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In the patients best interest. endangered or extinct?

kenny66Senior Contributor04 Aug 2014, 6:16 pm AEST

In the patients best interest. endangered or extinct?

With all the one sided debate about the supposed plague of disability welfare recipients on the ordinary tax payer, I have been trying to work through the more rational elements put forward. I have had great difficulty in finding truthful unbiased advice from both the media and the government, most of which has not been supported by independant studies or indeed any studies at all. It seems to me that no one has focused on the medical and pharmaceutical industry which are well and truely taking full advatage of the swirl of copious amounts of money flushing through the system. I am just using my experience in the mental health area but I am sure that many other people with disabilities have similar experiences, maybe the majority!!

Where I live, there is a shortage of doctors. Those that do come are lured by financial reward, very little competition and the lifestyle. There is NO bulk billing at almost all of them. If I need to access a bulk billing Dr I have to travel 1 and 1/2 hrs by bus as I cant drive because of my condition/medication. My local Dr Charges $80 for a consultaion.

Because he does not bulk bill, the cost of me obtaining a PBS medication is $118.90 including the script under this situation. It used to be that once I had one consultation I could simply ring up after that and pick up another script without seeing the Dr. That clinic has stopped doing this if you had not had a consultation with the Dr on a regular basis which I do not. This means I have to pay for a consultation with the Dr although I dont need it. All of the arguments about needing to see the Dr because he monitors how you are going on your medication and keeps an eye on any adverse reactions are absolute rubbish My "script consultation" involves meeting the Dr, asking for a script, him writing out one-asking me how I am, and no other investigation at all. This consultaion takes about 5 minutes. As far as mental health goes the local Drs I have seen since moving to this area have been either ignorant about the subject, scared of it or dismissive. Stigmatism is a feature. My psych is not able to prescibe medication outside of the antipsychotics etc I have for the schizophrenia, so the bus ride looks like the only alternative for me.

With all the talk about mens depression rates why is no one talking about the disengagement by Drs with there patients. No one is talking about the fact that very few of them have an onging relationship with their patients which could identify issues such as depression. When I go to the Dr for anything other than a script the first thing that happens is that I have to get a pathology test. If nothing arises from that then I am referred on to one of the specialists that the Dr has a relationship with. These practices directly lead to the vast overservicing in both pathology and specialist services. Patients dont choose to have pathology tests. Drs prescribe them.The fees for specialists in this area are astranomical at $500 per visit. My Dr tells me the reason the referral system is this way is because any misdiagnosis can lead to legal action, so the least litigious process is to refer them on to a specialist.

On the question of pharmacists. I thought I had a good relationship with mine until I found that he was substantially overcharging me. Stupid me thought that all drugs on the PBS were $38.90 so I never questioned the cost. One of my friends put me straight on that and sent me off to another pharmacy outlet. My current meds are ( I cant mention the names on the forum) at the local pharmacy $38.90-$38.90-$38.90-$38.90-$25.00 plus $100.00 (private script)= $280.60 per month. The other outlet charged for the same drugs $38.90-$38.90-$16.99-$6.00-$ $16.99-48.00= $165.78. When I fronted up to the chemist to complain about this he said he would match the price. I checked this out with Medicare who told me the rule is the customer can pay no more than $38.90 for PBS drugs so the Chemist is allowed to put a premium on chaeper ones. There appears to be no limit that the chemist can apply to private scripts. Well that is my say on the subject. Nothing will happen of course to stem the endless stream of taxpayers money flooding into the pockets of some medicos and some pharmacists. The government will not take on the AMA or the Pharmacy Guild, in the same way they have with mentally ill people recieving the DSP and generally.

2 replies

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In response to: In the patients best interest. endangered or extinct?

kristinSenior Contributor04 Aug 2014, 9:55 pm AEST

Re: In the patients best interest. endangered or extinct?

Hi Kenny,

That's daylight robbery! This is one thing that would probably improve significantly on the DSP because you pay much less for scripts and many clinics will bulk bill pension card holder's and children's consults, even if nothing else.

I think what you say about the pharmaceutical industry and the medical/pharmacy establishment generally is true. Mostly they are not being asked to cut their take. What you describe as the referral process sounds like on big butt-covering rort! Thankfully not all GPs are like this, sadly apparently many are.

Finding a decent GP who actually has some level of concern for you as a person is terribly difficult, especially in rural areas (I live in a country town too, but only about 1.5-2 hours from the city centre). Same for finding a psychiatrist who will actually do therapy rather than just write scripts for meds. It took me years after we moved here to find them both. My previous GP was caring but had no idea about medications and side effects, he nearly killed me by prescribing two contraindicated drugs (a strong anti-inflammatory and a strong pain killer). When I raised it with them he blamed my "sensitivity to drugs" (except what I experienced is common - about 50%), so that was it.

I went without therapy (or very occasional visits, all the way into the city) for about 5 years. That was incredibly difficult as I suffered quite a lot of trauma during those 5 years. For me therapy is like going to the gym. I go weekly and I regard it as an investment in maintaining and improving my mental health. If I go without for very long I suffer from severe and chronic depression. It's about 1.5 hours drive to see my psych but completely worth it as she's a very caring person, a good listener who doesn't pathologise, and miracle of miracles when she saw I was struggling to pay even the Medicare scheduled fee she offered to bulk bill me!

I apologise if this sounds like I'm waxing lyrical about how good I've got it when you are going through such a crappy time, but that isn't my point. If you know basically what you are looking for (and you may not get it all) in a GP or a psych then keep looking. Persist. There are good ones out there. Asking around even fairly casual acquaintances can be helpful in finding a decent GP; reasonable GPs tend to listen when one patient says they've found a good psych, and then refer others too (which is how I found both of mine).

Best of luck Kenny, try not to let the crap bring you down (which I know is easier by far to say than do). You deserve a better GP, one who treats you like a person.

Kind regards,

Kristin

In response to: Re: In the patients best interest. endangered or extinct?

kenny66Senior Contributor05 Aug 2014, 10:07 am AEST

Re: In the patients best interest. endangered or extinct?

Hi Kristin

Thanks for all your informative and supportive comments. I was really going off about the general rorting of the system by some in the medical profession when an argument is being put forward that it is people with disabilities do it exclusively. Regarding my own position, I am able to get around most of it and just need to put in the effort to shop around. Some, if not the majority of the Drs here do not bulk bill concession card holders and if they do its usually only one Dr in the practice that does it. As I said I can take a bus ride into the city where there are two that I know of that do it. There may be more, I just havent found them. Regional Queensland, and regional Australia, is a funny place where sadly there is a lack of even the most basic choices in medical services. I have tried most of the DRs within a 2 hr range, and havent found a connection with any of them. As I said, stigma and ignorance abound within the medical profession as well. There is also an attitude from some medicos that mental illness is a big city disease, not something that you get in the country. My Psych is a good guy and supportive but very focused on medication as the optimum treatment for mental illness. His clinic offers wellness-exercise-meditation-life coping skills etc programs, but I didnt find them attractive for me personally.

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