LETTER: Paradigm shifts at the expense of General Practice

DEAR News Of The Area,

MOST parents have, and probably still do, wish that their children would enter university to become a doctor, nurse, lawyer or financial genius.

I have been a doctor for 50 years and witnessed the paradigm shifts with dismay, and sadly conclude I would not advise General Medical Practice in the current setting in Australia; nor probably in the US or UK.

The Australian Governments of both major colours have systematically run general practice down with inadequate CPI rises in rebates and wilfully adopted a policy of divide and rule at the expense of everyone’s health.

The costs were rising sharply and most practices were sitting ducks for profiteering by multinationals, cooperatives, pharmacies and non-medical entrepreneurs.

The inexperienced politicians relied on lobbyists for “evidence-based information” and, as long as their perks were intact, including free health care or travel, the poorest sector was left to fend for themselves.

To add injury, many of the previous subsidies were removed without any publicity or responsible reporting.

The most surprising aspect of all this is the general public apathy. Decades ago it was the main focus at all elections, making it the hot potato which sharpened the politicians’ performances.

So, what do we get? The GP, for a standard consult, officially gets $43, whereas the podiatrist gets $180 with half subsidised, and psychologist likewise gets about $200 with more than half rebated through Medicare.

Pharmacists have not spent at least 10 years in hospital training and six years as undergraduates to understand and really know pathology, pharmacology, investigations and clinical debates, or the years of continuing medical education to be able to work out whether urinary symptoms are just an infection or if the patient has cancer, anatomical abnormalities, or adjacent organ pathology that warrants timely investigations or management.

It is a case of the blind leading the blind, with delayed diagnoses and more costly events – including catastrophes – will follow.

Throwing good after bad is the currently adopted policy. There is no public rejection, or concern on the horizon, about the fact that the care provided by a General Practitioner, after years of acquiring knowledge, skills and humanity-related qualities, has become part of a trend to convert people’s health into a marketable commodity.

More money is made by many sectors from health, without any improvement in health itself. Becoming unwell is more rewarding to some than to go fishing, mining or doing a job that is honourable, mentally satisfying or physically challenging.

I live optimistically for a miracle that we all will see the light some day – the sooner the better.

Regards,

Dr Gonasagaran Ruthnam.