Ready or not, voluntary patient enrolment is coming – that’s the message coming out of the AMA National Conference.
It will either be the biggest administrative headache of a GP’s career, or the data source that finally proves the profession’s worth to the powers that be.
Health Minister Mark Butler told delegates at the AMA conference over the weekend that his “two real priorities” for the next four years were fixing primary care and fixing aged care.
“The most terrifying statistic in health, which is an area replete with terrifying statistics, is that less than 15% of medical graduates are choosing general practice as their career,” Mr Butler said.
The Strengthening Medicare Taskforce, which had its first meeting on Friday, is set to come up with implementation and funding recommendations for major elements of the abandoned Primary Health Care 10 Year Plan before the year is out.
An implementation plan delivered by Christmas will mean major reforms can be funded in next year’s budget.
“The money will flow, that’s my commitment,” the Health Minister said.
Mr Butler was clear that voluntary patient enrolment (VPE), one of the more controversial aspects of the plan, would very likely be going ahead as early as next year.
“There’s very broad consensus across the sector [that VPE] is probably the first piece of work needing a deep dive from the taskforce,” he said.
“The second is ways in which we can encourage and facilitate genuinely multidisciplinary care.”
Third on Mr Butler’s list was looking at ways technology can be better leveraged in primary care, followed by a critical examination of whether the general practice business model is actually working.
Shadow Health Minister Anne Ruston, who also spoke at the conference, said she would not stand in the way of good policies and committed to supporting the government on policies that “are clearly in the best interest of Australia and the health system”.
In a session on charting a new path for general practice, outgoing AMA vice president Dr Chris Moy acknowledged that many in the profession were feeling powerless and overworked.
“The word that strikes me most [when discussing general practice] is the word despair, and I think that is true … when we’ve had that lack of direction for so long,” he told delegates.
“But I will say that on the other hand, there is actually something really positive [coming].”
Often, Dr Moy said, GP colleagues would encourage him to go into high-level Department of Health meetings and just logically lay out how valuable general practice is, and the savings it can deliver if funded properly.
“Can I tell you that [everyone else in that room] laughs at us?” Dr Moy said.
“And you know why? Because we don’t use data.”
GPs, he said, have been scared away from using data for years, potentially due to poor experiences with the Bettering the Evaluation and Care of Health (BEACH) project.
“But because we don’t use our data, we’re up against ADF and hospital funding, which just annihilates us because they can prove [the value of] the stuff they’re doing.”
VPE, divisive as it may be, offers a solution.
“[With VPE] linked to patient data, we can prove stuff,” Dr Moy said.
“We can prove that we do stuff and that we save money for [the government] … and we can start to go up against the hospitals and actually be able to not only improve care for our patients, but also start getting a change and reinvestment into general practice.”
Or it could all go horribly wrong.
The AMA’s new vice president, Sydney GP Dr Danielle McMullen, spoke to why many doctors were wary of VPE.
“I think we’re really scared about being asked to do more and go through more red tape for a meagre return,” she told delegates.
“I think we’re all worried that the fundamentals of our business model are at threat, and above all we’re human and we don’t like to change.
“But I’m confident that, as general practitioners, we’ve shown over the past couple of years how capable we are of change.”
Others, like incoming AMA Council of Rural Doctors chair Dr Ian Kamerman, weren’t so optimistic.
“You’re seeking transformational change with a burned-out, over-capacity workforce,” he said.
“At the moment, you’ve got large swathes of rural Australia undergoing market failure as far as access to good quality primary care, or any primary care.”
Going through a whole system of patient enrolment and data collection is a great idea, according to Dr Kamerman, but the stars are not aligned right now.
“Data measurement?” he said.
“I don’t have the time to do that.”