When we are sick the first point of contact is often the family doctor. Family doctors are commonly referred to as general practitioners or GPs in Australia. All Australian citizens, permanent residents and certain visa holders can access Medicare, which provides free or subsidised treatment by doctors and specialists.
General practitioners see all patients on a wide range of health issues from mental to chronic illnesses as well as for regular health checks.
Seeing a doctor requires booking an appointment in advance, although in urgent but non-life-threatening situations, a GP can usually see a patient immediately.
Melbourne-based GP and Vice President of the Australian Medical Association (AMA) Dr Tony Bartone explains.
“You can see a doctor without a Medicare card. However you’ll be expected to complete a private form or account for that treatment. If you do have a Medicare card, the Medicare card will cover a certain amount of the fees.”
Not all general medical services are covered by Medicare.
“Essentially any normal presentation to a general practitioner is covered by Medicare’s rebates. Sometimes, some services are not, services which do not fall within a health service definition, so a lot of preventative screening and a lot of other cosmetic procedures, for example, do not fall under the coverage of Medicare rebate schedule.”
Some doctors accept Medicare benefit as full payment for a service.
“Where you don't have a Medicare card, you’ll be expected to pay private fee for service. If you do have a Medicare card and use a Medicare rebateable service, there is rebate to the patient for that service of a certain amount. Now in certain circumstances, the doctor accepts that amount as full recompense for their services and that's called bulk billing but the majority of private consultations usually involves raising an account, paying that account, and then claiming the Medicare rebate back from the Medicare office.”
General practitioners see patients for a range of health issues from pregnancy screening, infections, health screening, chronic illness, to mental health problems and domestic violence.
The GP also refers the patient to specialists for further treatment.
“You can see a specialist in Australia without seeing a GP but Medicare rebate for such services is extremely reduced. In a normal state of practice, you would see a GP for a particular problem, which after a course of investigations and treatment and history and examination, you would then combine with a doctor, who would make a referral to see a specialist.”
Patients can choose their own preferred GP in a medical practice or request to see a female practitioner.
Dr Bartone says another reason to visit a GP is for routine health screenings.
“Maybe a check for diabetes, for a blood sugar, maybe a check for cholesterol. Certainly a blood pressure check, certainly a weight check, certainly a discussion around exercise and diet and lifestyle, work and life balance - these are the things that you would ask. Now, as we proceed to perhaps the more elderly members of our community, we will focus more particularly on ensuring that we’re picking up on the first signs of any blood pressure problems, any renal problems, or heart problems, any musculoskeletal problems such arthritis.”
Most clinics have their own after-hours arrangements if patients need to access their doctor outside of normal business hours.
“There are after hours locum services that sometimes are contracted by clinics. So these are larger services, which cover many many practices over night or after hours, on weekends or public holidays. Some practices do their own after hours and they’ll have their own arrangements. So it’ll be that the phone is diverted to an answering service or diverted to the doctor on call when the clinic is shut. However, each clinic will offer some form or some alternative option to after hours service when they are closed.”
After-hours patients can also ring the free 24-hour national Healthdirect line for general medical advice.
“These are all other services provided by the various governments both federal and states in the country. They provide a backbone, backup services for those who cannot access after-hours care through their normal general practice or may not have previously seen a general practitioner.”
In a medical emergency, patients in most states except Queensland and Tasmania need to pay for the ambulance service if they are not covered by private health insurance. Dr Bartone says purchasing an Ambulance subscription from your state’s major provider is a sensible idea.
“These ambulance services are not free but membership of the service for a yearly amount, a very nominal yearly amount, will ensure that there is no charge for that service where appropriate. It’s very hard for patients to decide sometimes whether it is or it isn’t an emergency, and so dialing the ambulance after hours if there is any doubt whether it is an emergency and you can’t get onto of your GP will often give you an over the phone triage response as to whether an ambulance is required as an emergency to take you to the hospital.”
Medicare provides free care for a public patient in a public hospital.
It also covers 75 per cent of the Medicare schedule fee for services at a private hospital, except hospital accommodation and items such medicine or theatre fees.
“If you have a Medicare card and you attend an emergency department of a public hospital there is no cost other than perhaps some incidental charges for ancillary, equipment or meditations but essentially, the service to the emergency department is covered by your Medicare card.”
Translating and Interpreting Service over the phone or on-site are also available for people requiring language assistance.
“Takes a bit of pre-planning and sometimes if it's a language…one of the more routinely popular ones, you do need to organise and book that interpreter service in parallel with your consultation to ensure that you have access.”
The consultation between a GP and a patient is confidential unless maintaining the patient’s private information puts the public at risk. Free 24-hour national Healthdirect line for general medical advice is available by dialing 1800 022 222.
Translating and Interpreting Service over the phone or on-site for people requiring language assistance is accessible by calling the TIS line on 131 450. For more on Medicare visit Medicare Australia or call 132 01.