My career in the health sector began with two nursing certificates over more than four years. To become a GP entailed a further 10 years of training,six full-time at university. I have also combined work in Aboriginal health,medical education and advisory roles with private practice. To maintain my qualifications,I complete mandatory ongoing education,pay hefty college,regulatory-body and indemnity fees,and I keep up to date with ever-changing Medicare,Pharmaceutical Benefits Scheme,immunisation and public health programs,and other health regulations.
A lot has changed over the past two decades. Public hospitals,such as Rachel Forster,South Sydney and King George V,have closed. Health services have been privatised and outsourced. There’s less access to physios,occupational therapists and outpatient clinics. New aged care and mental health referral pathways have blocked communication between GPs and service providers.
During the pandemic,GPs have not only played a major role in vaccinations,we’ve also had to manage increasingly complex care in isolation as overwhelmed hospitals have cut back on face-to-face consultations. Some specialty clinics have closed altogether.
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There is no guaranteed GP income. We get no hourly rate,holiday pay,sick leave or other allowance. If we are not seeing patients,we are not getting paid. Paperwork and following up on phone calls and correspondence leaves
most of us with many hours of unpaid work a week.
Medicare rebates have historically undervalued our service,but thefreeze several years ago compounded this. I earn at least 10 per cent less than I did six years ago. I worked at a small practice that had been operating in Redfern for more than 30 years. It closed six years ago because of this. That GP and I moved to a larger practice,which made the decision this year to abandon bulk-billing for all but the neediest,and First Nations patients.
The practice takes a proportion of all our earnings to pay for nurses,receptionists,equipment and the usual running costs. In the end,it’s a matter of survival.