Nicola Roxon has no new ideas after 12 months in the job

Why blog at all??  I think it is important to record my ideas, thoughts and comments as well my forecasts about General Practice.  In this way I can record where I think things are headed.  More importantly what actions I should take to align myself with what I see as the future.  I have done this all my professional life.  It is not second guessing.

But at the moment all I can discern are changes to registration which involves revalidation and comments on cognition tests for doctors. 

There are no changes to basic consulting patterns – no new ideas!!  So what is this telling us.

I believe that Nicola Roxon is just a public servant with a few new ideas but her kite flying evoked the wrong response.  She realises that if allied health is to do any Medicare paid work then there will be an additional cost.  there will be no cost savings.  Also GP’s will not back or support independant groups.  So they function alone and wear the medico-legal challenge.  It is no use thinking that the existing nurses working in doctors rooms will do any additional work.  Their sessions are always full.  There is no more room for any more nurses.

So what would be the result of any mandated changes..eg paid less for driving licenec medicals.  Doctors would still do them and the gap would be more.  Consult pattern will not change. 

Care plans have not altered patient outcomes.  They are done in addition to the normal consultation patterns.  I have written on this before.  So where does all this leave us.  With all this indecision it means that the AMA has got its act together and has formulated solid proposals and highlighted problems.  Now all Nicola can do is to play catch-up.  If she attempts to go against the AMA proposals then her plans will end up in a mess with patients having to pay more.

The major challenge in GP work is to integrate any followup plan in  a normal 15 min consult.  If you attempt to move to a special number then you are monitored  (see what has happened with level C&D consults)

Another challenge is to ensure that we have concise investigation plans for various diseases easily available so we can initiate investigations before referrals.