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
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| 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