GENERAL practice is "going down the toilet" and will "cease to exist" without sufficient government support and better incentives, a GP says.
Dr Allan Kirkpatrick, of Cardiff General Practice, in NSW's Hunter region, has been a GP for close to 30 years but he says the gradual erosion of benefits and incentives - alongside increasing demands - has pushed him to start considering alternatives.
"The way things are going... I'm not very far from walking out of general practice and just concentrating on doing palliative care in the private hospitals and nursing homes," Dr Kirkpatrick said.
"With time pressures, a full appointment book, and trying to squeeze in a whole lot of the extra things that are demanded now - like filling out Centrelink and WorkCover forms, writing letters, and incessant phone calls and emails from people needing different things throughout the day - it is pretty relentless for increasingly little reward."
Dr Kirkpatrick said when bulk billing incentives were cut from $13 to $6 at his practice, it became "much harder" to make a living.
"We are finding it harder to make ends meet while everything else goes up - such as compulsory super," he said. "We're not self-serving greedy bastards, we are struggling along here trying to provide an important service, and a bit of support and respect for GPs, from the public and the government, would be appreciated."
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After bulk billing the majority of patients for almost 30 years, he was going to have to start charging.
General practice saves lives, but for it to continue, the government needed to better support it, he said.
"We know a little about a lot, and we are very good at case-managing complex issues," he said. "We pick up melanomas early, we screen for bowel cancers and breast cancers, and we prevent complications of things like diabetes. But without accessible and affordable care, people just aren't going to turn up and ultimately it will end up putting more pressure on the hospital system."
Dr Kirkpatrick said a series of cuts and set-backs, such as the three-year Medicare rebate freeze, the loss of bulk billing incentives and practice incentive payments had made general practice less lucrative, and less attractive, to the next generation.
"They are not filling the general practice training positions," he said.
"And I think it's going to get even worse. General practice is on the nose and young doctors have worked this out. They are all looking to specialties and leaving GP training positions unfilled... We once had three registrars, now we have one part-time registrar."
He said as GPs retired, with fewer replacements, general practices would struggle to survive.
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