GP levels in aged care reaching “crisis point”

GPs working in aged care have warned that the new Aged Care Access Initiative contains little incentive for doctors to work in aged care facilities.

Under the initiative, accredited GPs who claim for 60 or more services within an aged care home, are eligible for an incentive payment.

But Dr Alison Sands from the North East Valley Division of General Practice in Melbourne says many doctors working in aged care are not accredited.

“That automatically excludes 30-40 per cent of our GPs in our division,” said Dr Sands.

“Also, a number of GPs who do work in aged care homes within our division do so under an independent provider number and so are not accredited.

“These GPs have a particular interest in aged care and a great deal of experience and expertise behind them but they are not able to get any of that incentive payment.”

Another problem with the access initiative according to Dr Sands, is that it only offers an incentive payment to the serving doctor.

Other similar incentive programs – for conditions like asthma and diabetes – have a practice payment to help to help fund “whole of practice” support for patients.

These include activities such as developing patient registers and supporting practice nurses.

Adding to GP concerns is the $2500 annual cap on the incentive payment.

Dr Terry Ahern is a Coburg GP who also has a role liaising between the aged care providers and the Royal Melbourne Hospital and he says the cap removes any incentives for GPs who do large amounts of work within aged care.

“If you are seeing half a dozen patients or 66, you could still get the same amount of funding,” said Dr Ahern

And with documentation demands only increasing, Dr Ahern believes GP levels in aged care have reached a crisis point.

“It’s very time consuming for GPs to work in aged care and as much as 40 per cent of the work they do can be unpaid,” he said.

“This will mean more new doctors will be reluctant to work in aged care.”

In an unpublished letter to the AMA, the RACGP and various medical newspapers, Dr Ahern has suggested a number of dramatic solutions to the GP shortage in aged care.

These include training practice nurses to perform more extensive roles, rotating GP registrars and registered medical officers through aged care facilities and refusing to do required paperwork.

“One way to make a protest would be to refuse to do that documentation for a period of time such as a week or a month,” said Dr Ahern.

“Those are my thoughts at the moment and there is a lot of support for them among doctors.”