Yesterday I went to my local GP for a whooping cough prescription, and to get the results of a blood test. I need the injection for my son to allow me to snuggle my grandchild when he comes. Exciting times.

The doctor was in her room for a good ten minutes with the door open before I was seen, ten minutes after my appointment time. I presumed she was looking up my history, ready to see me. This wasn't the case, as when I walked in she introduced herself to me, as if this was the first time I'd seen her, yet only a week ago I was in her surgery worried about heart palpitations which sent her on a mission to get my heart checked (a referral to a clinic in town), my blood test (taken by the nurse and processed by pathology) and an ECG (taken by the nurse).

Pretty routine - print off forms, tick the boxes, off I go to other professionals that actually test my health.

'I'll see you in a week' she said.

In a week, she's not only forgotton me, she hadn't bothered to look at her screen and see that I was her patient for the last three appointments.

'Um, I'm here for my results?' I say. I'm annoyed enough that I'm in here when a phonecall should have been enough.

She gets up the bloodtest and reads the numbers one by one. 'Thyroid - normal' she says, her finger tracing the screen.

I can see that. There's two columns - one's my number, the other is the normal range, so it's pretty easy to see all's good. Thing is, I'm not allowed to get the results of my own blood test until I've seen a doctor. My blood is not my property it seems. I figure it's because they don't want people reading the wrong thing into it. Far enough.

But why is she taking so long to say 'normal' for every item on the list?

'Your heart is normal too' she says. A relief. 'Would you like to see a psych or have me prescribe some anti-depressants?'. My blood boils. I've said 'no' to this question for the last three sessions with her and to every doctor I've seen about anxiety for years. Perhaps they should write that on my file? Besides, that's just a quick fix and I dont get along with psychs and I'm NEVER taking anti-depressants.

'No, but can you check to see if I've have a whooping cough injection in the last ten years?'. She obliges. I haven't, but she spends time detailing what I have had, which is wasting my time and is not what I asked.

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I'll have to go up to the chemist, get the script as it's not funded - it'll cost me fifty bucks - and come back for the nurse to inject me. The doctor prints off the script. I'm done in 8 minutes, but I can tell she's trying to keep me there. She's asking me questions and wants to check my blood pressure. I deny her that - I've had my blood pressure checked every time I've come in.

'Can you check if my husband's had whooping cough?' I ask.

'Sure, get him to come in for a consult and I'll check his blood pressure'.

'Um - can't you just look it up now so we can get a telehealth consult and a script? He doesn't need to come in'.

'Oh, but I should give him a check up!' she says.

'No, he doesn't need one. Please look it up for me'. She obliges. He hasn't had one, but she can't write him a script, ie, press the print button. He has to do a telehealth consult.

'Do you charge for that too?'

'Yes, $78 dollars. But you get it back on Medicare'. Well, I get $35 back on Medicare, but let's not get into an argument about it.

Last time I rang the doctors I needed a script for codeine or something to kill the worst migraine I had in years. In that conversation, she advised to take aspirin - 1000 mg. I read that study online and everything she said to me on the phone was read to me off that study* - verbatim. Every word. Fine - it worked. But that consult over the phone cost me $78.

Let's repeat that.

For a five minute conversation where she read off a screen the advice to take aspirin, I was charged $78.

For non Australians, we pay the 'gap' left over from what the state Medicare pays - so up to 15 minutes is around 75 to 80 bucks, and a longer consult is about 125 bucks. Still, is it reasonable to pay $35 odd dollars for a phone consult of 5 minutes?

Hmm.

Is this why she was keeping me in the room? To charge me at the higher rate?

This surgery used to bulk bill you (where Medicare pays the lot) at least occasionally, more if you were struggling, and especially if if they knew you well. When I spoke to the receptionist, they said it was up to the doctor you saw.

'But he only needs a script,' I said.

By this time I was really mad. You used to pay a flat fee of $10 for an over the phone script. And why should I even need one for a whooping cough injection that I buy from the pharmacist and the nurse gives me? Shouldn't the nurse get a bigger cut as she does the heavy lifting?

Apparently bulk billing clinics are on the way out, the receptionist tells me, because 'doctors don't get paid when they bulk bill'.

Yet how much do doctors get paid? According to Talent.com,

The average gp salary in Australia is $154,469 per year or $79.22 per hour. Entry-level positions start at $87,563 per year, while most experienced workers make up to $263,250 per year.

whereas another salary guide says $200,000 and $350,000 per annum.

So spending a couple of minutes talking to you on the phone and giving you a script you know you want and it didn't take any skill to diagnose or treat is going to make a dent in that income is it? Even if they do this a few times a day, they're always either booked out or going on holiday, so don't tell me that it affects their wage.

There's also very little follow up unless you beg for it, long wait times to see anyone, poor bed side manners, little desire to see us as people and not numbers, over testing and undertesting, googling information in front of you you expect them to know anyway (hey I could have done that!) and a tendency to give quick fixes (anti depressants???) over more holistic paths to recovery. It's got to the point where someone will say: 'why don't you ask the doctor' and I'll say 'oh they're not going to tell me anything'.

What am I missing here?

In the scheme of things (where part of the story is how much other countries pay for healthcare, or even have access to it) it's not a biggie. But I'm wondering about what I'm paying for here, and how much of it is justified.

Do you have faith in the health care system? Am I being entitled and unjustified in wanting value for money and decent service for what I pay for? Is there a better system that would serve us better?

With Love,

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