Dr Sonia Schutz
Important billing update; Dr Sonia Schutz
From 1st November 2022 Dr Schutz will no longer be bulk billing* regular pre-booked consultations.
At Mannum Medical Centre we pride ourselves on providing holistic quality general practice care. As you would know, I have a reputation for spending a long time with each of my patients. Patients appreciate it and often come to see me with multiple complex problems. However, complex chronic disease care takes time. Sometimes this is referred to as “slow medicine”.
Medicare, on the other hand, does not acknowledge the value of longer consultations. Seeing 2 people per hour earns considerably less that seeing 4-5 patients for between 6 to 15 minutes. Medicare is set up to promote production-line style medicine with short consultations covering only one problem.
It is important to know that Mannum Medical Associates is a private general practice. It is currently co-located at the Mannum Hospital but operates as a separate private entity, paying rent to the hospital for use of the rooms. The money paid by Medicare for each consultation does not go straight to the doctor’s pocket. Only a percentage goes to the doctor with around 50% going towards the costs of running the business. This includes the wages of the clinic nurses and administration staff, the costs of rent, equipment, amenities such as power, cleaning, insurance and accreditation, and so on. These costs have risen over the years. Staff wages have increased. And yet for many years the Australian Government froze the rebates, keeping them at the same rate rather than increasing them to match inflation. Recently the rebates were increased but at only ¼ of the inflation rate, the equivalent of 65cents per 15-minute consultation! It is no longer sustainable to bulk bill complex long consultations with these low and unrealistic Medicare rebates.
These changes are not about giving you more service or even longer consultations, but about being paid appropriately for the services I am already providing at a discounted rate.
I understand that charging a gap and no longer bulk billing will disadvantage some patients. However, I do not think it is my responsibility to subsidise a broken health system, one that the Government is unwilling to fund adequately. My only other alternative is to start seeing more patients per hour and limiting the consultation to one simple problem per consult.
There are options for those who feel unable to pay for a consultation. Currently my colleagues will continue to bulk bill pensioners, patients with a health care card and children under 16. This may change in the future if costs continue to rise, and the Medicare rebate does not rise in line with these costs. There are bulk billing clinics in nearby Murray Bridge as an alternative care provider.
If you have concerns about this change and the costs, I recommend you contact our local Federal Minister (Mr Tony Passin) to discuss government funding of primary care. Please know that this is not a decision I have made without considerable thought. And please do not complain or be rude to the receptionists when they inform you of the gap payment, they are just doing their job.
* What is “Bulk billing”?
Medicare is a public health insurance scheme funded by the Australian Government. When you see a doctor, Medicare will pay all or some of the costs of your care, depending on the fee set by the doctor. Bulk billing is when a doctor bills Medicare directly for the services provided to you, so you have no out-of-pocket expenses. If you are bulk billed, you’ve agreed for Medicare to directly pay your rebate to the GP for the service provided to you.
https://www.racgp.org.au/running-a-practice/practice-resources/medicare/medicare-and-billing
How about emergency patients?
I will continue to bulk bill emergency appointments (book on day) or patients seen via the emergency department of the Mannum Hospital to those u16, pension or concession card holders and DVA.