Are genuine patient needs being overlooked in the debate around after hours services?
By the time I’d had kids, I’d had my share of paediatric experience in both hospitals and general practice, yet even so there were a few nights with a sick child when I simply didn’t know what to do.
On those occasions, I can’t begin to say how relieved I was by the voice of a paeds reg on the other end of the phone line.
But most people aren’t as fortunate in this regard as me, or you. While I could give a concise and coherent account of my concerns, and readily understand the response, it’s no more reasonable to expect most members of the public to do this than to expect me to fix my own carburetor (although I did do a mechanics course in 1984).
So the recent debate in TMR and other fora over after-hours services has set me thinking.
Although I reckon few people truly need a GP in the middle of the night – most need a hospital or can wait till morning – precisely where to draw this line is not anywhere near as clear to the non-medically trained, as it is to you or me.
So yes, I think there’s a small, but genuine need for after-hours services.
However, one problem seems to be that it’s generally not the genuinely needy single mother, or the elderly person in pain with no car, who use these bulk-billed dial-a-doc. According to one doctor interviewed on the TV program, The Project, he’s even been called out for a pimple.
It’s not surprising then that these doctors have been accused of Medicare fraud by their peers for claiming an urgent item number for an apparently trivial problem.
On the other hand, some argue a doctor answering what’s said to be an urgent call for help should be paid as such, regardless of the eventual diagnosis. After all, they’ve been told by a receptionist that an urgent visit has been requested, and taken the time to visit the patient in good faith in the middle of the night.
There’s a lot more to this issue, not least the tendency of governments to encourage after-hours ‘convenience’ services in a bid to cut ED waiting times, and win elections.
Let us know what you think.
kerri@medicalrepublic.com.au
