The outgoing President of the Royal Australian College of General Practitioners (RACGP), Dr. Karen Price, wants GPs to share her vision of a profession to be proud of, one that is noble and resilient despite the “very deep pain of decades of neglect”.
appeal an exclusive podcastsaid dr Price said her final months as presidency would be among the busiest of her term, as her time is divided between speaking to young people, strengthening the Medicare taskforce and continuing to advocate for reform of general practitioner funding.
“The need for reform is long-standing, and the Medicare rebate freeze was just the beginning of the decline,” said Dr. Price InSight+.
“Even before that, Medicare’s indexing was the beginning of ‘slow frog cooking.’ Now we’re at the point where we need to do something, and that’s crucial.
“For at least a decade, if not more, there has been a damaging and ridiculous disparagement of our profession.
“The consequence of this is a missing workforce pipeline, which is only now really manifesting itself.”
Research published in MJA in 2020 showed that the proportion of University of Western Australia medical graduates who were registered as GPs as of December 2019 had fallen from about 40% of those who graduated in 1985–1987 to about 15% of those who graduated in 2004– made in 2007. At the same time, the 2022 National Data Report from the Medical Schools Outcomes Database showed that the proportion of senior medical students whose first preference was general practice had fallen to just 13.8%.
“We have supported and replenished the wonderful international medical graduates who now make up almost 50% of our college membership,” said Dr. Price.
“But it’s not a long-term strategy to keep importing professionals when there are absolutely highly qualified high school students, primary school students or even non-Australian-born students who are going to make great general practitioners.
“Australia failed in that regard.”
dr Price and the college have been very vocal about the future of bulk billing, urging primary care practices to “do what they have to do” to remain financially viable.
“We certainly have anecdotal evidence that patients who are very engaged with their GP and see him regularly are saying, ‘Don’t you dare bill me bulk – I want you to keep your doors open,'” he said you InSight+.
“We know [privately billing patients] It is most difficult for those doctors who work in low-income areas.
“And I know that to some degree this might have put some pressure on some doctors, but the message wasn’t about abandoning mass billing. It was do what you have to do to keep your doors open so you can serve your patients.
“If that means you have to gap load some, then do so.
“I have great sympathy for the doctors who work in low-income areas where they are very challenged by Medicare, and it’s just unacceptable that our affluent country has a system where people don’t have access to healthcare after care.” Expenditure.
“That’s not acceptable and I think most Australians would agree.”
dr Price remains committed to multisource funding for general medicine.
“There is no single answer,” she said.
“When you are in Rose Bay you need a very different source of funding than you are in Broken Hill or in Arnhem Land.
“It doesn’t matter what system you use, if it’s underfunded it won’t deliver results. All systems applied as a top-down approach have unintended consequences.
“What we’re trying to advocate is that GPs can choose what funding model to run their clinic on, and that allows for professional autonomy, it allows us to address the law of inverse care [the principle that the availability of good medical or social care tends to vary inversely with the need of the population served].
“In the [Strengthening Medicare] Taskforce, I keep bringing it to the table that there isn’t a health care system in the world that has really addressed the inverse care act in terms of funding – multi-system funding comes closest.
“If you go in one direction as Britain or as America, you have these horrible gaps and horrible system blockages and malfunctioning. We really want to avoid these very salient lessons.
“We cannot continue to cut out parts of the system and only fund parts of the system. That’s how you break the system.
“This is absolutely not about the income of family doctors. It is about the resources of the basic supply. It’s about GPs working to the fullest. It’s about us providing health care to all Australians.
“To ignore this problem, in my opinion, is to walk down the path of disaster.”
Despite all the problems, Dr. Price optimistic about the future of general medicine.
“If we can get some really strong signals from this administration, I think that will help boost morale,” she said.
“We have a 10-year plan and that’s probably how long the reform will take.
“I hope we can really start moving the scale. We need to be able to make a mark for the younger generation [of doctors] that there is much reason for optimism.
“If we’re going to do this intelligently, we have to look at the whole, we have to look at the rational use of resources, and we have to look at the whole system.
“And the evidence tells me that if you invest in primary care, you get a much better performing healthcare system with a lot less overall dollar investment.”
As her term expires, Dr. Price recounts her time as “wartime” President, coming into office at the height of the COVID-19 pandemic.
“People were like, ‘Oh, you drew the straw,'” she said.
“You could look at it that way, and the first year in Melbourne on Zoom, that was pretty tough.
“But when I think about it, I’m also lucky because I was able to show what the family doctor’s office can do. I got to speak about the obvious evidence of what my colleagues were doing. Leading a college and community through a pandemic is an amazing experience. I think I’ll look back on it with all that awe and wonder.”
And what is she particularly proud of?
“What I’m most proud of is hopefully reflecting a vision of general medicine that GPs themselves can be proud of. The GPs feel like they are heard, that they have a voice, that they are actually doing some freaking damage, they do a great job, and take pride in their professionalism.
“See, the system is really tough. Don’t let how you practice, try to practice in a professional way.
“I’m just proud that GPs can say we’re a noble profession. They have acted this way during COVID-19, and they are doing so by articulating the very deep pain of what has been neglected for decades.”
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