Dr Kerryn Phelps, AMA President - Radio 2SM
Interview - Radio 2SM, with Howard Sattler - Discussing Corporatisation of General Practice
SATTLER: Are you having trouble getting your doctor to come and visit you at home? You know, the old home visit used to be commonplace with doctors. But not now, with those who are corporatised, as they say, doctors who are being got together in groups to just work out of medical centres, a part of their, if you like, their service to the public does not include going home, apparently. And more and more doctors are refusing to do so. It's the result of a survey that has been confirmed, has confirmed that. Now, with elderly and chronically-ill patients, are they being abandoned as local doctors go into these so-called corporate practices? The President of the Australian Medical Association, Dr Kerryn Phelps, is due to catch a plane shortly but, has given us time to talk about that. Good morning, Kerryn.
PHELPS: Hello, Howard.
SATTLER: Okay. Not a good trend, I wouldn't have thought, but maybe money's more important than patients, in some cases, these days.
PHELPS: Well, I think the problem has been over a long period of time that house calls have been diminishing in number because it has just not been cost effective for practices to do that. Now, GPs in independent practices have been continuing to do house calls in a lot of cases, simply as a goodwill gesture. In many cases, they are having to charge for what that service is worth, like any other professional or any other person who comes to your house to provide you with a service of any sort. But, for doctors when they are looking after elderly, disadvantaged people, people who are unemployed, elderly with chronic disease, for example - because you feel a tremendous responsibility to make sure these people are properly looked after - but Medicare has really not been supportive of the house call for a long time. And I guess what brought this particular issue to a head just lately is this issue of corporatisation and whether it, as an activity which is not economically viable, will be continued under a corporatised...
SATTLER: …but hang on, your hippocratic oath, and the oath of all doctors, puts the patients first, not profits. Isn't that right?
PHELPS: Yes, it does. Absolutely. But, the point we have to make also is that doctors are running businesses, they're paying staff, they can't go broke in the process because nobody's needs are served in that respect.
SATTLER: But has it got to that? I mean, are we talking about potentially going broke or just making whopping profits here?
PHELPS: In the case of traditional general practice, then you're actually talking about marginal viability practices, and that actually affects people's employment. It affects a very large sector of the economy. Let's face it, GPs are a small business like anyone else. But when you're talking about the larger corporations, they are obliged under company law to maximise profits for their shareholders. So, there is this dilemma between what is best for patients, and what is best for shareholders.
SATTLER: Alright. Now, which way do you think it should fall?
PHELPS: Well, the AMA recognised this as a potential problem for a long time and we've been involved in discussions with the corporates to enshrine patients' rights and to develop a voluntary code of conduct so that contracting agreements do make sure that patients' rights are protected, and that doctors are able to practise in a way that they feel is best for their patients.
SATTLER: Alright. So do you think that house calls should continue? That you should be able, if you are so chronically ill, you can't get down to the surgery that they should go and call?
PHELPS: It's a matter, I think, of people finding a practice that, if they need a house call, will provide a house call. And I think that the debate that we still have to have in the community is to what extent are people prepared to pay for that service, if they're able to, and to what extent Medicare should subsidise the people who can't afford to pay for that service. So, I think it's very important that people are not unable to get a service that they need in that respect, if they can't afford it. So, this is where I do think we need to look at the future of Medicare and ensure that services like house calls, where necessary, are actually provided for people without them having to worry about whether they can afford it or not.
SATTLER: And, listen, you're not catching a plane to Canberra to have lunch with Dr Wooldridge, are you?
PHELPS:.
SATTLER: See ya.
PHELPS: See ya, Howard.
Ends