Wednesday, 3 May 2017

A Vanishing Icon !

Once upon a time - and not long ago - to proceed your name with the title " Doctor " was almost like having a Knighthood.   Every suburb and village seemed to have a resident GP who administered to the medical needs of residents and it was generally conceded that he or she would earn an above average income, live in a nice house and be able to afford an above average car.   They were treated with respect and becoming a doctor was one of the most sought after courses of study at University.

In todays world the number of medical doctors who are designated a " General Practitioner " is fast eroding.   For every new " GP " there are now about ten new " specialists ", simply because the financial rewards for providing GP services to the public are no longer rewarding.

It is a fact of life that those that qualify from university and begin years of gruelling, lowly paid training in a public hospital as a " registrar "doctor do so with a very large HECS debt.  Financial security is important to them and emerging and working as a GP no longer delivers that reward.  Most of the patients who will use their services will be billed through Medicare and the return for a twenty minute consultation has been pegged at $ 37.05.

Unless that GP has the good fortune to setup practice in a really affluent suburb where the vast majority of patients can afford to pay as a " private patient " at the rate somewhere between sixty and seventy dollars for each consultation the cost of opening and running a surgery simply do not  deliver financial security.

The end result is delivering statistical horror.  Many country towns and vast areas of the suburbs have no GP services.  In many others, booking an appointment with the few remaining GP's can be a matter of weeks ahead and consequently we see patients in long queues at the emergency department of the local hospital seeking help for what they would normally get from a General Practitioner.  As a result, our hospital system is fast reaching breaking point.

The average Australian now lives well into their eighties and medical frontiers are constantly advancing.   It is conceded that the gateway to good health is to have every person attended through life by a GP who understands their lifestyle and habits and makes sure that vaccinations and regular health checks are up to date.    That GP is the gate keeper - channelling his or her patient to the various specialists who prevent or treat the common diseases that occur with age.

The fact that few young emerging doctors are entering the GP field is ominous.  The existing GP ranks tend to be elderly and they can be expected to thin further in the immediate years ahead unless this category of practice is made more rewarding.

The " bean counters " who allocate medical expenditure are getting it wrong if they think they " save " money by cutting the return for a GP consultation.  That demand simply transfers elsewhere, and in most cases it is the hospital emergency department that has to be expanded and staffed to deal with the overload.

Perhaps a very good time to be realistic.  Just what priority should health hold in the general mix of public spending ?

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