Australian Doctor Australian Doctor 15th September 2017 | Page 10

News Pollies! Primary care needs a pay rise Comment Dr Justin Coleman The earnings gap between GPs and other specialists is ludicrous. It’s time to put it right. ONE always has to be cau- tious complaining about a GP’s hourly income, which would probably pass the pub test as being pretty good. When you’re earning three times the rate of the bloke serving you drinks, you might not want to air your grievances too loudly. But retreat from the pub- lic bar into the safety of a doctors-only forum, and it’s safe to let rip. Are you kidding me? What’s going on with those crazy wage discrepancies? I don’t begrudge any other doctor a reward for provid- ing the right care in the right orifice at the right time. Admittedly, anaesthetists may have the occasional death ... but who doesn’t have that problem? And I know that derma- tologists have to do lots of study about organs buried deep beneath the skin — liv- ers and so forth, they tell me. But let’s face it, they exert nearly all their brain power on the only part of the body that’s easy as pie to visual- ise, so how hard can it be? According to the latest MABEL (Medicine in Aus- tralia: Balancing Employ- ment and Life) figures, dermatologists get paid exactly twice what we do for staring at psoriasis: 4023_bp_master_HALF_PG_260x193_AD.indd 1 10 | Australian Doctor | 15 September 2017 $204 per rash-hour com- pared with our $102. They deserve a somewhat higher rate, sure, to make up for extra years of study and some sort of boredom allowance — but double? The world’s gone mad. As for the orthopods’ 150% mark-up on the standard GP rate, I won’t even go there. Although per- haps I should, at least until I pay off my mortgage. Arguably, the pay gap should be closed by raising the GP bar, rather than low- ering the specialist one. This would actually be quite likely to pass the pub www.australiandoctor.com.au test, as long as the pub was a plush, inner-city job, fre- quented by stockbrokers and accountants. Caring for other people’s money has always been far more lucrative than caring for their children or elderly parents. Of all the specialties, only paediatrics and psychiatry had an hourly rate within an extra 50% of ours, so I reckon they could join us in our protest. If you’re not surrounded by expensive machines like the radiologists and oph- thalmologists are, it’s harder to convince people that your skills are worth top dollar. Who can put right this undervaluing of primary care? Like everyone else, I’ll place that burden on politi- cians — at least, those with- out dual citizenship, if any remain by the time this goes to print. Fond as the pollies are of pub tests, for them, instead, I propose the bucket test. Divide the health budget into two buckets, labelled primary care and tertiary care. Give a politician next year’s budget increase and ask them to tip this extra cash into one of the two buckets. If they want publicity for their dollar, they’ll go ter- tiary care. A new cardiac ward, MRI machine or dial- ysis unit is photo gold. If they want health out- comes, it’s the primary care bucket every time. Count- less studies around the world have repeatedly dem- onstrated that the health of a nation’s citizens is better served through money spent on primary community- based care. If the politician chooses the primary care bucket, that wage gap will slowly reduce. If they choose tertiary care, I’m back down to the pub to whinge about my lot in life. Another whis- key, bartender, and hold the anti-pathy. ● Dr Coleman is a GP at Inala Indigenous Health Service, Brisbane. 31/08/2017 10:43 am