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Ask Dr Dave

Ask Dr Dave - June 1999

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Ask Dr Dave - December 1997

Ask Dr Dave - October1997

Ask Dr Dave - August 1997

Dear DD I have been reading the budget papers and was concerned to see that the government is removing between 30 and 40 million dollars each year for the next four years from the General Practice Strategy. I thought this money had come from general practitioners' pockets through reduction in the Medicare increases. Are we being shafted? Anismus  

Dear Anismus

Like a pig on a roast. Your figures are quite correct and the money did come from sacrificed increases in the rebate.

Let me quote from the Budget 97-98 Fact Sheet 6. 'There will be a 0.85% increase in the Schedule fees for General Practitioner Attendance items, with the balance of the fee increase available through the General Practice Strategy'.

'As a crucial element of the commitment to improving and supporting General Practice, the Government will review the current General Practice Strategy in consultation with the medical profession. The Government intends to work with the profession to develop alternative approaches to General Practice funding that will reinforce and promote strategies which achieve positive outcomes for patients.'

You have yet to come to terms with governmental newspeak. I suggest you go home early and watch a few episodes of 'Yes, Minister.' Beware of words like 'alternative', 'savings' and particularly 'collaboration'.

DD

Dear Mesmerized

The costs of Medical Director are largely paid for through its advertising. In this regard it is no different from many medical magazines and television. If it is a big issue for you, there are many rival programmes but they are significantly more expensive.

You may soon be able to get free Internet access and telephone calls if you are prepared to put up with the advertising. It sounds great to me. I am really looking forward to 'ad waiting'.

Dear Hurt and Disappointed

It is unlikely the Medicare rebate will even keep pace with inflation. The Department of Finance says that 80% of claims are bulk billed and that this is proof that the rebate is more than adequate.

DD

Dear Hooked

The best way to stop bulk billing is to follow this simple plan:

• 1. Nominate a quit date. (Remember you are trying to break a bad habit.) Put a notice in your waiting room that all bulk billing will cease on that date. The quit date should be between one and two months away.
• 2. Try and reduce the excuses for patients not paying at the time. Install credit card facilities and EFTPOS. Offer to send off the completed Medicare claim form away for the patient. With luck the patient will receive their cheque before the Bankcard bill!
• 3. Do not deviate from your intention. The first few months will be hard. Experience shows that patient numbers go down by about twenty percent and gross fees by about five percent. It takes about four months before income returns to the previous level.
• 4. Make sure you and your staff have their patter ready when quizzed about why bulk-billing has stopped. Your staff are in for a pretty torrid time in those first few months.

Dear Suspicious

The best way to stop bulk-billing has been the subject of debate on the Oz Doc list for some months. The above four point plan represents the consensus view of the many doctors who have stopped bulk billing in the last year. You can become part of the Oz Doc list by enrolling at www.gp.org.au/GPDivmailer.html. Other discussion groups of interest to general practitioners are run by MedicineAu. The page at www.medicineau.net.au/MailingLists.html gives you information on how to join.

DD

Dear Anxious

Yes, I am afraid it is sometimes true. You do not exist. But look on the bright side, you have had 15 seconds of fame which is not bad for an entirely fictitious character.

DD