Keeping the emergency in ED

What gets funded gets done. In primary care (i.e. General Practice), where additional resources or time is required, we are funded to fail. As small businesses, we simply cannot compete with the fully funded, 24/7 staffed EDs where there is no out of pocket cost to the consumer. It’s not rocket science. It’s maths.

Case in point: Adult with acute gastroenteritis.  Mild dehydration.  Assessment completed, appropriate to give IV fluids and monitor results.  GP time for assessment, insertion of cannula, regular review, let's allow a total of 20 minutes.  Treatment room bed now taken up (unlikely to have an isolation bay, so this may or may not be appropriate) consumables used, RN time.  Allow observation of 90 minutes post assessment and initiation of treatment, so say, close to 2 hours in the practice in all.  Medicare rebate: $73.95.  This is the patient's purchasing power.  If bulk billed, NO OTHER CHARGE can be raised e.g. can't charge for the cannula, the fluids, the RN time.  This has to cover ALL of the expenses, including rent, reception, insurance, holiday pay, long service leave, computers etc.  We would LOSE money.  If you can't pay the bills you have to close the doors and this is what has repeatedly happened when this has been attempted.  Patients don't want to have to pay and GPs can't afford to lose money + potentially would have to turn business away as there are no beds available in the treatment room.  We'd have to employ more nurses, build bigger premises, but no one wants to pay for this and Medicare does not pay well enough.

Look at the cost of the nurse-led clinics in Canberra.  $$$$ more than what Medicare pays GPs.  

GPs in acute care: Funded to fail.

Why the contribution is important

Reality check.

by Lady_Gwendoline on August 13, 2019 at 10:49AM

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Comments

  • Posted by mcrice August 13, 2019 at 17:26

    Well said Lady Gwendoline
    "Follow the money"
    The patient has FAR greater purchasing power in ED than in the community
    Level out the playing field and watch what happens
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