To be sustainable, a GP’s surgery has to be run as a business.
It now costs on average at least $200,000 (2014 calculations) per annum to run a small GP surgery, before the doctor themselves starts getting paid, before tax. (Many patients think the payment “at the front desk’ - whether Medicare or privately charged - is the GP’s “hourly rate”. They are unaware that the payment for the consultation is the only “revenue” of the surgery, and that all other myriad practice costs have to be paid, before the doctor starts getting paid, before tax.)
The costs of the practice are: salaries and wages for all the surgery support staff (including super), office rent, the GP’s medical liability insurance, workers compensation premiums, all other insurances, utilities, technology, office furniture & fittings, medical and special equipment, vehicle, accounting, legal expenses etc before the GP starts to get paid, before tax.
Let’s break this $200,000 p.a down so we can illustrate the costs of an average GP practice per day and per hour.
For this calculation we assume the following:
* The surgery operates 48 weeks per year (4 weeks holiday), 5 days per week.
* Opening hours: 9am - 6pm
* 1 hour lunch, but realistically the GP often sees drug reps during this time – at no charge – to ensure the GP knows the intricacies, including side effects & drug interactions, of the latest medicines coming onto the market.
* 15 mins tea break, taken once, either morning/afternoon
This seems to leave 7 & 3/4 hours of work time.
Realistically, however, there needs to be time between appointments, e.g.: for admin related to previous/future appointments and the GP to make/answer calls. Added to that there is - at the very least - 30 mins other admin every day (usually *much* more) that the GP must do with no money coming in at all, for checking specialist & hospital letters and reports/results/blood tests, phone calls to other doctors etc. even with regards past patients, government compliance, legal requests for medical records for court cases etc. Also a GP can’t see patients literally back to back, as they need to update patients’ records, breathe etc. (!)
Let’s say every day then that all this extra time takes approximately 1 hour out of the paid hours available. That gives 6.75 hours every day to bring in money for the surgery. Assuming again costs of $200,000 per annum (before the GP even starts to get paid) is then costs of $4166 per work week, which is $833 per day.
Assuming hours available to “charge”, as noted, are 6.75 hrs a day: the minimum cost per hour to run a surgery is approximately $124 (Again, that’s before the GP gets paid anything before tax…)
At present, GPs on normal Medicare payments* receive $37.05 for 7-20 mins, $71.70 for between 20 min-39 mins, $105.55 for 40 mins plus. (Note: Those amounts will go down by $5 each, from July 2015.)
That means, given the above payments, on average the most a GP can charge Medicare per hour is 4*$37.05 = $148.02
Bill Hayden once said he 'wouldn't rest until doctors were riding bicycles'... His socialist colleagues (on both sides of parliament) have ensured his aim is most definitely being carried out.
Indeed, it seems now like Tony Abbott is letting GPs' bicycle tyres down...
Well doctors, there is an alternative (even though it will break your heart):
Why not just LEAVE MEDICINE instead.
It's either that, or UNITE AND FIGHT for fair remuneration and respect.
*There are 4750+ Australian GPs whose Medicare was secretly frozen in 1992. They are now paid the equivalent of only HALF the usual Medicare, for identical work and responsibility, as their equally-qualified peers. For purposes of the above calculation we have only referred to GPs on the normal Medicare payments.