currently use the Ginninderra Clinic and I would have no problem paying the $30, my understanding is we are paying the “gap”. In other words you normally get about $30 back from medicare – so your appointment is actually $60 but your only paying what your refund would be. Am I correct in this understanding ?

If you pay $30 you don’t get $30 back from Medicare though, do you?…

MrPC – I agree… My grandmother is at the Doctors probably once a week.. and usually in there for a half hour appointment.

I currently use the Ginninderra Clinic and I would have no problem paying the $30, my understanding is we are paying the “gap”. In other words you normally get about $30 back from medicare – so your appointment is actually $60 but your only paying what your refund would be. Am I correct in this understanding ?

I used to go to Ginninderra for the free consults, but only if there was a genuine issue. They certainly weren’t the most convenient lot around, but at least if you got there before 6pm there was a chance you’d be seen before 10pm, whereas every other doc in town has a receptionist that tells you to come back in two weeks.

However, their exempting pensioners from the charges will not fix the problem. It’s the aged pensioners that are the problem. They want their free 10 minute chat with someone that’s polite and who will listen to them, regardless of whether there is anything genuinely wrong with them.

I’m tired of my taxes and my medicare levy going to that when I can’t even see a proper doctor without waiting hours (or worse, weeks) and now without paying up front. It’s not like PRY are losing money.

Deadmandrinking8:58 pm 25 Aug 09

F-k them. Looks like self-diagnosis and pharmacist from now on.

If they start charging then the quality of their work needs to increase.

SpellingAndGrammar8:01 pm 25 Aug 09

“Medical centres operator and diagnostics provider Primary Health Care Ltd says it expects significant growth in earnings per share and profit in 2010.

Primary on Tuesday reported a net profit for the year ended June 30, 2009 of $108.5 million, up from $7.86 million in the prior financial year.”
Source: – http://www.thebull.com.au/articles_detail.php?id=5261

Gotta love a business underwritten by government.

One has to admire their business strategy. Swan into Canberra – buy up all the local GP practices held by small GP groups, relocate them to their big, vertically integrated super centres, placate the masses with bulk billing for a while – make them think its the next greatest thing, thereby increasing the ACTs bulk billing rate for the first time in yonks and then once its all settled, we’ll start charging those ‘rich’ ACT residents.

It’s only our demographics (income-wise) that make us one of the lowest places for bulk billing in Australia when we are currently at an all time high for GP bulk billed services in Australia of 79.4%. Too bad if you’re one of those earning what Joe average and the rest of Australia does.
http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr09-nr-nr068.htm

I am fully prepared to pay to see a doctor. What I take offence to is waiting up to an hour past my appointment time and then being charged $60 for a 5 minute consultation, where the doctor is more focused on getting me out the door than providing medical advice!

The special doctors at Philip Medical Centre (so called specialists but only ex GP’s) already charge $30-$40. But they (when I was last there) had the choice to bulk bill passengers or to not. All you had to do was to ask the doctor.

Ruby Wednesday6:27 pm 25 Aug 09

My work doesn’t require a certificate for absences as a rule. You may be asked to provide a certificate for future absences (if you have excessive leave or a pattern of leave) but they cannot and do not ask retrospectively. As someone who is off sick at the moment with the dreaded lurgy, it’s nice to not have to go through the hassle of getting an appointment just to be told what I already know: I need cold and flu tablets, lots of fluids and bed rest.

thanks braddonboy, will use!

i don’t mind paying to see a gp, but i then want to be able to make an informed choice as to whether i need to see her, or not.

you don’t book your car in to a mechanics and simply let them loose, you can get a quote to see whether or not to bother – why would i book me in to see ‘my mechanic’ without that..? might do a review of the service here if it warrants one… ; )

grunge_hippy6:09 pm 25 Aug 09

thats a good idea kramer, I wish that could happen in all workplaces… i only go for the certificate, its usually only the common cold and there is nothing a doctor can do, which is what most people do, which clogs up the GP surgeries bit time.

for those who cant afford to shell out the $60+ dollars, its a hard ask, even if you do get it back from medicare. Not everyone who is struggling has a healthcare card!

I like to pool all my receipts and go in for a nice lump sum! I went yesterday and got $150 back. nice!

braddonboy said :

You could possibly save yourself waiting time at a doctor’s surgery if you took advantage of the free telephone health information and advice service…

Not helpful if you need a doctors certificate.

My doctor costs 65.00, but at least I can book appointments.

Phillip and Ginninderra are ‘walk in and take a number’ type places.

c9 said :

I imagine a lot of visits under bulk billing arrangements might as well not be made and because it’s free it’s too easy to go and see a doctor.

You’ve clearly never had to wait at these bulk-billing places to see someone. Trust me just because it’s free doesn’t make it easy. You regularly have to wait 2+ hrs in a waiting room full of other sick people and crying/yelling babies/children – there is nothing easy about it!

I don’t know the stats but I would hazard a guess that the number of people who go just because it’s free are very low. And during winter practically every other person in those waiting rooms is usually very obviously suffering from cough/cold/flu.

Thankfully my work has just started allowing a stat dec for sick leave days – so’ll now be able to stay at home getting better (rather than waiting for 2 – 3 hours to see a doctor and get a piece of paper), and keep my $30. Let’s just hope I never get *really* sick …I guess there’s always Emergency for that.

It’s probably not a bad thing in some cases that this charge will put people off going to see the doctor – I imagine a lot of visits under bulk billing arrangements might as well not be made and because it’s free it’s too easy to go and see a doctor. On the other hand, the ABC article points out taht Canberra has the lowest levels of bulk billing in Australia so it is unfair that Canberrans should have to pay for something whcih the rest of the country gets for free.

paperboy said :

AG Canberra said :

And then getting a large chunk of that back from Medicare – so out of pocket is not much at all.

The $30 or $40 cost is ON TOP OF medicare. It’s not a refundable fee.

Don’t think so. They either bulk bill where you pay nothing or they don’t bulk bill and you pay the full price. If they don’t bulk bill then so long as the doctor has the required registrations you walk down to medicare and get $30 or so back.

Never heard of a place who bulk bills and charges extra on top of that.

Clown Killer4:13 pm 25 Aug 09

An increase in the numbers of people clogging up hospital ER’s because they can’t afford to pay to see a doctor perhaps?

I doubt that the number of people who could genuinely not afford to pay to see a GP would lead to too much congestion at A&E.

On the other hand if you factor in the selfish dimwits who don’t have the money because they spent it on cigarettes, pokies, pay TV or any other of the working class ‘essentials’ then I guess you might have a point about congestion.

i believe i used that call lne your talking about braddonboy, either that or the CALMS line when i had a few niggling concerns about my daughters cough

screaming banshee said :

Ginnindera and Phillip medical centres can expect to see an increase in patient numbers as other Canberra residents discover how cheap it is.

My last visit cost me $58.

Er, offset against the decrease in patients who, until now, were getting free consultations perhaps?

An increase in the numbers of people clogging up hospital ER’s because they can’t afford to pay to see a doctor perhaps?

You could possibly save yourself waiting time at a doctor’s surgery if you took advantage of the free telephone health information and advice service, healthdirect Australia (it used to be the ACT’s healthfirst, I think). It’s a free call (from a landline) to a registered nurse who uses sophisticated computerised decision support systems to provide advice on what to do next – and that advice might be as simple as visiting your nearest pharmacy for some cold and flu tablets at your convenience or as urgent as immediately directing you to the nearest hospital ED. The number’s 1800 022 222. This service is not a replacement for either the 000 emergency service or your doctor – but it may save you a visit to the surgery.

Raging Tempest3:33 pm 25 Aug 09

AG, $32 (or thereabouts) is not a ‘large chunk’ when your doc charges $70 a pop – and this is at Phillip. Like most, if I could get in when I need to, no complaints, its the combo of the cost and the week waiting time that’s ridiculous.

AG Canberra said :

And then getting a large chunk of that back from Medicare – so out of pocket is not much at all.

The $30 or $40 cost is ON TOP OF medicare. It’s not a refundable fee.

Healthcare consumer advocate Russell McGowan:
“Healthcare is about providing the best possible services for consumers and clearly they’re not doing that”.

Price is only one aspect of providing a good service, Russell. These businesses are doing their level best to keep up with massive supply/demand shortfall – advocacy efforts should be focused on getting more doctor’s bums on seats, not laying the boot into businesses already doing their part.

I say bring it on – hopefully it’ll decrease the waiting times. Might make a few people think twice about chuckin’ a sickie if it’s gonna cost them something (aside from their dignity) to obtain a doctors certificate.

And then getting a large chunk of that back from Medicare – so out of pocket is not much at all.

Clown Killer said :

Jon, Katy, Kevin, Nicola, anyone – please fix our health system!

Fixing the health system is one thing. Protecting the health system against tightarses who couldn’t be fagged paying a lousy $40 for a consultation with a doctor is another thing altogether.

Agreed, i have no problem with pay to see the doctor, i’d have less of a problem if i could get in without having to make my booking a week in advance.

These medical centres have the right to make money just as much as anyone else but it seems everyone wants everything for free

Wait until you have had a chronic illness, or a chronically ill family member, then $40-$70 to see a GP (times many, many visits), sometimes just to get a referal to a specialist, won’t seem so trivial.

Sometimes a bit of compassion can go places – not everyone is as genetically blessed as you.

screaming banshee3:00 pm 25 Aug 09

Ginnindera and Phillip medical centres can expect to see an increase in patient numbers as other Canberra residents discover how cheap it is.

My last visit cost me $58.

Clown Killer2:45 pm 25 Aug 09

Jon, Katy, Kevin, Nicola, anyone – please fix our health system!

Fixing the health system is one thing. Protecting the health system against tightarses who couldn’t be fagged paying a lousy $40 for a consultation with a doctor is another thing altogether.

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