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A GPs work is never done


New data collected by the BEACH (Bettering the Evaluation and Care of Health) program highlights the amount of time GPs spend on non-Medicare Benefit Schedule (MBS) billable work.

This research is welcome, as it is provides some hard and reputable data on the time GPs spend on patient care outside of the face-to-face consultation.

The AMA has long had the view that non-contact care is often an underestimated and undervalued element of general practice, and in early 2011 asked BEACH to collect data on this aspect of GP work. We wanted reliable data that would highlight the fact that there is so much more to patient care than what the patient sees and what the Medicare rebate covers.  We wanted to be able to have that unseen work quantified.

The data gathered by BEACH is a great start, but it is just the tip of the iceberg. Results from the AMA 2011 Red Tape survey showed that, on average, GPs spent 4.6 hours a week on red tape, with some spending up to 9 hours per week.

While the BEACH data provides an overview across general practice, there are days where you can spend up to three hours on non-Medicare billable work for patients, such as completing a myriad of forms that keep bureaucrats employed, coordinating care, and sitting on the phone waiting for a desk clerk give the authority to prescribe. From the findings of the Red Tape survey, the AMA has estimated that time that could be spent providing an extra 15 million consultations a year is lost because of time spent on such administrative tasks.

As evidenced by the BEACH study, red tape accounts for the largest portion of doctor time spent on work that is not face-to-face. Not only does this reduce the time GPs have available for seeing patients, it also has potential consequences for doctor health if this work is done outside of the normal working day.

I have no doubt that the $15,000 BEACH estimates GPs lose through providing unpaid care is far short of the mark, given most GPs do not charge what they are worth.

Nevertheless, having hard data that corroborates what all GPs know, and have been saying for years, about the extra time they put in to support patient care and ensure access to needed services, is welcome. Not only will it add weight to AMA advocacy, I hope it will act as a reminder to GPs that they provide a service that is more valuable than the Medicare rebate reflects – a rebate that has failed to keep pace with the costs of providing medical care and continues to undervalue the worth of GPs.

When setting their fees, GPs need to consider all that is involved in providing quality patient care, and value that work appropriately.

The AMA provides members with a Fees Calculator, which is a valuable tool to assist them in determining, based on their own cost experiences, how much to adjust their fees.  If we are providing quality care to our patients, we should be comfortable putting an appropriate value on that care.

I hope that this research gives GPs more confidence when it comes to explaining to their patients that a fair and reasonable fee reflects all that goes into providing and managing their medical care.  It should also signify to patients who do pay a co-payment that they are paying for more than just face-to-face time with their GP.