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GP Copayment Facts and Figures

Boy am I talkative these days.  I need to get a life.

Anyway, just wanted to point out that NPs have finally made the spotlight with respects to the newly-proposed $5 copay and GP medicare rebate cut ‘n freeze.

In the above linked Australian Doctor article (poorly written and confusing, IMHO) they point out that GPs spending 9 minutes with a client will get $11.95 whereas an NP will get $20.85, a difference of $8.90.  They are outraged they are going to be paid less than an NP.  (Imagine the smirk on my face here.)

The article had a factual inaccuracy I’d like to point out in case any of you are asked about this: It stated an NP would get $20.85 for the above 9-minute consultation example.  This is incorrect.  An NP would get $17.85 based on the 85% reimbursement rate.  An NP is only reimbursed at 100% if they are working with a DVA patient, which is not reflective of your “usual” patient in private practice.  The true net difference in this example would be $5.90 in favour of the NP.

I also think its interesting they are upset, especially considering the following figures: In the fiscal July 2013 – July 2014 year NPs billed medicare a total of $5,538,937.  That’s 5.5 million dollars.  In that same fiscal year doctors billed medicare $4,379,791,863.  That’s 4.3 billion.  So what, you say?   Well, consider the following:

NP billings as a reflection of percent time spent with a client

  • 1% spent less than 5 min
  • 32% spent between 5 – 20 min
  • 36% spent between 20 – 45 min
  • 30% spent more than 45 min

VR-GP billings as a reflection of percent time spent with a client

  • 1% spent less than 5 min
  • 74% spent between 5 – 20 min
  • 22% spent between 20 – 45 min
  • 3% spent more than 45 min

As demonstrated above NPs spend more time with their clients as a whole – irrespective of the financial (dis)incentive.  They provide the care their clients need.  If that takes 45 min to do, well so be it.  GPs on the other hand take advantage of huge incentives by having consultation lengths between 5 and 20 minutes.  A government trying to trim the fat isn’t going to be looking at NPs and their measly millions – they’re looking at the billions spent on 6-minute medicine and trying to change how doctors practice.  It’s probably the first time I’ve seen a policy directed at trying to get doctors to lengthen their consultations and actually spend time with their clients.  I find it quite remarkable.

Anyway, the Australian Doctor article completely glosses over the fact that NPs get a pittance for all the time they actually spend with their clients compared to GPs.  Oh well.  There’s independent reporting for you. 🙂