GPs deserve aggravation rebates — the bulk-billing assignment of benefit mess proves it

The Federal Government has paused its new assignment-of-benefit rules for bulk-billed claims for 12 months, after GP groups warned the requirement for a written or electronic patient signature on every claim would create a bureaucratic nightmare.

The delay gives practices time to transition, but the episode has already exposed the scale of unpaid administrative work being dumped on GPs — particularly those caring for aged care patients or people with cognitive impairment, where signatures may need to be chased from family members or guardians.

Dr Pam Rachootin has an idea to help GPs deal with these government-generated dramas.

Should Medicare provide aggravation rebates for frustrated doctors?

Isn’t it interesting how the practice of medicine is turning into one giant compliance exercise?

This is due to the people calling the shots nowadays.

If they knew what doctors actually did, we might have a chance. But since they don’t, and are only interested in collecting metrics, their mission creates more and more meaningless work for us, giving them opportunities to tally numbers.

It is all about data entry and some mythological belief in the ghosts of “transparency”.

I agree that transparency is sometimes a desirable asset, especially for things like Glad Wrap, but perhaps not for every action taken in life.

Does someone really need to know if the practice can’t afford toilet paper?

At times (like every day), it feels as though these nameless, faceless wandering souls go to work with a mission to see how many ways they can disrupt the core business of medicine by imposing distractions.

At night, they dream of ways to undermine us at every opportunity.

It is getting to the point that we need a whole set of new incentive payments, to be designated as Aggravation Payments.

I would suggest that this new category would far exceed the Medicare benefits for any given consult.

In fact, we need multiple categories for the extremes of aggravation that we are now subjected to, all deserving of compensation.

Part of the payment would be calculated as an adversity quotient aimed at dealing with the failure of Medicare to be indexed, yet again, to the cost of living.

(Beware, for anyone who may be getting ideas, dying is no escape either, because that cost is increasing, too, for those so inclined.)

The aggravation incentive payment could also have an adaptive change component to help us deal with the ever-changing landscape of general practice: bleak one day, barren the next.

I’ve heard that the counterargument to being compensated for inflation is that we have already been trained in deep-breathing exercises, and that sort of inflation apparently counts.

I’m sure if you haven’t had this essential training, a free webinar will be offered as part of your illuminated CPD requirement.

Another offering in CPD will be acceptance theory, so suited to doctors practised in this field with our years of experience accepting frozen rebates.

And now it seems acceptance theory is being expanded to patients to ensure that they understand and agree to give consent for the inadequate Medicare rebate, frozen like a mastodon in the Siberian tundra, with attempts made to reconstitute the species from a fragment of extracted DNA.

Good luck!

As for burnout, that is not being taken too seriously, as it is seen as a personal failure, due to a lapse in maintaining our gratitude journals.

We should look back in history at healers of yesteryear, often midwives and other women knowledgeable in employing herbs for various conditions.

When anything was amiss, they could be convicted of witchcraft and burnt at the stake.

And we are complaining of burnout?

Apparently, the standard practice was to strangle the convicted witch and then burn their body, but sometimes in the Holy Roman Empire, the first step was skipped, and witches were burnt alive.

So, if you feel like a victim, just think again.

Who needs VAD when the death of general practice proceeds at record speed in the direction set in motion by AHPRA?

We really need to study the cohort of recently retired doctors to assign blame where it belongs.

I would bet my AHPRA renewal fee that AHPRA contributes significantly to destroying the medical workforce.

Of course, that sort of metric is anathema to the powers that be.

Fortunately, if there is a problem of destroying the medical workforce, the solution is simple enough.

All one has to do is make doctors redundant, and, like magic, the problem is gone.

Forget about all the research that shows the benefits of having a regular doctor.

Continuity of care and quality medicine have been abandoned for a decentralised system to facilitate patient convenience at a higher cost, but not to the patient.

Bypass the GP, destroy doctor morale, and they think they have achieved a real fix.

Dr Pam Rachootin is a GP in Adelaide, SA

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