Doctors and medical card holders

Megzor

Does anyone know how much a doctor gets for each medical card patient they have? How are they paid? Do they get a set fee according to how many medical card holders they have or according to the amount a medical card holder visits them?

Farmer Pudsey

they get aset fee/medical card holder that is on there list. There are two rates the standard rate that covers all means tested card holders and a higher rate for OAP who qualify for the over 70's card

queen of Umaill

By rights the shouldn't get paid for just having a medical card holder on their books and only get paid when the person has to go to them.#Logic doesn't work well in Irish government or with ministers.
And here was us thinking they had a high education.:rolleyes:

Kristopherus

Here's what you're looking for, OP. Happy reading:).

http://www.hse.ie/eng/Staff/PCRS/Contractor_Handbooks/Doctor_Schedule_of_Fees1.pdf

Farmer Pudsey

queen of Umaill wrote: »

By rights the shouldn't get paid for just having a medical card holder on their books and only get paid when the person has to go to them.#Logic doesn't work well in Irish government or with ministers.
And here was us thinking they had a high education.:rolleyes:

Are you off your rocker it would be open to wide spread abuse the present system costs enough. Then again no doctor would :rolleyes:phantom visit

femur61

Brother in law is a GP and he said he only gets €70/yr for a patient regardless of how many visits a patient has.

Quiet Lurker

Kristopherus wrote: »

Here's what you're looking for, OP. Happy reading:).

http://www.hse.ie/eng/Staff/PCRS/Contractor_Handbooks/Doctor_Schedule_of_Fees1.pdf

The fees on this are 2009 fees and have been reduced by just over 10% since then. So for a baby boy up to 4 years of age a GP is paid €77 per anumn.There is NO extra payment each time they visit.
There previously was a payment per visit but it was changed to capitation in 1992 for cost reasons. Also the extra payments for patients who are distances away from the surgery were removed in 2011 which was a real disadvantage for GPs in remote rural areas.

Maura74

I do not have much faith in the medical professionals now that I am getting pass my sell by date.

As you can see , from the disturbing article in the news recently in the UK and I expect it happens in Ireland as well and it should not happened for a trust to gain when the medical professionals help to kill off patients

http://www.telegraph.co.uk/health/healthnews/9644287/NHS-millions-for-controversial-care-pathway.html


http://en.wikipedia.org/wiki/Liverpool_Care_Pathway_for_the_dying_patient

Sierra Oscar

queen of Umaill wrote: »

By rights the shouldn't get paid for just having a medical card holder on their books and only get paid when the person has to go to them.#Logic doesn't work well in Irish government or with ministers.
And here was us thinking they had a high education.:rolleyes:

GP's would gladly welcome such a scheme. Quite frankly, the current contract is a dream situation for the government and a bit of a nightmare for GP's. A medical card patient could attend at GP every second week, and the practice will still only receive an annual stipend of ~€70. It is a major issue for GP's currently as private practice has collapsed (down 70% in some cases) and more people are being put on medical cards. When the current system was agreed it was envisaged by GP's that private patients would essentially subsidise medical card holders, but that has changed entirely. It is actually quite unfair for private patients too, considering that they have to pay €40 - €50 per visit.

Personally I think some sort of system will have to be introduced whereby a medical card will entitle you only to a certain number of 'free' GP visits before you have to start paying a nominal fee out of your own pocket. Naturally exemptions would have to be made for those with long term illnesses, but it would help to cut out the current abuse of the scheme whereby some patients are only attending surgeries because they have little else to be doing.

Go into any GP practice and you will often find that it is the same patients in the waiting room each Monday morning - with little wrong with them. These patients are always medical card holders, private patients just have to cope it would seem.

Lenin Skynard

I know a good few lads in their 20s/30s that have medical cards and haven't seen a doctor once since they were in short pants. If the GP is getting €70 per year per head the GP is doing alright I'd say. Most medical card holders I know have never used it once.

bbsrs

Quiet Lurker wrote: »

The fees on this are 2009 fees and have been reduced by just over 10% since then. So for a baby boy up to 4 years of age a GP is paid €77 per anumn..[/Quote


I think every child under the age of 16 should be able to get a GP visit card which the parent can purchase for €80 per year.

get_even

the GP i attend charges 40 euro , i still think its too high btw

Godge

Quiet Lurker wrote: »

The fees on this are 2009 fees and have been reduced by just over 10% since then. So for a baby boy up to 4 years of age a GP is paid €77 per anumn.There is NO extra payment each time they visit.
There previously was a payment per visit but it was changed to capitation in 1992 for cost reasons. Also the extra payments for patients who are distances away from the surgery were removed in 2011 which was a real disadvantage for GPs in remote rural areas.

Sierra Oscar wrote: »

GP's would gladly welcome such a scheme. Quite frankly, the current contract is a dream situation for the government and a bit of a nightmare for GP's. A medical card patient could attend at GP every second week, and the practice will still only receive an annual stipend of ~€70. It is a major issue for GP's currently as private practice has collapsed (down 70% in some cases) and more people are being put on medical cards. When the current system was agreed it was envisaged by GP's that private patients would essentially subsidise medical card holders, but that has changed entirely. It is actually quite unfair for private patients too, considering that they have to pay €40 - €50 per visit.

Personally I think some sort of system will have to be introduced whereby a medical card will entitle you only to a certain number of 'free' GP visits before you have to start paying a nominal fee out of your own pocket. Naturally exemptions would have to be made for those with long term illnesses, but it would help to cut out the current abuse of the scheme whereby some patients are only attending surgeries because they have little else to be doing.

Go into any GP practice and you will often find that it is the same patients in the waiting room each Monday morning - with little wrong with them. These patients are always medical card holders, private patients just have to cope it would seem.

Minimum payment is €70 for a child, then there are the payments for immunisation which a baby gets from the GP on top of that (see section 3).

Payments go up to €300 a year for an older patient.

There are also allowances for a nurse, secretarial staff etc. plus €20,000 for just being in a rural area (see other parts of Section 1). It is a little but of a lie to say you just get €70 for a patient.

beeno67

Very true. It is also a little bit of a lie to say the GP gets the money. The money goes to the practice to pay for staff, premises, insurance, light, heat etc. capitation payments plus allowances for nurse secretarial staff etc are basically pooled and make what is essentially the gross profit of the practice. After all the expenses are paid the GPs get to share the profits

Icepick

The way the system works, people without a medical card subsidize medical card holders twice. More socialist madness.

dissed doc

queen of Umaill wrote: »

By rights the shouldn't get paid for just having a medical card holder on their books and only get paid when the person has to go to them.#Logic doesn't work well in Irish government or with ministers.
And here was us thinking they had a high education.:rolleyes:

That increases the cost massively. At the moment it's a pretty good deal for the government and patients - unlimited GP services unlimted appointments for €60 or €70 a year.

What would you do? €10 an appointment if it was pay as you go? Not a bad idea actually, as it would make it clear (finally) to those complaining about €50/appointment that are heavily subsidising medical card holders.

L1011

Godge wrote: »

Minimum payment is €70 for a child, then there are the payments for immunisation which a baby gets from the GP on top of that (see section 3).

Payments go up to €300 a year for an older patient.

There are also allowances for a nurse, secretarial staff etc. plus €20,000 for just being in a rural area (see other parts of Section 1). It is a little but of a lie to say you just get €70 for a patient.

Fees don't go up linearly - they go down, quite significantly, after childhood and takes quite some time (40 years!) to return to more than the childhood fee.

Staff allowances do not cover the cost of the staff - someone with a list large enough to receive the full payment will have more staff than they receive payments for.

Rural Practice Allowance, while it in theory still exists, is point blank not issued to new GPs taking over rural lists. Its now down to 17k - which is about the amount you'll spend in extra fees for locums and out of hours due to being in a rural area.

http://www.attorneygeneral.ie/esi/2010/B28162.pdf is the current fees - that handbook is out of date and seems to be used constantly in arguments both here and on politics.

Most GPs would LOVE to go back to the fee per item era - the reason this was removed was because the state thought it was open to abuse (patients being recalled when they didn't need to be, etc).

L1011

dissed doc wrote: »

What would you do? €10 an appointment if it was pay as you go? Not a bad idea actually, as it would make it clear (finally) to those complaining about €50/appointment that are heavily subsidising medical card holders.

I'd say €15/appointment would be quite realistic if everyone paid the same amount. There are private practices in cities that charge €30 as it stands but they're working off the actually quite small and constantly shrinking number of private patients out there - who all go to the doctor a lot less than someone who gets it for free (which, obviously, does have its health benefits in the long run).

Sierra Oscar

Lenin Skynard wrote: »

I know a good few lads in their 20s/30s that have medical cards and haven't seen a doctor once since they were in short pants. If the GP is getting €70 per year per head the GP is doing alright I'd say. Most medical card holders I know have never used it once.

And I know quite a few medical card patients who could attend their local GP twenty - thirty times a year. The GP is not doing as well as some would argue in such a scenario. It all balances out, although that balance is off somewhat now with the collapse in private practice. I guess my point is that the medical card system is not as lucrative as many would argue it is.

It is a pretty decent contract for the state considering that the GP has to provide 24/7 cover for the patient 365 days of the year.

creedp

Sierra Oscar wrote: »

It is a pretty decent contract for the state considering that the GP has to provide 24/7 cover for the patient 365 days of the year.

Which GP's are obliged to provide 24/7 cover 365 days a year under the current contract?

L1011

creedp wrote: »

Which GP's are obliged to provide 24/7 cover 365 days a year under the current contract?

All of them

creedp

MYOB wrote: »

All of them

Oh right that why the light is always on in the GP surgery? C'mon lets be more realistic here. While you may be referring to the fact that GP's must always respond to emergency calls, many a time I have rang a GP only to get a forwarding number of an after hours service DubDoc or SouthDoc and this only exists in some parts of the country. Other than that its off to the A&E I go ..

L1011

creedp wrote: »

Oh right that why the light is always on in the GP surgery? C'mon lets be more realistic here. While you may be referring to the fact that GP's must always respond to emergency calls, many a time I have rang a GP only to get a forwarding number of an after hours service DubDoc or SouthDoc and this only exists in some parts of the country. Other than that its off to the A&E I go ..

The co-op is the legal provision of 24h cover. The specified minimum regular hours are far, far less. 8-6 weekdays from memory.

If there is no co-op the GP *must* provide the cover themselves or pay for a contractor to do so.

If you know of a GMS contracted GP who is not providing emergency out of hours cover, report them to the PCRS as it is a gross violation of their contract. I suspect you won't find any.

Jumboman

Sierra Oscar wrote: »

Go into any GP practice and you will often find that it is the same patients in the waiting room each Monday morning - with little wrong with them. These patients are always medical card holders, private patients just have to cope it would seem.

I cant see anyone going to the doctor unless they absolutely have to.

Its like going to the dentist you only go because you have to.

maninasia

Jumboman wrote: »

I cant see anyone going to the doctor unless they absolutely have to.

Its like going to the dentist you only go because you have to.

Eh no it's not, if you can't figure this out what's the point of me explaining.

Reduce fees to 15-20 euro/visit, flat fee for all patients, stop the current nonsense of taxpayers paying for others and not being able to go themselves.

murphaph

femur61 wrote: »

Brother in law is a GP and he said he only gets €70/yr for a patient regardless of how many visits a patient has.

....and medical card holders are 8 times more likely to visit a GP than non-card holders.

murphaph

maninasia wrote: »

Eh no it's not, if you can't figure this out what's the point of me explaining.

Reduce fees to 15-20 euro/visit, flat fee for all patients, stop the current nonsense of taxpayers paying for others and not being able to go themselves.

Agreed but I think you could reduce it to a fiver or a tenner at most (perhaps a tenner for non-card holders and a fiver for card holders) and most people will not go unless in genuine need. A huge part of the problem with medical card patients going to the GP with a sniffle is because if they get a prescription for a few Lemsip then they don't have to pay for them, but if they walk into the chemist and buy Lemsip without a prescription, they pay the normal price like everyone else.

In Germany, where prescriptions are "free" (we pay hefty compulsory insurance every month) they specifically exclude cough and cold stuff...which you pay full price for, even with a prescription. All other things are covered by the insurance.

I know medical card holders who have a cupboard full of prescriptions that they don't need. A lot of these medications, pain kilelrs etc. end up being given to friends and family

woodoo

I agree with charging medical card patients €5 per visit and GP Visit card holders €10 per visit. They could then reduce the rate for private patients to €20 or €30.

The free GP idea of Fine Gaels is a terrible idea, it will just create waiting lists to see a doctor like in the UK. As it is i can see a doctor on the day or maybe the next day if they are busy if i need to.

Jumboman

maninasia wrote: »

Eh no it's not, if you can't figure this out what's the point of me explaining.

Reduce fees to 15-20 euro/visit, flat fee for all patients, stop the current nonsense of taxpayers paying for others and not being able to go themselves.

Are you saying people go to the doctor for fun ?

I know people who never go unless very sick because the doctor will always find something wrong with them such as high BP etc.

Crasp

Jumboman wrote: »

Are you saying people go to the doctor for fun ?

I know people who never go unless very sick because the doctor will always find something wrong with them such as high BP etc.

Are you serious? People won't go to the doctor in case they do their job properly and perhaps discover a potentially fatal or debilitating disease such as high blood pressure?

"I better not get this lump looked at in case the doctor tells me I have cancer"

yeah, best just to leave it undiagnosed.

Jumboman

Crasp wrote: »

Are you serious? People won't go to the doctor in case they do their job properly and perhaps discover a potentially fatal or debilitating disease such as high blood pressure?

Debilitating ? most of my family have high BP its a very common condition.

Their is debate as whether or not it is harmfull to human health.

GPs who are in the pockets of the drug companies will of course tell you its dangerous and that you need medication to treat it.

Notice how most GPs will never tell people to excise to treat high BP or depression they will just throw pills at them.

People should try to excise before they take pills for BP or depression but of course their is no money to be made in that.