Don’t just grieve: let’s get our act together

2 minute read

My emotions since the rebate freeze have pretty much followed the classic Kubler-Ross stages of grief


It’s been only two weeks since we were blindsided by the extension of the Medicare rebate freeze, and on reflection, my emotions since have pretty much followed the classic Kubler-Ross stages of grief

So with apologies to Kubler-Ross, let me explain.

Denial – The Medicare freeze was overlooked on the night, and didn’t make major news. According to a friend in the lock-up, she didn’t even hear it mentioned all day – probably because wading through the several kilograms of budget papers is somewhat akin to an archaeological dig. Plus being unflagged, the move wasn’t on anyone’s radar.

But when the news did hit, surely I wasn’t the only GP to succumb briefly to disbelief.

Anger – Then anger hit. Why don’t people in general, and politicians specifically, understand the true value of primary care? Of course, doctors’ earnings aren’t a priority in the minds of economists or newspaper journos, and everyone born since 1972 seems to think GPs are free anyway, but it’s not about that.

Investing in primary care boosts the health of populations. And uninvesting will do harm.

Bargaining – If we all write a letter, sign a petition, write to our local MP, surely we can get the decision reversed!

Depression – With a cash-strapped government, I’m not holding my
breath for this to occur. And despite the majority of care being delivered in the community, hospitals and specialists are seen as the saviours. Few specialists bulk bill anyway, so GPs and our patients will take the hit.

Acceptance – While far from happily accepting the extension, the freeze has already prompted self-reflection among the profession regarding our billing practices and our value. The realisation that we, as a discipline, need to be united has been brought sharply into focus, as has the understanding that passively absorbing greater and greater relative cuts will get us absolutely nowhere.

It’s simplistic and naïve to say all GPs should cease all bulk-billing immediately. But we do need to win the hearts and minds of the public about general practice as a profession, not just their own GP.

While it’s rarely acknowledged publicly, the quality of general practice is patchy. This needs to change, and maybe now is the time to take a long, hard look at ourselves.

The ball’s in our court.


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