GP Home Visits !

Another of those spats between the states and the Federal government has broken out over medical costs.   In most areas, local General Practitioners work a roster to provide what they call an " Emergency Home Visit service " at weekends, and sometimes this is also available weekdays after 4 pm.

This advertised service is bulk billed and consequently many who would otherwise make a visit to a hospital emergency room use this GP callout instead, and that is where the costing meets a fork in the road.   Hospitals and their emergency rooms are a state cost.  Medicare - which pays GP reimbursements - comes from the Federal Treasury.

The cost analysis people estimate that each patient presenting at a hospital emergency room costs between $400 and $500 for that visit.    A GP making a home visit out of hours can claim between $127 and $ 150, depending on whether that call is classed as " an emergency ".   It is claimed that the vast majority of such calls do attract that designation, and this compares with the $36.30 a GP receives if they see a bulk billed patient at their practice.

We have over stressed emergency rooms and our ambulance services are under pressure and anything that offers relief is welcome.  This after hours home visit service has been long established and most GP's are under pressure to contribute their time on a roster basis as a public service.  There have certainly been instances where it has saved lives by diagnosing a critical need for a patient to be rushed to hospital, which probably would not have happened had it not been available.  In some cases, making the decision at the weekend to wait and consult a doctor during the working week can be fatal !

Concern is being expressed that this after hours bulk billing service is costing $220 million annually. Most GP's do not normally make weekend or after hours calls and by pooling their numbers to provide this service on a rostered basis the public can be attended by a GP and individual doctors still maintain an uninterrupted lifestyle for most weekends.

Several years ago it was proposed to establish private after hours GP services in the community and clinics for this purpose were to be provided at public expense.   Some plans called for these to be staffed by GP's on the public payroll, while others envisaged the pooling of private practice GP's who volunteered their services on a rostered basis.   Some actually became a reality, but with very mixed results and now they are few and far between.

It would be a disaster if this weekend home visit service were to cease.   It would obviously push emergency room traffic to breaking point and the obvious answer is to reach some sort of funding arrangement between the Feds and the states.   That $36.30 bulk billed fee for a surgery consultation is too low, given the cost of running a practice and the lower $127 call out fee for a weekend home visit is reasonable, given that the doctor must provide transport and in some cases the visit can be very time consuming.   Deciding whether to class the call as an " emergency "  - and claim $150 - is a matter of conscience.

That old adage - " If it 'aint broke, don't fix it "  comes to mind !