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Ripped Off

Dear Ripped Off

Surely you are not surprised. It is only human nature to wish that all your wants and needs will be satisfied at once. I am sure you would give the same answers in their position.

Maybe general practice should be more like McDonald's. "Ah Mrs Jones, just your usual. That would be the ... BP check and scripts. Would you like a side order of fasting cholesterol with that?"

Unfortunately for GPs, our patients often want something that is not on the menu. "Oh, by the way doc, just before I go, can you do anything about this nagging back pain that wakes me every night?" Do you scribble Naprosyn on the bottom of the script, or say "Mention that to me next time" or stop to check that your biannual prostatic secondary or an ankylosing spondylitis is not about to walk out the door?

Time and money. Everybody's life revolves around it and most people have more of one than the other. You could probably satisfy most patients' needs by seeing only three patients an hour. The patients who want this sort of service must then be happy (or at least prepared) to pay $50 per consultation.

Whatever your style of practice, it is imperative that you inform your patients the basis on which you work. At least then they will understand why they have had to wait 45 minutes or why it costs $20 out of pocket to see you or why they are out the door after they have been given only the briefest description of their symptoms. DD

Sympathetic

Dear Sympathetic

I too felt sorry for him. It must have been a terrible shock for him to come into the health portfolio and find that the Labor government had virtually frozen increases for GPs' fees in their forward estimates for the next four years. He was undoubtedly right not to tell the leaders of the GP organisations about this, for it would only have frightened them and made them worry about their future. And, although as Health Minister he has the power to index these fees to the CPI, it would upset all those hard working public servants that tell him what to do and we couldn't have that.

He seemed to think that the "pay doctor" cheques might be a good idea, but his advisers (who are very clever) thought that it would tend to make doctors less likely to bulkbill and he had already promised the Australian people that he would never allow that to happen. DD

Newbile

Dear Newbile

Computers are really good at some things and really bad at others. They are still pretty hopeless at speech recognition, useless at making medical diagnoses and make rotten television sets. By now most people have had some experience with the things they are good at; balancing a cheque book, writing a letter, presenting a talk and helping you to get organised.

In the last few years the internet has revolutionised the way we use computers. The ability of one computer to communicate with another even at slow speeds has seen a major shift in the things computers do. Secure email is now replacing the fax for business communications, the World Wide Web is everyone's encyclopaedia and Internet Relay Chat is the piazza of the cyberworld.

ICQ is the cyber-equivalent of the coffee shop of Seinfeld. ICQ can hang in the corner of your screen while you get on with your work. If one of your friends comes on line, you will see her name change from red to blue in your contact list. If both of you feel inclined, you can start a conversation either in text or, if you have it installed, by internet phone. If you are busy, you can put up a "Do Not Disturb".

ICQ is part of the revolution in changing the way we work. Businesses that allow their staff to work from home can be in constant communication with them via ICQ. Media and computer companies use this type of technology now. Divisions of general practice, medico-political groups and government health bureaucracies could all benefit from using ICQ.

Unfortunately, despite all the hype about teleradiology, telepsychiatry and telesurgery, doctors still need to be in the same room as the patient. So, at least for the moment, it's still "Beam me up, Scotty." DD