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Morale in General Practice: Is the glass filling up?

Thursday December 5, 2019

This month’s Medicus magazine focused on morale in our hospitals – but what about morale amongst us general practitioners? Some would say that General Practice has been downtrodden and neglected for so long that GPs have forgotten what it is like to feel positive. In truth, as I talk to a wide range of GPs, I hear mixed messages.

Many will say that they have a rewarding, flexible career and by community standards, are relatively well paid for it. As GPs, we also have the advantage of the opportunity to own our own businesses, and are in demand to practise in a wide variety of settings.

In my AMA work, I have always found that I have been respected as a GP, and it has been very helpful on many occasions to know something about almost every branch of medicine.

However, I also hear many GPs pointing out the income discrepancy between themselves and their non-GP colleagues, and the many years of government neglect of General Practice. Does anyone remember the ill-fated Relative Values study, which showed General Practice so undervalued the government decided they couldn’t afford to tackle the imbalance and simply shelved the whole report?

I am a glass half-full person, and I see some encouraging signs emerging recently. Whenever I attend meetings with the Department of Health, or the MBS Taskforce, there is always talk about the central role and importance of General Practice.

In fact, one of the first actions of the MBS Taskforce was to defend General Practice from a very strong consumer group push to dismantle our gatekeeper role, so ensuring that patients continue to access non-GP specialists only upon GP referral.

In the words of MBS Taskforce Chair Professor Bruce Robinson, “We have the world’s best and most efficient health system, why would we want to dismantle it?”

He added that he would like to see the role of the GP strengthened, not weakened.

So we have fought the Medicare freeze and won, with General Practice the first specialty to be thawed. We have successfully fought the proposal to artificially regulate pathology rents. These are the first fundamental steps to ensure the survival of General Practice.

But what can we do to ensure we flourish and fulfil our potential in providing the most cost-effective healthcare in Australia?

The AMA has been pushing Federal Health Minister Greg Hunt very hard to recognise the importance of General Practice, and most importantly back this up with action. We also have had dialogue with the MBS Taskforce. I think it is fair to say that most of what we might gain will not come via increases to the consultation rebates, even though I have been advocating for better rebates for longer consultations.

Where we have made progress is in the recognition of the work that we do that is not face-to-face consulting, which most estimates put at around 30 per cent of hours worked. The government has agreed to implement the MBS Taskforce recommendation to introduce voluntary patient registration, and allocated $450 million to start with the over-70s.

Minister Hunt has also asked for a 10-year plan for the future of General Practice. The AMA will be part of the Steering Committee advising on this, and I intend to play an active part in pushing this in the right direction.

So if we continue to advocate forcefully and constructively, the future of General Practice looks brighter now than it did a while back. Representing the whole profession and with a GP President, the AMA has a central role to play in this.

So what can you do? Firstly, bill what you are worth. The government determines patient rebates, not fees. High bulk billing rates are always quoted to justify government inaction.

Secondly, maintain your AMA membership and encourage your colleagues to join, as this gives us all a stronger voice.

Finally, be an active member; please email me with any problems or suggestions at Simon.Torvaldsen@amawa.com.au