GPs not taking on patients - how's that even legal?

RobFowl

OK going to take a deep breath and offer a few comments.
Am a GP so biased..

GP's don't offer private and medical card patients different levels of service. They both get the same access and one doesn't wait longer than the other.

GP's are well paid but the work is hard and there is a lot of pressure (not looking for sympathy). In my locality 3 colleagues have killed them selves over the last few years.

There are too few GPs in this country and this is not going to change anytime soon. If the capacity to see extra people is not there it is simply not there.

Alun

RobFowl wrote: »

GP's are well paid but the work is hard and there is a lot of pressure (not looking for sympathy). In my locality 3 colleagues have killed them selves over the last few years.

There are too few GPs in this country and this is not going to change anytime soon. If the capacity to see extra people is not there it is simply not there.

Well the admittedly rather simplistic solution then is for there to be more GP's available to spread the workload more.

What exactly are the barriers to this happening, I'm genuinely curious? In any other business, having to turn down a stream of potential customers would be an immediate signal that they need to expand.

RobFowl

Alun wrote: »

Well the admittedly rather simplistic solution then is for there to be more GP's available to spread the workload more.

What exactly are the barriers to this happening, I'm genuinely curious? In any other business, having to turn down a stream of potential customers would be an immediate signal that they need to expand.

Not enough GP's being trained is one problem. We don't even train enough to replace thiose retiring.
Second the terms a conditions of the state contracts are such that oftne no one will take them on. Many advertised medical card lists get zero applicants.
Attracting GP's from abroad means competing against other countries where often the pay is higher and the working conditions better..

Dr Brown

RobFowl wrote: »

GP's don't offer private and medical card patients different levels of service. They both get the same access and one doesn't wait longer than the other.

.

That has not been my experience.

I remember a few years ago when I was trying to get an appointment with a Doctor who mostly sees medical card patients the receptionist told me the Doctor was booked up for the day but as soon I said I was a private patient she was able to fit me in for an appointment the same day.

Now that I'm a medical card patient it always takes me at least a few days to get an appointment.

I think at the very least you could say that private patients are "more equal" than medical card patients.

Chiparus

Dr Brown wrote: »

That has not been my experience.

I remember a few years ago when I was trying to get an appointment with a Doctor who mostly sees medical card patients the receptionist told me the Doctor was booked up for the day but as soon I said I was a private patient she was able to fit me in for an appointment the same day.

Now that I'm a medical card patient it always takes me at least a few days to get an appointment.

I think at the very least you could say that private patients are "more equal" than medical card patients.

Have to say that is not my experience. Most GPs treat all patients equally and would welcome the introduction of a properly resourced one tier health system.

RobFowl

Dr Brown wrote: »

That has not been my experience.

Have worked in (even owned) a good few GP practices and in my experience they are treated no differently at all.

Alun

RobFowl wrote: »

Second the terms a conditions of the state contracts are such that often no one will take them on. Many advertised medical card lists get zero applicants.

Who are the contracts with, each individual doctor, or the practice as a whole? If it's the practice, then couldn't any new doctors needed be just employees and as such unaffected? For small single doctor practices it'd be a different matter, I suppose.

Having said that I have no idea how most GP practices are organised from a business point of view.

John Mason

same in finglas living here for years, cannot get a local doctor.


one night i really needed D-doc but wouldnt facilitate me as i was registered in the area

Gavin "shels"

Chiparus wrote: »

Have to say that is not my experience. Most GPs treat all patients equally and would welcome the introduction of a properly resourced one tier health system.

How would that work?

Chiparus

Gavin shels wrote: »

How would that work?

Everyone would have "free" GP healthcare , like the NHS.

Topgear on Dave

RobFowl wrote: »

Not enough GP's being trained is one problem. We don't even train enough to replace thiose retiring.

This line has mad me go "Jesus, we are screwed"

This is madness.

MayoSalmon

Chiparus wrote:

Everyone would have "free" GP healthcare , like the NHS.

No thanks

Gavin "shels"

Chiparus wrote: »

Everyone would have "free" GP healthcare , like the NHS.

Which means that the working person will more than likely get a tax increase in due course...

Easier option in my option would be a flat government subsided GP visit costing everyone €20 per visit with the exception of people on PRSI contributed pensions or something to that effect. Financially Ireland will never be able to implement "free" healthcare - in an ideal world we would.

Chiparus

Gavin shels wrote: »

Which means that the working person will more than likely get a tax increase in due course...

Easier option in my option would be a flat government subsided GP visit costing everyone €20 per visit with the exception of people on PRSI contributed pensions or something to that effect. Financially Ireland will never be able to implement "free" healthcare - in an ideal world we would.

They tried to introduce a co-payment in Australia (€5)

https://ama.com.au/ausmed/co-payment-‘poison’

c6ysaphjvqw41k

This post has been deleted.

Gavin "shels"

Wyatt Tangy Ripper wrote: »

This post has been deleted.

Generally you'll utilise things more when they're free... I know personally I will only fork out €50 per visit + €20-30 on antibiotics if no over the counter, natural remedies, etc... work. My last resort going to the doctor whereas if it was free it would be probably my first resort especially if I was getting a prescription for €2 rather than forking out €10-15 for some over the counter product.

AndrewJRenko

splinter65 wrote: »

Say no to certain people and they’ll be on Liveline complaining to super sympathetic J Duffy that their GP doesn’t care about their kids.

So what? The GP responds with 'As you know Joe, I can't breach patient confidentiality, but I can tell you that some people come in looking for a prescription for medicated shampoo' or whatever. These people are highly paid, highly technical professionals and have no excuse if they let their patients call the shots.

Is there any evidence that medical card patients abuse the system? Is there any evidence that co-payments are the solution to this abuse?

Dublin Spur

Gavin shels wrote: »

Generally you'll utilise things more when they're free... I know personally I will only fork out €50 per visit + €20-30 on antibiotics if no over the counter, natural remedies, etc... work. My last resort going to the doctor whereas if it was free it would be probably my first resort especially if I was getting a prescription for €2 rather than forking out €10-15 for some over the counter product.

I'm the same but it's not ideal that non-medical card citizens cannot access primary care in this country without it costing them around €100 between consolation and prescriptions.

I have put off going to a GP many times due to the cost involved, its a bad cycle to get into when you're unwell.

Unwell people should not have a financial barrier to access primary care in a modern society. I see Video doctor services being more mainstream over time, I used them last year and they're excellent, around €30 I think

iamwhoiam

Fann Linn wrote: »

Every under 6 child has a medical card.

Its not a medical card for the under 6 .They have free GP services and still pay for any medication prescribed . There is a difference between the under 6 free GP scheme and a medical card .

odyssey06

Chiparus wrote: »

They tried to introduce a co-payment in Australia (€5)

https://ama.com.au/ausmed/co-payment-‘poison’;

My (hazy) understanding of the French system is that it is co-payment based, but am open to correction...

Topgear on Dave

From living in the Netherlands I believe that the GP service was free paid for with an obligatory health insurance that we were all forced to get when we started work.

The service was free but like the OP says not all GPs were taking on patients but they could point you in the direction of one that was.

I also think it was common enough for the GPs and pharmacies to tell people to GTFO if they were looking for medicines they werent entitled too or wanting too many. (anecdotal though, this wasnt me)

splinter65

AndrewJRenko wrote: »

So what? The GP responds with 'As you know Joe, I can't breach patient confidentiality, but I can tell you that some people come in looking for a prescription for medicated shampoo' or whatever. These people are highly paid, highly technical professionals and have no excuse if they let their patients call the shots.

Is there any evidence that medical card patients abuse the system? Is there any evidence that co-payments are the solution to this abuse?

Joe never allows any right of reply to anyone, government dept, local authority or private individual.
Oh a caller is not allowed to name names, but they are allowed to use a big broad brush to paint whole professions as crooks or whatever.

AndrewJRenko

splinter65 wrote: »

Joe never allows any right of reply to anyone, government dept, local authority or private individual.
Oh a caller is not allowed to name names, but they are allowed to use a big broad brush to paint whole professions as crooks or whatever.

That's nonsense. I've heard Joe speaking to business owners to respond to customer complaints.

Topgear on Dave

AndrewJRenko wrote: »

That's nonsense. I've heard Joe speaking to business owners to respond to customer complaints.

The worst move a business owner can make is to go on.

He has absolutely skinned a few of them. Better to say nothing and let things blow over.

AndrewJRenko

Topgear on Dave wrote: »

The worst move a business owner can make is to go on.

He has absolutely skinned a few of them. Better to say nothing and let things blow over.

I've heard him absolutely skinning a few, and I've heard him giving a fair hearing to those who add further information to the scenario set out by the customer that puts a very different spin on the situation.

amtc

I recently stood on a piece of glass, and rang my doctor but couldn't get an appointment so he directed me to a and e. I didn't have a letter (i couldn't drive due to injured foot) ...was charged a and e fee.

A and e full of medical cards patients with minor injuries. Seemed to be hangout place.

splinter65

AndrewJRenko wrote: »

That's nonsense. I've heard Joe speaking to business owners to respond to customer complaints.

If the business owner has the nerve to ring joe then joe has to let him on.
But he never brings on any representative from the DSP or medical cards or environment to correct the absolute nonsense that is spouted on that show on a daily basis.

Dr Brown

amtc wrote: »

A and e full of medical cards patients with minor injuries. Seemed to be hangout place.

How do you know they were medical cards patients ?

Abby19

The actual annual fees GPs receive for medical card patients are listed in this statutory instrument
http://www.irishstatutebook.ie/eli/2016/si/233/made/en/print

Here is the basic text but the format might be off
Reference Number

Description

Amount

(1)

(2)

(3)

1.

Male patient aged under 5 years

€74.59

2.

Male patient aged 5 years or more and less than 16 years

€43.29

3.

Male patient aged 16 years or more and less than 45 years

€55.26

4.

Male patient aged 45 years or more and less than 65 years

€110.38

5.

Male patient aged 65 years or more and less than 70 years

€116.28

6.

Patient aged 70 years or more residing in the community

€271.62

7.

Patient aged 70 years or more residing in a private nursing home (approved by the HSE) for continuous periods in excess of 5 weeks

€434.15

8.

Female patient aged under 5 years

€72.76

9.

Female patient aged 5 years or more and less than 16 years

€43.79

10.

Female patient aged 16 years or more and less than 45 years

€90.37

11.

Female patient aged 45 years or more and less than 65 years

€121.29

12.

Female patient aged 65 years or more and less than 70 years

€129.72

13.

Supplementary out-of-hours fee

amtc

Dr Brown wrote: »

amtc wrote: »

A and e full of medical cards patients with minor injuries. Seemed to be hangout place.

How do you know they were medical cards patients ?

Because there's one window to register and one to pay and they didn't go to that one.