Philosophical Conversations Public Opinion Junk for code
parliament house.gif
Think Tanks
Oz Blogs
Economic Blogs
Foreign Policy Blogs
International Blogs
Media Blogs
South Australian Weblogs
Economic Resources
Environment Links
Political Resources
South Australian Links
"...public opinion deserves to be respected as well as despised" G.W.F. Hegel, 'Philosophy of Right'

corporate medicine « Previous | |Next »
August 8, 2008

One of the changes in primary care is the rise of corporate medicine over the last 10 years. The corporates hoped that by setting up medical centres with GPs, pathology and radiology facilities and sometimes allied health-care workers, these would make money from a process of internal cross-referrals. GPs would refer their patients for pathology tests and X-rays to the in-house facilities, and some referrals could also flow the other way.

medicine.jpg For these medical centres to work, the corporates had to get GPs into them and money was paid, sometimes quite big sums, to lure the GPs in. For a lot of older doctors and some young ones too, this was a chance for them to pay off their mortgage and have something to put into their superannuation.

The new model medical centres are often open six or seven days a week and are usually open for extended hours every day. They all bulk-bill. A lot of them don't take appointments for their doctors. Patients therefore have to queue up and wait, and if a patient chooses to see a particular doctor rather than the first doctor available, then that obviously means an even longer wait.

The emphasis is towards encouraging loyalty to the medical centre rather than loyalty to the one doctor. Tuck Meng Soo, a Canberra GP, describes how the corporates work in The Canberra Times:

If a patient comes in for a check-up for her diabetes or to discuss the complications of her latest antidepressant medication and the consultation takes 20 minutes, the GP still gets $32.80 from Medicare. So, for a corporate to maximise income for itself and the GPs working there, they need to encourage patients with chronic and complex problems to seek health care for their conditions elsewhere and to encourage as many six-minute consultations as possible. This is precisely what the structure of the corporate medical centres does.

As more GPs are seduced into working for corporates, the non-corporatised GPs are left with an increasing caseload of patients with chronic and complex problems with the ''easy'' coughs and colds that used to leaven their day taken away. At some point, the burden of work and responsibility gets too much to bear and many non-corporatised GPs just give in and leave medicine or join the corporates.

| Posted by Gary Sauer-Thompson at 3:51 PM | | Comments (3)


The McDonaldisation of health care. Had to happen sooner or later, bit it doesn't sound like an improvement.

My GP charges $52 for a normal length conultation and 80 something for a long consultation.
When someone goes to a bulk billing doctor are they able to get more from medicare when a long consultation is involved?

As I've said before on your blog, Gary, health care and the market just don't mix. This is supported by ample empirical evidence. The onus is on Governments to actually govern and sort out funding arrangments that maximize benefit to patients/consumers and satisfy the clinicians. Trying to let the invisible hand achieve this results in inequity and inefficiency.