Patients shun GPs and bear the pain in cost-of-living crunch

Patients are delaying or avoiding GP appointments as the cost-of-living crisis bites, with 2 million fewer standard consultations taking place in Victoria this year compared with before the COVID-19 pandemic.

Melbourne GP Dr Rodney Aziz, who owns 45 practices in Victoria, estimates about a third of patients across his clinics are postponing appointments because of rising living costs.

“We have really noticed it this year,” the Hawthorn East doctor said.

“Patients are delaying treatment and presenting to hospital emergency departments rather than seeing their doctor.”

GPs are also reporting that cash-strapped patients are stockpiling a long list of medical issues before making an appointment.

“It is extremely concerning to see people turning up with several months of symptoms such as chest pain,” said Dr Sarah Lewis, the clinical director of Port Melbourne Medical.

Lynda Greasley put off going to her GP for two months this year because she couldn’t afford it.Credit: Chris Hopkins

Lewis fears postponing care may have a long-term impact on her patients’ health.

“The consequences will be down the track ... delayed cancer diagnoses and missed diabetes and heart disease where timely diagnosis and treatment can improve outcomes.”

An analysis of Medicare data by The Sunday Age reveals a marked decline in the number of standard 20-minute GP consultations in Victoria.

In 2019, about 12.3 million standard consultations occurred during the first six months of the year. That dropped almost 20 per cent to 10.2 million in the same period this year.

That is despite the state’s population growing by an estimated 53,000 people during this time.

Data collected during the COVID-19 pandemic peak years has been excluded because GPs did not provide their usual services due to lockdowns and the availability of respiratory clinics, which were funded outside of Medicare.

The cost of seeing a GP continues to rise: fewer than 65 per cent of Australians now have all their appointments bulk-billed, federal Health Department data shows. The average out-of-pocket fee is $40.10 in Victoria, according to data from online healthcare directory Cleanbill, with some electorates having only a handful of bulk-billing GP clinics.

Royal Australian College of General Practitioners president Dr Nicole Higgins said many GPs had been forced to increase the cost of consultations because of a rise in wages and operating costs such as electricity.

Royal Australian College of General Practitioners president Dr Nicole Higgins has raised concerns about the drop in GP consultations.Credit: Alex Ellinghausen

“Those costs are having to be passed on to patients,” she said. “So the gap is widening with out-of-pocket costs, which then creates another barrier for care.”

Higgins said it cost taxpayers about $40 each time a patient saw a GP compared with $600 if they presented to an emergency department at a hospital.

Lynda Greasley, of Pascoe Vale in Melbourne’s north, put off going to her GP for two months this year because she couldn’t afford it. The 56-year-old had a consistently upset stomach and a sudden onset of dermatitis but felt she had no choice but to put up with her symptoms.

She said her regular GP did not bulk-bill, so she was at least $40 out of pocket every time she saw them – and sometimes more.

Lynda Greasley’s out-of-pocket medical costs over the past three months

• 4 visits to a GP: $193
• 2 visits to a gastroenterologist: $147
• ultrasound: $80
• dermatologist: $219

Greasley, who works full-time in real estate and also cares for her 24-year-old daughter who has a mild intellectual disability, eventually made an appointment in May.

So far, her out-of-pocket medical costs have totalled more than $600 for four GP consultations, a gastroenterologist, ultrasound and dermatologist. She still doesn’t have a diagnosis and the testing continues.

“I really try to look after my health because I have to look after my daughter,” Greasley said. “I am her sole parent.”

Australian Medical Association Victorian president Dr Jill Tomlinson said Medicare rebates for patients had not kept pace with the rising cost of living.

“Visiting a GP is becoming increasingly unaffordable for people on lower incomes,” she said.

Dr Jill Tomlinson, hand surgeon and the Victorian president of the Australian Medical Association.Credit: Penny Stephens

Consumers Health Forum chief executive Elizabeth Deveny said Australians were ignoring symptoms and searching for a diagnosis online to avoid the cost of seeing a GP.

“Every day, we hear people telling us that they can’t afford the cost of a co-payment, the radiology request, the medicine or even getting there or taking the day off work because they’re concerned about their job security,” she said.

“They decide not to go because the costs are too great and they believe they can wait a little bit longer. That’s not always a wise decision to make.”

Federal Health Minister Mark Butler said it had never been harder or more expensive to see a doctor.

He said that from November, bulk-billing incentives would be tripled for GPs who didn’t charge out-of-pocket costs for children, concession cardholders and pensioners.

“Doctors’ groups have called this a ‘game-changer’ and GPs right around the country have said this will help them maintain and even shift back to bulk-billing,” he said.

Butler said a $1.5 billion indexation boost to Medicare rebates would also reduce pressure on GPs.

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