Why invest in general practice?
Accessibility and affordability of longer consultations in general practice need urgent attention
Dr Ramya Raman
Vice President RACGP & Chair RACGP WA
Recently, I’ve had many conversations with colleagues and politicians regarding the need to increase Medicare rebates, particularly for longer consultations. But why? Do policymakers actually understand what GPs actually do for their patients?
A 62-year-old patient of mine presents for a review of his diabetes care. The consultation begins with him explaining how tough it has been to balance running his small business while being the sole carer for his wife, who has been diagnosed with dementia. We dive into his blood results, which show poorly controlled diabetes with early-onset renal disease. We review his medication compliance, which has not been ideal, and discuss options including a webster pack. He says he has been struggling to get some of his medications due to shortages. I call his pharmacist to discuss this, explore alternatives, and relay this to him.
As we plan his follow-up appointment, he mentions he’s been recently struggling with bloating and constipation – a new symptom. We are 22 minutes into the consult.
I wonder if I should ask him to book another appointment. But, as the sole carer for his wife and a small business owner, I know he struggles with time. So I decide to address his latest symptoms and work through potential red flags.
As I walk him to the door and arrange his next appointment he says, “Doc, I’ve been struggling to come to terms with my wife’s diagnosis of dementia. I’m tired of running around for appointments for myself and for her. I just can’t see her like this, it’s really getting me down…”. It’s 38 minutes into the consult. This is just one example of a ‘long consultation’ in the rooms of a specialist GP.
Specialist GPs are the first point of contact for most Australians dealing with chronic health issues. But the current Medicare funding structure often fails to cover the true costs of longer consultations. This election presents an opportunity for policymakers to take meaningful action in supporting general practice and the health of Australians. We are calling on a 40% increase to Medicare rebates for Level C and D consultations.