The topic of the after hours GP continues to be a significant talking point in government circles and across the medical field in 2019.
With discussions ongoing about the role of Medicare and the diversion of resources from public and private institutions, there is a genuine debate to be had about how a 24/7 practice can thrive and what the costs and benefits look like when weighed against one and other.
Here we will take a closer examination of this debate, seeing what is being argued by advocates and dissenters.
Managing Industry Costs
In 2017 there was a comprehensive review conducted by the government that focused in on the role of after hours GP and the results were not entirely flattering. The Medicare Benefits Schedule Review Taskforce reached a conclusion that the initiative was not providing value for money for the Australian taxpayer, rising by a significant 170% when compared from 2010-11 to 2015-16. That is not commensurate with the increase in population growth and because of this spike, there is doubts and concerns about the validity of the industry if costs under Medicare are to be correctly managed into the future. There is also a variety of insurance schemes that have different policies and with the $80 rebate, it can be hard to justify services that fall under that threshold on a repeated basis.
Lowering Industry Standards and Norms
For what is being described as an ‘Uberfication’ of the industry where consumers are driven by smartphone apps for convenience at the click of a button, the after hours GPis viewed in some circles as a threat to the industry standards and norms in 2019. Other than those specialists in rural communities who are trusted and based in those local areas, there are other potentially dubious operators who can promote themselves as specialists without the necessary skills or qualifications, using the need for convenience to abuse the system at large. So far there has been very little instance of this occurring, but simply opening up an online avenue can lead to problems.
The subject of convenience is seen as a major benefit for the after hours GP as patients can receive at home care with one phone call or digital message. Whilst offering flexible work hours for the specialist, this allows those who struggle to travel, those who find it logistically difficult to reach a practice or others who have unique conditions the ability to see their trusted GP when it suits them. That is a privilege that is not taken for granted from the perspective of those that need these types of initiatives.
Relieving Emergency Rooms
The medical field is universal when it comes to one single domain, and that is the stress of the emergency room where pressure to deliver can be overwhelming. When these spaces are exhausted for space and resources, having an outlet such as the after hours GP where patients can receive care is paramount to alleviating these pressures. Even one or two less patients in a cluttered environment with dozens of patients can help those staff who are on call, a scenario that only increases the need for beds and medical attention on site.
Making the Case-By-Case Argument
Due to the after hours GP being such a hot topic for debate, it is worthwhile looking at the middle ground arguments where the initiative can be implemented and where it can be pulled back in some circumstances. In rural communities where traveling to see a general practitioner can be logistically difficult, this is where these programs can genuinely save lives. Likewise in suburban locations with a demographic dominated by seniors and the elderly, this is where a direct line can be drawn between supply and demand. Then there are dense metropolitan regions where there is a high density of public hospitals and private practices, offering a wealth of medical services ready and available for that constituency.