RACGP : ‘ It is time for GPs to abandon universal bulk-billing ’

Infectious agents : Doctors expose the real threats to James Bond

How can doctors possibly set up mixed-billing practices when the vast majority , if not all , of their training is in bulk-billing practices with principals who openly say , “ I ’ m not comfortable discussing money .”

What other business offers free services and pays for some of it out of its own pocket ?

Not enough of us have the courage to push for change , but if

Bond ’ s ability to avoid serious orthopaedic injury despite numerous fistfights , falls and crashes is quite remarkable .

It ’ s medically possible Bond has inherited an SMAD9 gene mutation , which confers high bone density with resistance to fractures , as well as a broad mandible and large shoe size . But then higher bone density also causes a tendency to sink when swimming , and isn ’ t this at odds with

enough of us are given the means and tools to do so , we may have a winner .

I stopped bulk-billing everyone in 2013 and have not looked back .

It is not about whether bulk-billing is a good service model or not ; it is about how I feel about myself when I give everyone the same service , which I think is good , while working more than I want to and , on occasion , in a way that feels unsafe and frantic .

Dr Imaan Joshi GP , Liverpool , NSW

Thank you , Dr Karen Price ! What a relief to finally have an RACGP president stand up and state the obvious .

I agree that if we all privately bill even just the non-concession card holders and children , suddenly the Medicare rebate will go up .

Why should hospital doctors get paid so much more ?

Why don ’ t we have equivalent employment benefits , such as holiday pay / sick pay / maternity leave / salary sacrificing / superannuation / long-service leave ?

Who would train as a GP now ?

Dr Jennifer Bowler GP , Gwynneville , NSW

Memo , RACGP . Who was it , in concert with the AMA , who virulently opposed the 2014 plan under Tony Abbott to introduce a co-payment ?

It was only $ 7 , but once the principle is established , increasing it is much easier .

A modicum of vision and backbone in 2014 would have seen general practice in a far better state in 2021 .

Too little , too late , RACGP — as usual .

Dr Joe Kosterich GP , Woodvale , WA

The recommended AMA rebate for

a standard consult is $ 86 .

Argue for an increase in Medicare rebate and you might get a dollar extra a consult , but you also get the expectation that bulk-billing can continue .

It is not sustainable and hasn ’ t been for a long time .

Dr Felicity Shepherd GP , Cremorne , NSW

Time to hang up on the PBS authority script line , says RACGP

The authority script line is a fun event in paediatrics as well .

After the 1-5 minute wait on hold , and after the confirmation of all the different numbers , I ’ ll get something like this : “ Could I have Concerta 27mg tablets for one a day and 30 with five repeats for ADHD , please ?”

“ Sure , I ’ ve just got a few questions . Is that for once-a-day dosing ?”

Indeed , and I ’ m surprised at your lack of recall . “ Will that exceed 80mg a day ?”

Is this the final result of calculators in schools ? “ Was it first prescribed between the ages of six and 18 ?”

Well , she is 10 , and it ’ s the first time .

“ Is it in accordance with state and territory laws ?”

Ah no ... you ’ ve got me there , never mind ! And so it continues . What an absolute waste of everyone ’ s time .

I had one lady last week who couldn ’ t even bring herself to ask these questions and was just laughing about how ridiculous

they were . At least that made it interesting .

They should absolutely get rid of the entire process . It serves almost no purpose .

Dr Stephen Ansley Paediatrician , Gold Coast , Qld

Is anger at the heart of anti-vax lies ?

It is autonomy , and its perceived infringement , that fuels the anger at vaccine programs , especially vaccine mandates .

After the Vietnam War and the mass protest marches , there is no prospect of any political party reintroducing conscription .

Individual rights trump potential societal benefits .

I can choose my doctor , my gender , my treatment , my partner , my job , my recreational drugs , my birth plan , my super fund , my complementary medicines .

‘ Sleep with me or you ’ ll lose your job ’ has been rightly consigned to the dustbin of history — even for CEOs , movie stars and pop stars .

But ‘ get vaxxed or you ’ ll lose your job ’ is regarded as the same evil imperative , an unrequested and automatically declined invasion of my body , my rights .

And for the unscientifically minded , there have been disasters like thalidomide and Vioxx — both regulator approved and marketed as safer than the alternative drugs . So when it comes to vaccine mandates , the knee-jerk response is ‘ I decide what goes into my body ’, rather than the scientific reasoning that the binary choice is between filling my lungs with a rapidly evolving bat virus or my deltoid with a small dose of highly regulated , sterile medicine .

But the truth is this choice is not between conscription and liberty but between conscription and invasion by a merciless enemy .

Dr Ian Hargreaves Surgeon , Sydney NSW

Doctors referred to

AHPRA after woman ’ s corporate heart check death

Along with these corporate health checks , you can include sleep studies , pharmacist blood pressure checks and the blood group screening

offered by naturopaths .

These are all money-grabbing enterprises rather than good patient care .

The Federal Government should shoulder some of the blame for the way it has degraded general practice and allowed these businesses to flourish .

Dr Tan Letran GP , Liverpool , NSW

GPs react to the RACGP ’ s rebrand

Rebadging a brand is probably evolutionary — like a dog marking its

territory .

It usually seems to coincide with the appointment of a new CEO , president , editor , vice-chancellor , etc .

It is also invariably expensive , involving branding companies , cartoonists and office supply companies .

Its greatest expense is the alienation of traditionalists , who see no need for change and who identify with the symbols of their youth .

I wonder if the influence of branding our Prime Minister ‘ ScoMo ’ has anything to do with this burgeoning phenomenon ?

Professor Max Kamien GP , City Beach , WA

Bond ’ s many amazing feats in the water — so often filled with sharks and other human predators ?

Dr Michael Copeman Oncologist , Palm Beach , NSW

GP fights back over acronyms in specialists ’ letters

I spend a lot of my limited time googling

these abbreviations only to discover that the specialist ’ s secretary has managed to misinterpret the abbreviation . And why wouldn ’ t they , given they make no sense to anyone but the author of the letter ?

The other thing that happens is that autocorrect has auto-uncorrected them .

I recently rang an endocrinologist and said his letter was incomprehensible and therefore useless .

The time he spent redoing it could have been spent using complete words in the first place .

Dr Vivienne Tedeschi GP , Bowraville , NSW

Initialisms not acronyms . An acronym is an initialism that can be used as a word .

Consultants use initialisms to differentiate themselves from the rest of us .

Dr Henry Berenson GP , Charnwood , ACT

I now send letters back if the writing is illegible ( yes , some ED reports and op notes are still handwritten ).

I also send them back if they contain subspecialty-specific or institutionally specific abbreviations .

I spent 20 years running courses for doctors that focused on communication

with patients .

Perhaps I should start again but this time focused on doctor – doctor communication .

Dr Paul Nisselle GP , Melbourne , Vic