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Dr Kerryn Phelps, AMA President, Radio 2UE, with Alan Jones

JONES: …An endangered species is the family doctor. In Australia, there are 23,000 practising general practitioners - 90 per cent of us visit, at least, once a year. But in the last couple of years, we've seen nothing but all out attack on the medical profession and on doctors. And, as a result, a growing trend towards the corporatisation of general practice - in other words, the local GP disappearing, and in their place come these massive medical centres. You couldn't blame GPs for wanting to get out of running their own practice - they put in ridiculously long hours, they mean a lot in our lives, and they receive, via the Medicare rebate, a fee which is a joke. So it's fitting this week is the Australian Medical Association's Family Doctor Week, and the theme is 'Your Doctor is with you for life'. The AMA Federal President, Dr Kerryn Phelps, says it's all about reminding people that their local GP is always there - right through life - but there's more to the week than that. The AMA's drawing attention to issues including managing health in the workplace, early cancer detection, making long-term plans for your health, and what I believe is one of the major issues, and you've heard me talk about this for years, now, facing this country - childhood obesity. Dr Kerryn Phelps is on the line. Kerryn, good morning.

PHELPS: Good morning, Alan.

JONES: Poor old GP, by gee, don't they get belted up.

PHELPS: It's been a very tough couple of decades for general practice, and I think we have the lessons from places like the United Kingdom where they now have a critical shortage of GPs because life got so tough - that doctors were getting out and doing other things.

JONES: I mean, you're not frightened of running tough campaigns but, as a measure of the problem facing doctors, if you were to start, today, a campaign to increase, say, the Medicare rebate for doctors, you'd most probably be laughed out of town, wouldn't you?

PHELPS: Well, we've certainly been talking for some time about this Medicare rebate issue.

JONES: What's the doctor get?

PHELPS: $23.45 for a standard patient.

JONES: Unbelievable - $23.45 for what?

PHELPS: For a standard consultation of up to 20 minutes.

JONES: Unbelievable.

PHELPS: So, we have actually been involved for the last six years…

JONES: Sorry, Kerryn, to interrupt you. Are there visits?

PHELPS: With home visits?

JONES: Yes.

PHELPS: With home visits, they are actually not much better, they're in the range of about $39.00. Now, you couldn't get any tradesman to come to your house for that amount of money.

JONES: You can't, no, no.

PHELPS: So, GPs are finding that they're having to, even where they're living in areas which have higher numbers of disadvantaged people, they're actually having to charge according to what they think they have to in order to maintain the viability of their practices. And that, of course, can cause some hardship for some people. So, we really do need to get a grip…

JONES: …Oh, yes. Oh, gosh. I mean, it's infantile to ask a professional person, in this day and age, to perform a service for $23.45. Then, you've got the other thing, haven't you, where you've got the specialists, obstetrics and so on, in professional indemnity insurance? I mean, how much do some doctors have to pay for that?

PHELPS: Well, if you're talking about obstetricians, and they are endangered species, you've hit the mark completely there, because obstetricians are paying, in New South Wales, I've just seen one obstetrician's bill for medical indemnity for this year and it's $132,000, before he opens his door.

JONES: So, because we've become an increasingly litigious environment, if the child doesn't pass the exam at 17 years of age, we sue the doctor for the way the baby was delivered?

PHELPS: Yeah, well, unfortunately, obstetrics is a high-risk business and there are some catastrophic injuries, which are birth related. But, I think that we need to look at other ways of managing the disabilities in children that are related to birth injuries other than reverting to the adversarial court system, and we've been working very hard to get around that.

JONES: So, I mean, it's reaching the point where it could be unaffordable for doctors to work either at the $23.45 consultancy rate, or to pay the professional indemnity insurance?

PHELPS: Well, this is clearly the problem, and practice costs, generally, including medical indemnity, but also staff costs, and costs of just simply running the business, have increased, astronomically, over the last, well, particularly the last decade. And medical rebates and fees just simply haven't kept up. And while people are talking about 'gaps', I mean, you just need to look at the Medicare Benefits Schedule (MBS) to see where the gaps are coming from.

JONES: Absolutely. Say something to us about obesity.

PHELPS: Well, childhood obesity is a major problem. As you said in your introduction, it's one of the major highlights of Family Doctor Week.

JONES: I'm so delighted we're talking about this, 'cause I've been arguing from a sports point of view, for four years, that the greatest issue we've got are drugs, alcohol, obesity and inactivity. At long last, we're getting some profile on the problems.

PHELPS: Well, certainly, your interest in sport would fit very much in with this issue of childhood obesity because lack of physical exercise is one of the major problems causing childhood obesity. In the 1960s, there were only 3 per cent of children under the age of fifteen, obese. We're now looking at one in five boys and girls who are overweight or obese. So, that's been an enormous, enormous increase, and it really is setting us up for a public health disaster.

JONES: It's activity and diet, isn't it?

PHELPS: It is activity and diet. And, of course, diet - we're seeing children barraged with ads for junk food. If you just turn the television on, for example, at kids viewing hours in the afternoons, you'll see a barrage of junk food commercials. Now, while every so often it's not a bad thing to have some foods … high fat or high sugar but, if it's something that is every day and if, I think, a lot of people are looking to pre-packaged or processed foods rather than cooking healthy foods, school canteens need to take some responsibility, too. And the parents need to exert their authority in the home and say, 'Well, I'm only going to buy good quality foods'. So, that's all the kids will have to choose from.

JONES: Quite. Keep at it. Good to talk to you again.

PHELPS: Thank you very much, Alan.

JONES: That was Dr Kerryn Phelps. But it is Family Doctor Week, and I think we can, at least, if we can't do anything, we can at least lend our voice to making sure that we give up a little bit of doctor bashing.

Ends

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