On this page:

• What does Medicare cover?
• How does bulk billing work?
• Knowing how much Medicare will pay
• Medicare safety net explained

So here’s your ÌÇÐÄVlog guide to Medicare – what’s free, what’s not, and how far the safety net really stretches to stop your medical costs spiralling out of control.

What does Medicare cover?

For starters, everything you get in a public hospital as a public patient is free. You’ve already paid for it through your taxes.

That includes surgery, medical appliances, accommodation, tests and medicines. Out-patient services, such as check-ups after a surgery, are also covered at public hospitals. Medicare covers emergency services, chronic illness management, and elective surgeries like joint replacements, cancer treatment and hysterectomies.

For the purposes of this article, we’re going to talk about services outside the public and private hospital systems that are covered by Medicare. These include:

• consult fees for doctors, including GPs and specialists
• tests and scans, such as blood screens, MRIs, X-rays and ultrasounds
• eye tests at an optometrist – one per year for over 65s, one every three years for everyone else
• subsidised prescription medicines through the Pharmaceutical Benefits Scheme (PBS).

What doesn’t Medicare cover?

Although there are exceptions, Medicare generally doesn’t cover:

• dental treatment outside a hospital
• glasses and contact lenses
• allied health services like physiotherapy, chiropractic, podiatry and psychology – although you can access Medicare-subsidised care with a treatment plan from your GP
• ambulance – some state governments provide it but most people need to purchase private health insurance or an ambulance subscription from the ambulance service
• hearing aids and other devices.

How does bulk billing work?

Bulk billing is when your doctor sends your bill directly to Medicare, making the service free for you. The name comes from the practice of sending multiple patients’ accounts to Medicare at the same time, hence ‘bulk’.

While many GPs, optometrists and pathologists do offer bulk billing, not all do. Your doctor might want to charge more than Medicare pays for a service. In this case, Medicare will still pay for some of the bill, but you’ll have to pay the rest.

You’ll have to make a claim to Medicare to receive your rebate. Your doctor’s office might be able to submit the claim electronically, otherwise you can .

Either way, you should take your Medicare card to your appointment, and check beforehand if and how much you’ll be out of pocket.

What about private health insurance?

Private health insurance can cover you for treatment and accommodation you receive as an admitted patient in a hospital. However, it is illegal for it to cover out-of-hospital services that are already covered by Medicare, such as GP visits and specialist appointments. Many of the things not covered by Medicare, such as dental care or glasses, are covered by extras health insurance policies.

Knowing how much Medicare will pay

There’s a document called the (MBS), where the government publishes what it thinks is a fair baseline price for the medical services it subsidises, called MBS fees (or sometimes schedule fees – it’s the same thing). MBS fees play a big role in everything that’s coming up.

On your doctor’s bill you should be able to find an item number, which you can use to look up the MBS fee for each service. When your GP bulk bills, they’re billing Medicare the MBS fee amount for a consultation. If they don’t bulk bill, you can claim 100% of the MBS fee on Medicare.

For non-GP services, Medicare will cover 85% of the MBS fee and you pay the rest. This is the case whether the provider charges the MBS fee or more.

There’s a cap on how much you pay in gaps

The Greatest Permissible Gap (GPG) is a rule that keeps expensive specialist services within reach of people on modest incomes. It does this by capping the value of individual gap fees, which in 2024 is $98.70. The GPG means you’ll pay either $98.70 or 15% of the MBS fee, whichever is lower. It applies to services with an MBS fee over $658, and increases annually in line with inflation.

For example, let’s say you have an out-of-hospital procedure. Your doctor charges you $1200, but it has an MBS fee of $1000. Medicare won’t cover the extra $200 on the bill unless you qualify for a safety net, but because it’s an expensive service, Medicare will cover a bigger percentage than usual.

Medicare will cover 85% of the $1000 MBS fee, leaving a $150 gap. That’s more than the GPG, so Medicare pays another $51.30. That means your total out of pocket expenses will be the $98.70 GPG cap, plus the $200 the doctor charged you above the MBS.

Medicare safety net explained

Original Medicare Safety Net

Even with the GPG, your out-of-pocket costs can add up if you need numerous services.

The Original Medicare Safety Net (OMSN) limits the total amount you have to pay in gap fees each year to $560.40. Once you cross that threshold, the Medicare rebate for all out-of-hospital services jumps to 100% of the MBS fee.

Not all your out-of-pocket expenses are counted towards meeting this threshold. Any cost you incur because your doctor charges above the MBS fee is not counted. Only the part of the MBS fee that Medicare doesn’t cover is counted. In the example above, $98.70 will contribute to meeting the threshold.

If you’ve qualified for the OMSN, for that $1200 procedure Medicare will pay the full $1000 MBS fee. Because in that example the doctor charged above the schedule fee amount, you’ll still be $200 out of pocket. 

Extended Medicare Safety Net 

The Extended Medicare Safety Net (EMSN) comes into effect when your total out-of-pocket expenses for a year reach a certain threshold. For this threshold your whole gap payment is counted – that is, the difference between what your doctor charges and what Medicare pays.

In 2024 the threshold is $2254.20 ($811.80 if you have a Commonwealth Concession Card or receive Family Tax Benefit Part A). Once your expenses reach this threshold, Medicare covers up to 80% of your out-of-pocket expenses for the remainder of the calendar year. Some services in areas like obstetrics and IVF are also capped at a dollar amount.

Remember, this is on top of the standard Medicare rebate and any part of the bill the OMSN has covered. If you receive that $1200 treatment after qualifying for the EMSN, Medicare would cover the full $1000 MBS fee (under the OMSN), plus $160 of the remaining $200 bill.

Safety net for families, couples and concession cardholders

The higher benefits in the Medicare Safety Nets are automatically paid once you reach the threshold. Individuals don’t need to register. If you’re a couple or have dependants, you can . (This is different to getting a family Medicare card.)

Registering as a family lets you count everyone’s medical expenses towards reaching a single threshold. Once the threshold is reached, the safety net applies to all family members, not just those who had a prior expense.

If you qualify for Family Tax Benefit Part A, your family qualifies for the lower EMSN threshold. There are around when you can claim the safety net, based on how you receive the FTB Part A payment.

Concessional families

If you have a Commonwealth concession card, your individual EMSN threshold is lower. Even if you’re registered as a family, the EMSN comes into effect for you when your personal expenses hit that lower threshold. Your expenses also contribute to meeting the family’s general threshold.

If some, but not all, family members have a concession card, those that have one form a “concessional family”. At least one parent must have a concession. Medical costs for these family members are counted together towards meeting the lower concessional threshold. Once this is reached, the safety net applies to all concession cardholders. 

As with individuals, medical expenses for concessional family members also contribute to reaching the general threshold for the rest of the family.

The post How does Medicare work? appeared first on ÌÇÐÄVlog.

On this page:

• Psychiatrists
• Psychologists
• Counsellors
• Psychotherapists
• What to look for in a therapist
• Other options
• More information

If you’re feeling anxious, stressed or depressed, having relationship problems or struggling with addiction, there are many professionals who can help.

For problems such as anxiety, depression, stress, grief or difficulties with coping, your first port of call could be your GP, who in turn may choose to refer you to a psychiatrist, psychologist or another mental health practitioner.

The alternative is to seek the help of a psychologist or counsellor yourself – but when you’re feeling under siege or overwhelmed already, researching to find the right person to help can be almost too much to bear. So we’re here to do the hard work for you, to guide you toward the best mental health professional for your needs, and let you know what you should look for in an individual practitioner.

Psychiatrists

A psychiatrist is a qualified medical doctor with additional training and qualifications to become a specialist in the diagnosis, treatment and prevention of mental illness and emotional problems.

In addition to talking therapies, psychiatrists are able to prescribe medication to treat people, and have specialised knowledge of mental health disorders caused by biological changes in the brain, such as schizophrenia, Alzheimer’s, dementia and delirium.

To see a psychiatrist you’ll need a referral from your GP. Ask your doctor if they think talking to a psychiatrist would be appropriate and useful – they might suggest a psychologist or counsellor is a better option. If your doctor feels you could benefit from talking to a psychiatrist, they may well bring it up with you first.

Training

Becoming a doctor requires five or six years of university study followed by 12 months as an intern in a general hospital. This is followed by at least another year in a hospital as a Resident Medical Officer.

Postgraduate training in psychiatry, conducted by the , takes at least another five years, during which time they work under supervision in hospitals and community clinics with children, families, adults and the elderly on a full range of psychiatric problems.

Experience and competence are tested throughout the training process.

Cost

Costs vary greatly depending upon whether you see a psychiatrist through a public health service, such as a community health centre, or privately.

Medicare rebates are available, though out-of-pocket expenses may apply if the doctor doesn’t bulk-bill. Make sure you ask about costs and billing when you make your first appointment.

Psychologists

Psychologists deal with everything from depression, stress, anxiety, eating disorders and suicidal thoughts, to improving relationships and personal growth. The professional title is restricted to psychologists who are registered with the via the (PsyBA).

Psychologists aim to change the behaviour and thought processes of their patients, teaching them skills to function better and improve their quality of life without the use of medication. A typical patient undergoes short-term treatment in a series of four to 10 sessions.

Sometimes a single session will suffice, while other patients will need long-term treatment and support. The psychologist should give you an indication of how many sessions will be required at your first meeting.

Training

Psychologists undergo an accredited four-year university degree, and after two years of supervised postgraduate practice they can be registered with the PsyBA.

Clinical psychologists have an additional two-year postgraduate Masters degree (which also entails supervision), and while they may charge more, they can offer a higher Medicare rebate (where applicable).

Costs

The Australian Psychological Society recommends fees of $119 for up to half an hour or $218 for one hour, although it’s up to the individual practitioner.

Medicare rebates under the Better Access initiative are available if you are referred to a psychiatrist or psychologist.

There’s no Medicare rebate if you see a psychologist without a referral, though your private health insurance extras cover may offer a rebate. Check with your fund, as benefits are sometimes very limited. Your private health insurance may also cover any extra sessions you require above and beyond those allowed under the Better Access scheme.

Counsellors

Unlike psychiatrists and psychologists, counsellors have a wide and varied level of training. Unfortunately anyone can call themselves a counsellor, whether they’ve done a correspondence course that teaches the basics, a two-year diploma or the six years of training and supervision required for the Masters of Counselling Psychology – or no training whatsoever.

Training

Membership of one of the professional associations for counsellors means the counsellor has undergone an accredited training program of at least two years, undergoes continuing professional development and meets agreed ethical and professional practice standards.

The (ACA) is a national peak association for counsellors and psychotherapists with more than 3000 members.

The (PACFA) is an umbrella organisation for 37 member organisations, and individual counsellors and psychotherapists join one of these organisations – they may advertise membership of either PACFA, the member organisation or both. Counselling psychologists may or may not be members of the Australian Psychological Society, PACFA or ACA, but they are registered with PsyBA.

If you’d like to see a counsellor who’s not a registered psychologist, look for someone who belongs to either ACA or a PACFA member organisation so you can be confident they have adequate training and ethical standards.

Both peak bodies have searchable lists of members on their websites so you can find one that suits your specific needs and location. They’re also collaborating to provide a single master list of all counsellors and therapists in Australia.

Costs

As a ball-park figure, counsellors charge between $60-$150 per session. Some charge more or less than this, or may charge according to a client’s financial circumstances. At present there are limited benefits available for members insured with Medibank Private (extras cover), providing the counsellor is accredited with ACA or PACFA.

The peak bodies are looking to extend private health coverage of counselling. And remember, counsellors who are registered psychologists may charge more, but you may be eligible for Medicare or private health rebates.

Psychotherapists

Psychotherapy is any kind of psychological talking therapy that aims to restructure the personality or self. Many trained mental health professionals practice psychotherapy, including psychiatrists, psychologists, general practitioners, counsellors, art/music/drama therapists, and social workers. It’s also possible to train as a psychotherapist at postgraduate level without having a therapeutic background.

As with the term “counsellor”, anyone from a correspondence course enthusiast to a psychiatrist can call themselves a psychotherapist, so if they’re not a registered psychiatrist or psychologist, look for qualifications (such as a Master of Medicine in Psychotherapy for medical doctors) and/or membership of an appropriate professional association (ACA or a PACFA member organisation) to ensure they’ve undergone accredited training and meet ethical and work practice standards.

What to look for in a therapist

Qualifications

There are many different diplomas and degrees on offer. Be warned, though, that some impressive-sounding qualifications may not have accreditation with relevant peak bodies, and may not be government-accredited either. Your best bet is to look for membership of an industry association.

Strengths and interests

Some therapists specialise in particular areas such as drug and alcohol management, family therapy, eating disorders, sports psychology or relationships. Keep this in mind when searching or seeking referral for a therapist or counsellor.

Approach

Therapists and counsellors use different approaches, from cognitive-behavioural therapy, expressive arts and psychoanalytic therapy to somatic psychotherapy, hypnotherapy and transactional analysis and many more in between. You may find a particular approach more appealing to you – see below for useful resources.

Interpersonal compatibility.

The relationship between you and your therapist is an extremely important one. If you don’t click with them, move on as quickly as you can.

Better Access scheme

While some people may prefer to find a therapist on their own, others may choose to go through their GP which may give you access to subsidised care with a psychiatrist or psychologist.

Under the Better Access scheme, patients can receive Medicare rebates for 10 individual and/or 10 group sessions per calendar year with a psychologist or occupational therapist or social worker who’s had appropriate training in mental health services.

The treatment is an integral part of the General Practitioner Mental Health Treatment Plan and encourages a team-based, multidisciplinary approach to mental health care in the community.

The initiative was designed to provide treatment for common mental disorders such as depression and anxiety, where short-term interventions are likely to be useful in cases of mild to moderate severity.

It isn’t designed to provide intensive, ongoing therapy for people with severe, chronic illness or with more complex or intensive care needs. In such cases, referral to Medicare-subsidised consultant psychiatrist services or state/territory specialised mental health services may be more appropriate, especially if affordability is an issue.

Other options

Telephone and web-based counselling

There are several free telephone and online counselling services on offer, the main ones being , and .

These services are often staffed by volunteers who are professional counsellors, psychologists and social workers, and training at Certificate IV level may be offered to people who aren’t otherwise qualified. While best known for crisis support (the big ones are open 24 hours a day, 7 days a week), they also offer assistance with relationship issues, loss and grief, drug, alcohol and gambling problems and mental health and wellbeing.

Online therapy

(for depression) and (depression, generalised anxiety and worry, social anxiety, relationship breakdown, and loss and grief) are free online programs designed and developed by staff at the at the Australian National University, in collaboration with other experts. They provide evidence-based information and teach strategies drawn from cognitive, behavioural and interpersonal therapies, as well as relaxation and physical activity.

Books as therapy

There are many self-help therapy books offering information, insight and therapeutic strategies (usually based on cognitive-behavioural therapy). Though some are undoubtedly better than others, studies on the effectiveness of bibliotherapy for depression have found that it’s almost always better than no treatment, and sometimes as good as professional therapy. The Black Dog Institute website has a that can help with depression.

More information

For more information about the types of treatment available, various industry associations and mental health in general, visit the following:

The post Mental health professionals appeared first on ÌÇÐÄVlog.

On this page:

• Thermography for breast cancer
• Live blood analysis
• Electro-dermal testing
• Bio-impedance analysis (BIA)
• Electro-interstitial scanning (EIS)
• VEGA testing
• Applied kinesiology
• Hair analysis
• Iridology
• ÌÇÐÄVlog verdict

They may offer a test – or a battery of tests – to find out everything that’s wrong with you, from using whizz-bang machines and prodding different body parts, to hair and finger-prick blood tests.

After the test, they’ll likely identify certain herbs, “remedies” or supplements that can help you with your newly discovered syndrome/s, and helpfully sell them to you while you’re booking in an extensive series of therapy sessions.

Having sat down for an hour with someone prepared to listen to the minute details of your health concerns, you’ll already be feeling better, confident your practitioner understands what’s really wrong with you – because there’s always something, and you’ll rarely hear an “I don’t know”.

The question is; do these tests actually work? We look at some of the more common ones here to help uncover the truth.

Thermography for breast cancer

Women over 40 are entitled to free mammograms, and they’re recommended every two years for women 50-69, to screen for breast cancer. They’re sometimes uncomfortable or even excruciating, and there are some wild assertions they actually cause breast cancer. So when a natural therapist offers a “safe, accurate and comfortable” alternative screening for women of all ages, it’s not surprising that some women, particularly younger ones – for whom the traditional process is considerably more painful – are interested.

Thermography, also known as thermal breast imaging, measures the temperature of skin on the breast to produce “heat pictures”. Its use is based on the premise that the skin overlying a malignant breast lesion can be warmer than that of surrounding areas. However, studies have shown that the tumour has to be several centimetres in diameter before it can be detected (mammograms can pick them up at around 0.5cm).

As points out, “There is no current scientific evidence to support the use of thermography in the early detection of breast cancer and in the reduction of mortality”.

Oh, and mammograms don’t cause breast cancer.

Live blood analysis

Live blood analysis (also called dark field microscopy, or Hemaview, after a popular make of machine) involves a drop of your blood being placed under a microscope with the image transferred to video screen. By looking at the shape, size and proportions of blood cells and other components, proponents claim they can detect all sorts of diseases and health problems, such as digestive, eliminative and immune issues, “liver sluggishness”, the presence of bacteria, fungus and yeast, vitamin deficiencies, “amount of toxicity”, pH and mineral imbalances – just to name a few.

A lack of evidence has led the (TGA) advertising complaints resolution panel to demand the withdrawal of ads suggesting live blood analysis can be used for diagnosing health problems related to immunity, nutritional deficiencies, stress and free-radical damage, among other things. Or, as haematologist Professor Hatem Salem says, “The notion that one can diagnose all sorts of ailments by examining a drop of blood on a video screen is both ridiculous and plain stupid.”

Electro-dermal testing

There are a number of measurement techniques that fall into this category, including bio-impedance analysis (BIA), electro-interstitial scanning (EIS), bioresonance and VEGA machines.

All of them claim they can somehow determine your internal physiological status by placing electrodes on your skin and measuring electrical resistance. These devices are widely used by naturopaths, chiropractors and other natural therapists, who claim that their machines are able to diagnose both serious and self-limiting health conditions.

Some say they’re “TGA approved”, which actually means that the device is (or was) listed with the TGA on the basis that it’s reasonably safe – not that it lives up to the grandiose claims that the accompany advertises. Reputable scientific research consistently disputes any therapeutic claims made for these devices, and this is backed up by expert opinion from physicists and specialists in immunology and allergies.

Bio-impedance analysis (BIA)

This is often and correctly used to measure body composition in terms of fat, water and lean body mass, and can be a useful tool for weight management and physical fitness programs – think body fat scales. However, some practitioners claim it can also measure cell toxicity, inflammation and energy levels, as well as determine your cellular age. But endocrinologist Professor Lesley Campbell tells us, “The claim that BIA can assist in monitoring toxicity, inflammation, malnutrition and poor cellular function is unscientific and unfounded.”

Electro-interstitial scanning (EIS)

This is based on measuring and interpreting resistance to the flow of electric current through interstitial fluid (the fluid between the cells) via six electrodes placed on the body. It’s claimed the data can be used to assess the health status of all of the major organs of your body, as well as diagnose ADHD and monitor hyperthyroidism, hypertension, atherosclerosis and depression. Dr Stephen Barrett of (a US-based organisation which applies scientific methods and principles to establish the validity of alternative health products and services), consulted scientific and medical literature and spoke with biochemistry experts to conclude, “Electro interstitial scans have no proven practical value and could cause large amounts of time and money to be wasted by people who believe the speculations”.

VEGA testing

This is often used to detect allergies and food intolerances by having one electrode placed on your finger, another on an acupuncture point on your hand or foot, and introducing a sealed container of food into the circuit. Reduced electrical current means a sensitivity. However, as physicist Professor John Storey points out, “The device simply measures the electrical resistance of the patient’s skin. There is nothing in the device’s operation worth discussing, unless one has a particular fascination with the electrical resistance of a person’s skin.”

Applied kinesiology

Kinesiology is the science of human movement. Applied kinesiology (AK) applies nonsense theory to this science. Practised by some chiropractors and other natural therapists, the premise is that every gland and organ dysfunction is accompanied by a weakness in a corresponding muscle, and by testing the strength of various muscles, the therapist can diagnose stresses, imbalances and sub-optimal functioning.

Similarly, nutrient deficiencies and allergies can be diagnosed by having the patient hold a test substance while the practitioner tests their muscular strength. According to allergy expert Professor Chris Corrigan, “This is all completely bizarre and, I am afraid, utter nonsense. There is no scientific evidence or mechanistic base to suggest that these tests could be remotely effective.”

Going hand-in-hand with AK is Nambudripad’s Allergy Elimination Technique (NAET), which is based on the notion that allergies, caused by energy blockages diagnosed with AK, can be permanently cured with acupressure and/or acupuncture treatments. Suffice to say, if you have a previously unknown allergy diagnosed with AK and miraculously cured with NAET, it probably never existed in the first place.

Hair analysis

Hair analysis is used legitimately to detect certain chemicals and metals, which indicate their presence in the body. Troubled footballer Ben Cousins agreed to regular hair analysis for illicit drugs – then shaved his head and waxed his body before fronting up for a test! Meanwhile, people in high-exposure environmental or occupational situations may use this form of testing if they’re concerned about overexposure to heavy metals such as mercury, lead or arsenic, which can all show up in hair.

But is it useful for the average Joe to get an analysis from their naturopath? Probably not – they’ll almost certainly find some metals, but whether it’s of any clinical significance is dubious. The reliability of hair testing for mineral deficiencies is questionable, and claims that it can detect allergies are completely unfounded.

Iridology

Iridology is the study of the iris (the coloured part of the eye) to diagnose disease, based on the notion that every organ in the human body has a corresponding location within the iris. By examining the markings and patterns of the iris, the practitioner can determine whether a particular organ is healthy or diseased.

It’s true that there are signs of certain diseases in the eye – for example, a whitish ring around the iris indicates high cholesterol. But the claims of iridologists go way beyond these broad signs.

Clinical trials that put iridologists’ skills to the test variously find there’s little consistency between practitioners, that seriously ill people may be diagnosed as healthy (and vice versa) and a practitioner presented with the same iris more than once will diagnose it differently each time.

Patterning of the iris is often used for bio-identification because it’s so consistent and unchangeable over time: this wouldn’t be the case if it changed to reflect new illnesses, such as cancer, and surgery, such as hysterectomy. This may be why the claims of some iridologists have tempered in recent years to suggest that the iris simply shows underlying health weaknesses, which may or may not be activated according to your lifestyle.

According to the , “The practice of iridology has no basis in science and is considered to be disproved alternative health care.”

ÌÇÐÄVlog verdict

As Quackwatch observed, “These [electrodiagnostic devices] and similar tests are used to diagnose non-existent health problems, select inappropriate treatment, and defraud health insurance companies. The practitioners who use them are either delusional, dishonest, or both.”

If you consult a natural therapist, take their advice with a grain of salt, and certainly avoid paying for any tests or therapies similar to those above. A nice massage, a chakra realignment and some sound dietary advice (that doesn’t exclude major food groups) could do some good, even if only to your mental state.

Any suggestion of allergy, food intolerance, genuine nutrient deficiency or serious illness should be verified by a medical specialist or allied health professional. If you have a real health problem, visit a qualified doctor for a correct diagnosis.

Are you paying for dodgy diagnostics?

Most health insurance funds offer extras cover rebates for services such as naturopathy, homeopathy, chiropractic and iridology and other alternative therapies whose scientific and medical validity has been questioned. Even if you don’t use them yourself, you’re likely to be subsidising someone else who is! Some policies offer more of these than others, so choose accordingly.

More information

• Visit for information about the national breast cancer screening program.
• The is a non-profit association which focuses on health misinformation, fraud, and quackery as public health problems.
• The regularly run articles about non-proven medicines and therapies.
• covers unproven and scientifically questionable claims of alternative health therapies, vitamin peddlers, and other health frauds.

The post Alternative diagnostics appeared first on ÌÇÐÄVlog.

On this page:

• Shopping around
• Things to keep in mind
• Medical records and eHealth
• Bulk-billing
• Useful contacts

The best doctors do more than just diagnose – they co-ordinate your complete healthcare, sending you for the right tests and to the right specialists. They’ll help you stay healthier and limit unnecessary hospital visits.

Shopping around

If your current doctor isn’t up to scratch, or you’re moving house, now’s the time to shop around.

To find a new GP you can:

• ask your current doctor for advice
• ask your family, friends and neighbours for recommendations
• ask a local pharmacist or other medical professionals who have dealings with doctors in the area.

Ring your local Division of General Practice or contact the (AGPG) and ask for a list of the doctors practising in your area. Some divisions can even provide additional information about the doctors – like interests and expertise, or languages spoken.

Professional associations such as the Australian Medical Association (AMA) and the Royal Australian College of General Practitioners (RACGP) may also be able to help.

See useful contacts below for details.

Things to keep in mind

Once you’ve narrowed down a list of possible doctors, visit their practices and consider the following:

Location

Can you get there easily? You might find it more convenient to see a GP closer to your workplace, rather than one near home.

Opening hours

Extended hours are an advantage if you have a chronic condition that tends to flare up at odd times, or if it’s hard to get away from work during business hours.

Medical centres tend to be open longer hours than traditional surgeries, but you won’t always get to see the same doctor every time unless you book in advance.

If you need a prescription or some other medical attention outside your regular doctor’s surgery hours, you might find it convenient to drop into a 24-hour medical centre and see a different GP. If you do this, you should tell your regular doctor about the visit and any medication that was prescribed. Continuity of care is important for good health, particularly if you have a chronic condition.

Home visits

Does the practice offer this service?

Languages spoken

If English isn’t your first language, it’s worth looking for a practice with professionals that speak your language.

Male or female GPs

If you’d prefer a male or female doctor, check that the practice offers the choice. A 2005 study found older GPs (aged 65 plus) and female GPs generally provide longer consultations.

Premises

Are the rooms clean and tidy? If you’re the family type, are there toys and an area where your kids can play while they wait?

Information

Posters and brochures in the waiting room are a plus – they show the practice is aware of the importance of public health education. Look out for a practice information sheet that provides information on thing like fees, appointments, home visits, and repeat prescriptions.

Specialities

Do any of the doctors have extra qualifications or areas of expertise that might be of benefit to you? A doctor with a diploma in obstetrics or paediatrics can be useful if you have or are planning to have kids, for example.

Accreditation

There are agencies (Australian General Practice Accreditation – AGPAL – and General Practice Australia – GPA, for example) that independently rate the quality of general practices and award accreditation to practices that meet a benchmark quality standard. Ask the practice if it’s accredited, or look for an accreditation certificate or logo on display.

Billing

Ask how you’ll be billed when you make an appointment:

• you may be able to get a discount if you pay upfront;
• it may cost more to have an appointment on a Sunday; or
• the practice may bulk-bill.

Decision time

Once you’ve made a choice, take the plunge and go in for a consultation. There’s no obligation to go back to that doctor if you’re not satisfied. Your final choice should be a GP that makes you feel comfortable, and one whose knowledge and judgment you trust.

Medical records and eHealth

Keeping track of your records

When you move practice your medical records should follow you. You can either authorise your old practice to provide a copy or summary of your health information to your new GP, or ask your new GP to request the information for you.

If the practice you usually go to closes down, or if your GP leaves the practice or dies, things aren’t so simple.

In general, there’s very little regulation about what happens to your medical records in these situations, and it varies in each state and territory. In Victoria, for example, the law stipulates that patients must be provided with written notice about what’s going to happen to their records, where practical, and a notice must also be placed in a local newspaper. Similar laws exist in the ACT, but in other states you may not be given that consideration.

Storage of records

Any medical records that aren’t transferred or claimed may have been stored securely under a third party’s supervision. 

Several states have laws that specify how long records must be kept before they can be destroyed. So if you don’t get a chance to claim your records before the practice closes, you might be able to track them down after the fact. But if you’re not informed of their whereabouts or you happen to miss the notice in the paper, there’s not a lot you can do. And it’s not just an issue of privacy. At best it’s also an inconvenience; at worst, a health risk.

There are professional guidelines for the management of health information, including the retention of medical records in GP practices, but we think they should be made into laws.

eHealth

The Federal Government’s vision is a national, cradle-to-grave, electronic health record for all Australians. Your eHealth record should ideally hold your complete medical history – from diagnosis details and treatments, to all contacts you’ve had with the health system.

In theory, this appears to be a sensible move. eHealth records can help prevent unnecessary or inappropriate treatment, and provide protection against potential adverse drug interactions and allergies. They also mean you won’t have to explain complex medical histories whenever you see a new medico.

In practice, though, there are several unresolved privacy issues. It’s currently unclear where and how your information will be stored, and who’ll have access to the records.

And things are complicated more by the current complex plan for state and territory to implement and manage eHealth independently.

We want all consumer concerns to be addressed before this eHealth vision becomes a reality.

Bulk-billing

Consultation costs

If you’re a budget-conscious patient, bulk-billing is great. You pay nothing upfront, and you don’t have to go to the trouble of claiming fees back from Medicare. The problem is that it’s not always available.

Medicare says around 75 per cent of all GP services are bulk-billed. But although practices often bulk-bill concession cardholders, many charge other patients privately.

The says many GPs can no longer afford to bulk-bill all their patients because of the gap between Medicare’s rebate and the cost of the scheduled fee. The estimated cost of providing a standard (Level B) consultation is $55 but the rebate is just $31.45.

Length of consultation

GPS say higher fees help them spend more time with each patient. Longer consultations are usually associated with benefits like higher patient satisfaction and an increased likelihood of preventive care.

And there’s a concern that where practices do mainly bulk-bill, GPs may find themselves under pressure to see more patients more quickly to remain viable. However, in reality there’s no published evidence suggesting you’ll receive a shorter consultation if you’re bulk-billed than if you’re privately billed.

A 2003 report to the Federal Government proposed a change to this MBS structure, but there’s been no action on this to date. Apart from some additional incentives to bulk-bill specific groups, including Commonwealth concession cardholders and children under 16, the situation remains the same.

Useful contacts

Finding a GP

To find contact details for your local Division of General Practice, or the AMA or RACGP in your state or territory, visit:

Making a complaint

If you have a complaint about some aspect of your healthcare (the clinical treatment you’ve received or your doctor’s conduct, for example), it’s a good idea to first discuss your concerns with your doctor or another doctor in the practice. But if this doesn’t resolve your problem, you have several options.

You can complain to:

• the independent health services commission/ombudsman in your state or territory,
• the relevant Medical Board in your state or territory, or
• your local branch of the AMA or other professional association of which your doctor is a member, where applicable.

For contact details for these bodies in each state and territory, visit .

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