A Coalition backbencher who once worked as a GP is calling for a crackdown on “cowboy” doctors in any government push to overhaul Medicare.
Andrew Laming, who is still a qualified eye specialist, has also suggested financial rewards for high-performing doctors, and taken a swipe at his government’s recent Medicare reform efforts.
“At the moment we don’t have speed limits on doctors,” Dr Laming told AM.
“I think that if you’re seeing more than 10 patients per hour you can’t be delivering quality medicine, doesn’t matter how smart you are.
“So we do need to be looking at ways to pull the cowboys up. It’s been a difficult discussion that’s never really been had,” the Queensland Liberal MP said.
Dr Laming believes any health reform needs to reward quality medicine, giving successful doctors financial incentives through the Medicare system.
“And that means identifying some targets for patients, rewarding GPs that hit them and of course no rewards for those that don’t,” he said.
“It’s a hard world out there but we have to be looking after people with chronic disease and making sure that they’re in the hands of the best possible providers.”
Australian Medical Association (AMA) president Brian Owler said he would support measures to reward doctors doing the right things.
“Overseas, there are other models where people are actually given extra funding, particularly for chronic disease management,” Dr Owler said.
“Those more complex patients that are more likely to end up in hospital care, if we can manage those patients better and if you invest in general practice for GPs to do that better, then you have savings in the system in the long-run because you keep those patients in the community out and of hospital.
“I think if we’ve got GPs already doing that, then that should be recognised and I think we should be … providing incentives so that GPs can do a better job of that really important work.”
Doctors, pharmacists to raise concerns in consultations with health minister
New Health Minister Sussan Ley will this week begin consultations with key groups in the sector as she works on the Government’s third attempt to overhaul Medicare.
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Dr Owler said the discussion should be centred around quality of care, not the number of minutes for a consultation.
“We need to talk about how we get the best out of general practice and primary care for prevention and chronic disease management … rather than just basing everything on the length of consultations,” he said.
“What we should be doing is getting to talk about how we actually manage people better in the community and keep them out of more expensive hospital care.
“There are problems still with the proposal that’s on the table but now I think at least there is a new Minister, she has time to get across the portfolio, to do the consultation. ”
The Pharmacy Guild is using the Government’s search for health savings to renew the push for pharmacists to be given greater responsibilities, allowing them to issue repeat prescriptions and treat minor ailments such as middle ear infections.
“Around the world what we’re finding is that governments and health systems are using pharmacy in a range of areas, taking pressure off doctors and emergency departments and finding ways to actually enhance patient health outcomes and at the same time increase overall efficiency,” executive director John Quilty said.
Mr Quilty does not believe this would be at odds with the Government’s desire to reduce so-called six-minute medicine.
“Doctors would have more time to actually spend using their full array of skills in terms of treating patients with more complex and more chronic health conditions,” he said.
Last week, Ms Ley announced the Government had dumped plans to cut the rebate for short GP visits by $20, amid a fierce political backlash and stiff opposition from doctors.
Ms Ley said the Government remained committed to a GP co-payment as a price signal in the health system.
“It is still Government policy, but that doesn’t mean I’m not keen to hear people’s views about it,” she told ABC News Breakfast.
Dr Laming expressed disappointment with how his senior colleagues have handled the Medicare debate so far.
“All power to Sussan Ley – she’ll be consulting widely,” he said.
“There’s plenty of good people who can come up with some good ideas, but as I’ve said, 2014 was not a good year in Medicare reform and we need to make sure that the shadows of 2014 don’t affect this consultation process.”