In a masterstroke of barely disguised money saving, Hockey has finally grasped the co-payment nettle and introduced a hefty $7 impost on the Australian public every time they want to see a doctor. I personally think $1 would have had the same effect without creating quite such a political firestorm.
The obvious concern is that all the patients that would have clogged GP waiting rooms may now rush en masse to the nearest Emergency Department, thus transferring the cost and work-load to the state governments. However the Australian government is hinting that even that door might close, leaving patients with coughs and runny noses out in the cold (no pun intended).
So what does this all mean for the medical workforce?
I must admit that I too have worked long shifts in both General Practice and Emergency Medicine, and grumbled about the trivial nature of the maladies that some members of the general public present with.
Doctors seem to fall into two camps on this:
- Those that believe that the right to "free" healthcare is sacrosanct
- Those that think that a co-payment is a good idea to give patients pause for thought
Whichever camp you fall into, bear in mind that your job exists to serve the needs of those patients and their maladies, trivial or otherwise.
The Australian government clearly wants to curb wasteful cost blowouts in health. Fair enough, and probably a necessity over the long haul.
Make no mistake, however - doctors, and their salaries are high on priority list of savings, being one of the largest costs. A co-payment reduces demand, ergo reduces the need for doctors to see patients, ergo reduces the size of the medical workforce.
Bravo for sensible economics. However, the lack of congruence should not be lost on us between this, and the massive increase of the numbers of medical graduates over the last few years. There are already concerns about a surplus of doctors in the marketplace that will only increase year by year. Should we anticipate an accelerated rate of unemployment amongst the medical profession?
If the co-payment for hospitals does not happen then there will be a natural gradient for doctors to follow the patients and therefore working in an Emergency Department just became a more promising career path. If it does happen then doctors may struggle to find any work at all in the future.
My suggestion: consider retail pharmacy as a career - I predict good times ahead for OTC consultation!
Dr John Bethell
Director, Wavelength International