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Doctors fees for med card

  • 19-01-2011 2:28pm
    #1
    Gottalovegreys
    Registered Users, Registered Users 2 Posts: 128 ✭✭


    Someone just told me even if a patient (medical card holder) doesn't ever go to see their GP that the GP still gets paid a fee per year? Surely this can't be right?


Comments

  • #2
    RobFowl
    Moderators, Science, Health & Environment Moderators Posts: 11,669 Mod ✭✭✭✭RobFowl


    Gottalovegreys wrote: »
    Someone just told me even if a patient (medical card holder) doesn't ever go to see their GP that the GP still gets paid a fee per year? Surely this can't be right?

    It is true but they also get the same fee if the same patient attends 50 times or more in a year.
    The system used to be based on attendances but this was phased out as it was far more expensive.


  • #3
    dissed doc
    Closed Accounts Posts: 1,489 ✭✭✭dissed doc


    Gottalovegreys wrote: »
    Someone just told me even if a patient (medical card holder) doesn't ever go to see their GP that the GP still gets paid a fee per year? Surely this can't be right?

    Firebrigades still get paid even if there are no fires.


  • #4
    Big_G
    Moderators Posts: 1,589 ✭✭✭Big_G


    This is called capitation. GPs are the only healthcare providers that have it. The other contractors in the medical card system, dentists and pharmacists, do not have this. In the case of dentistry, the patient is currently limited to one visit per year. Any visits outside of that and the dentist is not paid.


  • #5
    Odysseus
    Registered Users, Registered Users 2 Posts: 6,754 ✭✭✭Odysseus


    Nothing wrong with this, in the same way they are paid extra for both those on methadone and those over 70 as both groups will be attending the GP more often. I would say that it is a case of swings and roundabouts in terms of cost to the state.

    But can I ask a question is it legal for a GP to charge a GMS patient for a home visit? I ask as I know a case where the GP will only do house visits to GMS patients if they pay. Some of the lads in work [GPs] are under the impression that it is, but they are not 100% sure. I know it is unethical even though I know the extra pressure home visits put on GPs but I would be interested in knowing for sure. Sorry for the thread hijack!


  • #6
    RobFowl
    Moderators, Science, Health & Environment Moderators Posts: 11,669 Mod ✭✭✭✭RobFowl


    A doctor cannot legally charge one of his/her GMS patients for a house call. This also applies if they are part of a co-op or rota covering at night.
    the only time they can (and there is an alternative special claim ) is when the patient is a GMS patient of another doctor who is not part of a rota or co-op with the doctor who carries out the house call.

    So basically the answer is no it is generally not legal for a GP to charge a GMS patient for a house call.

    If they do it can be reported to the HSE locally but it has to be by the patient or closest relative.
    Odysseus wrote: »
    Nothing wrong with this, in the same way they are paid extra for both those on methadone and those over 70 as both groups will be attending the GP more often. I would say that it is a case of swings and roundabouts in terms of cost to the state.

    But can I ask a question is it legal for a GP to charge a GMS patient for a home visit? I ask as I know a case where the GP will only do house visits to GMS patients if they pay. Some of the lads in work [GPs] are under the impression that it is, but they are not 100% sure. I know it is unethical even though I know the extra pressure home visits put on GPs but I would be interested in knowing for sure. Sorry for the thread hijack!


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  • #7
    beeno67
    Registered Users, Registered Users 2 Posts: 1,218 ✭✭✭beeno67


    Odysseus wrote: »
    Nothing wrong with this, in the same way they are paid extra for both those on methadone and those over 70 as both groups will be attending the GP more often. I would say that it is a case of swings and roundabouts in terms of cost to the state.

    But can I ask a question is it legal for a GP to charge a GMS patient for a home visit? I ask as I know a case where the GP will only do house visits to GMS patients if they pay. Some of the lads in work [GPs] are under the impression that it is, but they are not 100% sure. I know it is unethical even though I know the extra pressure home visits put on GPs but I would be interested in knowing for sure. Sorry for the thread hijack!

    I would agree with RobFowl but just to add, there are some instances where medical card patients can be charged. Usually this revolves around non-contract duties such as signing some forms etc


  • #8
    Sid_Justice
    Closed Accounts Posts: 2,720 ✭✭✭Sid_Justice


    How much does a GP get per GMS patient. I actually thought it was close to 1000 euro but a GP I was talking to was very quick to understate how mcuh they get per patient.

    different amounts based on
    doctor only
    >70s
    full medical card.


  • #9
    Odysseus
    Registered Users, Registered Users 2 Posts: 6,754 ✭✭✭Odysseus


    RobFowl wrote: »
    A doctor cannot legally charge one of his/her GMS patients for a house call. This also applies if they are part of a co-op or rota covering at night.
    the only time they can (and there is an alternative special claim ) is when the patient is a GMS patient of another doctor who is not part of a rota or co-op with the doctor who carries out the house call.

    So basically the answer is no it is generally not legal for a GP to charge a GMS patient for a house call.

    If they do it can be reported to the HSE locally but it has to be by the patient or closest relative.

    Cheers thanks for that Rob. I'm not in a position to report sadly. I did get him up once for my dad, but I had to go down myself and insist. He didn't ask but was lingering about very suggestively when he was finished. I think he is too wide to do it in front of another person.

    However, I know of older patients on my mam's road asking for a home visit and he basically refuses, but as soon as they mention they are will to pay he suddenly has the time.

    I know the extra demands that home visits put on GPs, but these patients are in a lot of cases people who where private patients of his for up to 30 years prior to getting the medical card. I know myself the level of care my mother now gets has dropped since she turned 70.

    He made his living out of this people for years, and the way they are treated once they hit 70, well what can you say it leaves a very bad taste. Thankfully he recently went into semi-retirement and a new GP who takes an interest in the patients is working there too. The difference in care is so vast, basically it's shocking. I would love to be in a position to report him, but as it never directly happened to my parents as you said I can't as I cannot stand over it.

    Thanks for your response.


  • #10
    Odysseus
    Registered Users, Registered Users 2 Posts: 6,754 ✭✭✭Odysseus


    Sid_Justice wrote: »
    How much does a GP get per GMS patient. I actually thought it was close to 1000 euro but a GP I was talking to was very quick to understate how mcuh they get per patient.

    different amounts based on
    doctor only
    >70s
    full medical card.

    You can add patients on methadone treatment to that. Those I have no problem with as in certain cases the over 70s and methadone patients will attend more often, so it is only right that the GP gets a higher payment, they will provide treatment more often.


  • #11
    irishh_bob
    Closed Accounts Posts: 5,700 ✭✭✭irishh_bob


    dissed doc wrote: »
    Firebrigades still get paid even if there are no fires.


    and guards still get paid even thier are no reports of burglarys , could you possibley make a more spurious comparison ?


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  • #12
    RobFowl
    Moderators, Science, Health & Environment Moderators Posts: 11,669 Mod ✭✭✭✭RobFowl


    Sid_Justice wrote: »
    How much does a GP get per GMS patient. I actually thought it was close to 1000 euro but a GP I was talking to was very quick to understate how mcuh they get per patient.

    different amounts based on
    doctor only
    >70s
    full medical card.

    It varies from €40 per year for 5-14 yr olds to €270 for over 70's
    There is an increased payment for over 65's in long term hse approved nursing homes.
    Methadone care pays higher but is separate from the GMS contract (it's seen as a specialist role and requires extra training).
    These figures are due to decrease as a result of the recent budget.


  • #13
    Sid_Justice
    Closed Accounts Posts: 2,720 ✭✭✭Sid_Justice


    which patients give the GP 700 euro per card?


  • #14
    Kristopherus
    Registered Users, Registered Users 2 Posts: 11,907 ✭✭✭✭Kristopherus


    RobFowl wrote: »
    It varies from €40 per year for 5-14 yr olds to €270 for over 70's
    There is an increased payment for over 65's in long term hse approved nursing homes.
    Methadone care pays higher but is separate from the GMS contract (it's seen as a specialist role and requires extra training).
    These figures are due to decrease as a result of the recent budget.
    Are those charges the latest ones or are the being cut more this year?


  • #15
    RobFowl
    Moderators, Science, Health & Environment Moderators Posts: 11,669 Mod ✭✭✭✭RobFowl


    Sid_Justice wrote: »
    which patients give the GP 700 euro per card?

    None that was the fee for the "over 70's" medical card which was abolished almost 3 years ago.


  • #16
    RobFowl
    Moderators, Science, Health & Environment Moderators Posts: 11,669 Mod ✭✭✭✭RobFowl


    Kristopherus wrote: »
    Are those charges the latest ones or are the being cut more this year?

    They were the ones before the last round of cuts. GP's haven't actually been given the new rates yet.


  • #17
    El_Dangeroso
    Users Awaiting Email Confirmation Posts: 5,620 ✭✭✭El_Dangeroso


    RobFowl wrote: »
    It varies from €40 per year for 5-14 yr olds to €270 for over 70's
    There is an increased payment for over 65's in long term hse approved nursing homes.
    Methadone care pays higher but is separate from the GMS contract (it's seen as a specialist role and requires extra training).
    These figures are due to decrease as a result of the recent budget.

    Fecking hell, that's nothing! I knew people on the medical card in their 20's that went to the doctor about 8-10 times a year because they could. Presume over 70's would be more than that.

    It's kind of a kick in the teeth that the regular public are both paying taxes to pay the medical card fees and probably paying higher GP fees to make up the shortfall.

    I've known PAYE workers in the past that would put off health issues because of the cost of visiting a GP (€60 at the time) but these people would not qualify for medical card.


  • #18
    katyjo
    Closed Accounts Posts: 12 ✭katyjo


    excuse me? 'regular public' what's a regular person? I work full time on a decent wage but because my husband was made redundant we now qualify for a medical card which is highly welcome with 4 children. He chose to take part in a CE scheme so he was still working for his money & I pay tax, prsi & the universal social charge so am I a 'regular person'??

    highly offensive term to those who contribute & have done since they left school, yet need help with medical expenses due to no fault of their own.


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