GP s escaping under the rip off redar

my_ais

Ok, having worked in the area im privy to a little bit of insider info. Basically, if a GP has a certain quota of medical card patients his secretary is pretty much paid for by the state, this depends on the lenght of service the secretary has done. They also get paid for holidays, locum cover and many other perks once they have a medical card patient base. The one thing i will say, GP'S do not get paid €50 from the state for every Medical card holder visit. There are two systems available to GP's as to how to claim for these visits, one im not sure of, the other is called STC (Special type consultation) whereby the GP can claim a certain fee for about 10 specific treatments, these include ECG tests, wart removal etc, otherwise the GP receives a set fee per medical card patient per annum, i think its about €160 per person per year plus any special type consulation that they may have during the year. The reality is though, the average medical card holder visits their GP 12 times a year, private patients average about 3 i think. Another misconception is people paying extra for blood tests, the GP's dont pay for them, its another money making tool! All tests are processed by the local hospital lab and the only expense incurred by the GP is the phone call to tell you your results (which in fairness, is never gonna hit the €10 or €15 you paid extra).
Another money maker is the drug payments scheme. Basically, the GP's have a drug budget target to maintain each year. For example, say its €100k per annum, if they manage to keepy their medical card prescriptions under that quota then they get a percentage of the cut eg, if they only prescribed 90k worth of drugs then they will get a percentage of the remaining 10k. This is a very appealing money spinner for GP's and they can make a fortune on this! Hence why if you are on a medical card you will be prescribed cheaper generic drugs whereas if your paying the lovely sum of €50 for your visit, he will also prescribe you the most expensive drug available (this is to make up to the pharmacies i think). The short and the long of it is this, it is a hugely profitable profession, but, a profession it is and a job that only a select few can do. Do i begrudge them their earnings? Probably!!. It sure opened my eyes though, my image of gentle, caring Doctors quickly went out the window when i see how they are all scrambling to claim back as much money as possible grrrr.

bogview

what sort of codology and conspiracy theorys are you goin on wit..........bord snip is only a talking form for the government so they can look good at budget by only inflicting 90% of the cuts ........every one will think there great then a the gravey train will move on to the next station

L1011

my_ais wrote: »

Another misconception is people paying extra for blood tests, the GP's dont pay for them, its another money making tool! All tests are processed by the local hospital lab and the only expense incurred by the GP is the phone call to tell you your results (which in fairness, is never gonna hit the €10 or €15 you paid extra).

They, in some areas, have to pay the courier for the bloods. In others they drop them off themselves and in others the state picks them up for them. There are a few costs but theres still a lot of profit!

I work in this sector too and know that there are actually a lot of GPs making very little money - and many rolling in it; while charging much the same.

bogview

ejmaztec wrote: »

What kind of bowl do you use?:pac:

A kind of bowl(ed) over with your witism....and whatever your havin yourself:p

ejmaztec

MYOB wrote: »

They, in some areas, have to pay the courier for the bloods. In others they drop them off themselves and in others the state picks them up for them. There are a few costs but theres still a lot of profit!

I work in this sector too and know that there are actually a lot of GPs making very little money - and many rolling in it; while charging much the same.

Or they get stupid people like me to volunteer to take them in for feck all, just because one of them happens to be my wife's.:(

Larianne

Slightly off topic but in line with what's been posted above:
I have to get bloods done in the GP surgery in 2 weeks. Will I have to pay for them then or like what some posters have said, the hospital processes them?

my_ais

MYOB, as far as i am aware, any GP practice outside of the city limits has a courier service provided by the HSE (in the west anyway), the Surgery i worked for was within the city limits and has now also been provided with a free courier service courtesy of Westdoc so im assuming this is a roll out scheme for the rest of the country. Whilst i do appreciate that some practices are not making as much as others, it is a business and does need to build up so it shoudnt be too long before they start making alot of money. The poor mouth does not wash with me, i have been completely turned off th whole profession (bar my own GP who is a pet ). As for the theory that there are now so many medical card holders due to the recession, the scope for profit is lowering, well then, LOWER YOUR PRICES!!. Personally, if i were to pay €30 a visit for my GP, the thought of a medical card would not be as a appealing as it is when i have to pay fecking €50 a visit!

To answer your question Larianne, the odds are on you will have to pay for blood tests!Usually between 10 & 15 € in my experience. The hospital lab always processes bloods taken by your GP as they do not (in most cases) have the equipment to process them on site. There is no charge to the GP from the hospital for this service, but there is a charge to you

Santa Claus

Also worth mentioning is the freebies GPs get from drug company reps to try and get them to prescribe that drug company's products over competitors.
These included "conferences" in glamorous place which are not taxable (my GP was in monte carlo for 5 days with his wife last year courtesy of GSK for a "conference").

When I mentioned about some GPs getting their spouses to work as receptionists for them I wasn't factoring in an income for the spouse as they're directly benefiting from the household income (if the wife doesn't receive a salary then the GP can use their combined tax credits).

ejmaztec

Larianne wrote: »

Slightly off topic but in line with what's been posted above:
I have to get bloods done in the GP surgery in 2 weeks. Will I have to pay for them then or like what some posters have said, the hospital processes them?

I don't recall my wife having to pay extra. They just get shipped off to the nearest hospital with a lab facility.

eth0_

chalkitdown wrote: »

No, the deliberate shortage of medical school places.:rolleyes:

There are more med school places in Ireland now than there ever has been, which means there soon won't be enough jobs for new graduates of medicine in Ireland, because of Harney's cost cutting and hiring freeze.

chalkitdown

eth0_ wrote: »

There are more med school places in Ireland now than there ever has been, which means there soon won't be enough jobs for new graduates of medicine in Ireland, because of Harney's cost cutting and hiring freeze.

Yes, after much prevarication there are new places being made available this year. These new entrants will qualify in five to six years time, maybe then prices will start to come down. Too little too late.

Santa Claus

eth0_ wrote: »

There are more med school places in Ireland now than there ever has been, which means there soon won't be enough jobs for new graduates of medicine in Ireland, because of Harney's cost cutting and hiring freeze.

There's a large proportion of Irish med students from the middle east who return home after they've finished their studies and residency here (mainly the male doctor as women doctors are limited to gyn/obg in many middle eastern countries but are free to specialise in whatever they want here).

Svalbard

my_ais wrote: »

Ok, having worked in the area im privy to a little bit of insider info. Basically, if a GP has a certain quota of medical card patients 1. his secretary is pretty much paid for by the state, this depends on the lenght of service the secretary has done. They also get 2. paid for holidays, locum cover and many other perks once they have a medical card patient base. The one thing i will say, GP'S do not get paid €50 from the state for every Medical card holder visit. There are two systems available to GP's as to how to claim for these visits, one im not sure of, the other is called STC (Special type consultation) whereby the GP can claim a certain fee for about 3. 10 specific treatments, these include ECG tests, wart removal etc, otherwise the GP receives a set fee per medical card patient per annum, i think its 4. about €160 per person per year plus any special type consulation that they may have during the year. The reality is though, the average medical card holder visits their GP 12 times a year, private patients average about 3 i think. Another misconception is people 5. paying extra for blood tests, the GP's dont pay for them, its another money making tool! All tests are processed by the local hospital lab and the only expense incurred by the GP is the phone call to tell you your results (which in fairness, is never gonna hit the €10 or €15 you paid extra).
The short and the long of it is this, it is a hugely profitable profession, but, a profession it is and a job that only a select few can do. Do i begrudge them their earnings? Probably!!. It sure opened my eyes though, my image of gentle, caring Doctors quickly went out the window when i see how they are all scrambling to claim back as much money as possible grrrr.

1. GP receives a state payment for secretary only if he is in a rural area with a small population (less than 500 people I think).

2. GP has a 24/7 contract with GMS, 365 days a year. Do you really begrudge payment for a locum so s/he can take a few weeks off?
Another factor to consider when bashing GPs - they are on a 24/7/365 contract. Do any of you have any notion what that must be like? It seems the people on here GP bashing are private patients who only darken the door of their local surgery less than once a year; I'm sure a lot of elderly and chronically unwell patients with medical cards value the time and care received, including out of hours and home visits, all for the princely sum of 150 euro per year.

3. 10 very specific treatments that really don't arise all that often (ECGs, suturing, removing foreign bodies)

4. Varies depending on age of the patient, can be considerably less than 160.

5. Paying extra for blood tests. Taking & sending of blood tests, checking the results, informing patients and arranging follow up take up a large chunk of daily workload. Also not all GPs charge extra for this service, none of those I have experienced in any case.

my_ais

Sorry, dont know how to quote but salvard, i worked in a city practice, there was allowance ( a hefty one at that) for the secretary there. You seem to have taken my post up wrong in places. I know they get paid feck all for GMS patients and that STC's are rare and few but they are benefiting in other ways such as drug purchase scheme etc which more or less compensates for their "365 day" contract!! Remember, its up the the GP to decide whether or not they want to take GMS patients, they are a private enterprise, who can, if they so wish, take up a contract with the HSE so no, i have feck all sympathy for anyone that signs into a contract knowing what it involves.
As for blood tests, come on!!! taking blood takes about 3 minutes on avearge, you stick a label on them,fill in a very basic request form on the bag and wait for the HSE to collect. The results are mostly fed into your practice system via email so its not exactly hard work, it especially does NOT warrant an extra 10 - 15 € on top of the €50 you have already handed over.

As far as i know the average sum is €160 per annum, a few under and a few under never mind the nice little earner that the over 70's medical card used to yield.

Im guessing you are a GP yourself are ya The facts are, their current prices DO NOT REFLECT TODAY'S CRISIS and if they want to have a full panel of GMS patients and very little private patients then they are going to have to lower their prices!!

bogview

Svalbard wrote: »

1. GP receives a state payment for secretary only if he is in a rural area with a small population (less than 500 people I think).

2. GP has a 24/7 contract with GMS, 365 days a year. Do you really begrudge payment for a locum so s/he can take a few weeks off?
Another factor to consider when bashing GPs - they are on a 24/7/365 contract. Do any of you have any notion what that must be like? It seems the people on here GP bashing are private patients who only darken the door of their local surgery less than once a year; I'm sure a lot of elderly and chronically unwell patients with medical cards value the time and care received, including out of hours and home visits, all for the princely sum of 150 euro per year.

3. 10 very specific treatments that really don't arise all that often (ECGs, suturing, removing foreign bodies)

4. Varies depending on age of the patient, can be considerably less than 160.

5. Paying extra for blood tests. Taking & sending of blood tests, checking the results, informing patients and arranging follow up take up a large chunk of daily workload. Also not all GPs charge extra for this service, none of those I have experienced in any case.

No GPs to be found in this area mainly after 6pm after that you talk to a machine and wait for the menu of options .............enter MIDOC who takes your call promises a nurse will call you back which will happen and he/she decides whether your are to become a client or a patient

Svalbard

my_ais wrote: »

Sorry, dont know how to quote but salvard, i worked in a city practice, there was allowance ( a hefty one at that) for the secretary there. You seem to have taken my post up wrong in places. I know they get paid feck all for GMS patients and that STC's are rare and few but they are benefiting in other ways such as drug purchase scheme etc which more or less compensates for their "365 day" contract!! Remember, its up the the GP to decide whether or not they want to take GMS patients, they are a private enterprise, who can, if they so wish, take up a contract with the HSE so no, i have feck all sympathy for anyone that signs into a contract knowing what it involves.
As for blood tests, come on!!! taking blood takes about 3 minutes on avearge, you stick a label on them,fill in a very basic request form on the bag and wait for the HSE to collect. The results are mostly fed into your practice system via email so its not exactly hard work, it especially does NOT warrant an extra 10 - 15 € on top of the €50 you have already handed over.

As far as i know the average sum is €160 per annum, a few under and a few under never mind the nice little earner that the over 70's medical card used to yield.

Im guessing you are a GP yourself are ya The facts are, their current prices DO NOT REFLECT TODAY'S CRISIS and if they want to have a full panel of GMS patients and very little private patients then they are going to have to lower their prices!!

No, not a GP. Not related to one either.

Fair enough about the secretarial subsidy, I heard it was for small rural practices only, but clearly I'm misinformed.

There's more to blood tests than the physical task of doing them, there's making sure all results come back (Health Links is not full proof) and then viewing them all (and there can be lots as I'm sure you know), then acting upon the results appropriately, which sometimes involves meeting the patient again, organising more tests or deciding its best not to act on certain results (often the hardest decision). BTW i never said I thought people should be charged extra for blood tests, in fact I think they should not be. i just took exception to people minimising the role of the GP as just a blood letter while the lab does all the real work.

If GPs want any income/job security then the GMS is pretty much the only show in town, so its 24/7/365 contract or nothing, its not negotiable. Private only GPs suffer like any business. Also its not only public contract GPs that have a 24/7 commitment - any GP that takes on a patient has a 24/7 commitment to them. Perhaps not in Dublin where people may be expected to skip on down to A&E if they have any probs after hours, but its not like that in rural practice.

AmcD

my_ais wrote: »

the GP receives a set fee per medical card patient per annum, i think its about €160 per person per year plus any special type consulation that they may have during the year. The reality is though, the average medical card holder visits their GP 12 times a year, private patients average about 3 i think. /QUOTE]

Ok so parts of this statement are true, i.e. about medical card patients visiting 12 times a year on average.
However the medical card scheme is not quite the goldmine you make out. This is why private patients subsidise the medical card patients. The figures below are from March 2008 before Mary Harney decreased them by 8%

Male Female
0-4 years €81.62 €79.61
5-15 years €48.39 €47.93
16-44 years €60.48 €98.90
45-64 years €120.80 €132.48
65-69 years €127.25 €141.98
70+years €139.08 €154.25 (for patients who already qualified for a medical card before their 70th birthday). Over 70's who get a medical card for the first time on their 70th birthday get a capitation fee of €280.
As you can see we make an absolute fortune from seeing young children.

Just for the record the drug budgeting scheme finished years ago. I think in principle it was a good thing: it improved generic prescribing habits and invested in the physical infrastructure of surgeries.
Also GPs do not make money out of prescribing either cheap or expensive drugs. It makes no difference except to the pharmacist.

I am not poor-mouthing. GPs in affluent areas have a huge potential to make money. Gps in underprivileged areas don't.

L1011

Svalbard wrote: »

1. GP receives a state payment for secretary only if he is in a rural area with a small population (less than 500 people I think).

Practice Support Subsidy is available basically anywhere. Finglas is neither rural nor small yet its the most recent place I heard a customer talk about their payment.

Svalbard wrote: »

5. Paying extra for blood tests. Taking & sending of blood tests, checking the results, informing patients and arranging follow up take up a large chunk of daily workload. Also not all GPs charge extra for this service, none of those I have experienced in any case.

Since the introduction of HL7 nationwide in the past few years this workload has been slashed, you get all the previous days results in in a few minutes in the morning and you see the abnormal results instantly. Healthlink has its problems but the main one is sending results to the wrong surgery these days... Cork and Donegal's own systems are basically bulletproof.

Svalbard

MYOB wrote: »

Since the introduction of HL7 nationwide in the past few years this workload has been slashed, you get all the previous days results in in a few minutes in the morning and you see the abnormal results instantly. Healthlink has its problems but the main one is sending results to the wrong surgery these days... Cork and Donegal's own systems are basically bulletproof.

I suppose the practice I'm referring to isn't ready to fully make the leap to paperless records!
Staff there still keep a record of all tests sent and check it off against results received to make sure none get lost.

And I'll say it again, I don not think people should be charged extra for blood tests, I just object to people minimising the role of GPs. I do believe blood tests are part of GP's job description and should be covered in the price of the consultation.
Of course if they are attending a nurse's phlebotomy clinic then that's different.

The thing about the rural subsidy - perhaps that applies to a practice nurse not secretarial staff? Maybe?

pigpoor

the MIDOC service may be tedious and difficult to get familiar with but when you get through the bureaucracy and if private costs €60 for the visit,.... quite good experiences of this service but a little too expensive :P

L1011

Svalbard wrote: »

I suppose the practice I'm referring to isn't ready to fully make the leap to paperless records!
Staff there still keep a record of all tests sent and check it off against results received to make sure none get lost.

And I'll say it again, I don not think people should be charged extra for blood tests, I just object to people minimising the role of GPs. I do believe blood tests are part of GP's job description and should be covered in the price of the consultation.
Of course if they are attending a nurse's phlebotomy clinic then that's different.

The thing about the rural subsidy - perhaps that applies to a practice nurse not secretarial staff? Maybe?

Recently I've found the posted paper results are more likely to go AWOL than the electronic ones! All bar one of the computer systems I know the setup of lets you record all tests sent against incoming electronic results; all three main modern ones do.

You may be right about the practice nurse - but they're very rare in very rural areas from experience as it is. I'll see if I can ask a customer discreetly....

bogview

anybody have any comments/views or experience of MIDOC

L1011

MIDOC is just the generic HSE out of hours service in the midlands isn't it? There's usually a one in 20 or so chance that its your own GP that comes out. Service is going to be much the same as going to a doctors surgery, albeit with the potential for a slightly cranky GP thats been woken up in the middle of the night if its a quiet one!

Blue_Wolf

You are an idiot! They have really expensive insurance, they pay tonnes and tonnes of tax, they spent over 15years in college (which costs a fortune) They spent 10years working the good guts of 24hour shifts and feck all money.

So ya after all the hard work they spent 25 years learning how to do their job and save lives you have begrudge them just because you didn't bother working hard for something in life.

If anything you should be moaning about tradesmen who spent 3 years learning a trade charge more than doctors do and dont even do the job properly.

Take your head out of your ass.

bogview wrote: »

I was with my GP recently and was charged €50 for the priviledge.The visit lasted approx 10 minutes. On that estimate they would take in about €12000/week or €600000 a year. Not a bad little earner would everbody agree:o

Blue_Wolf

Wow more smart comments, clearly uneducated seeing as you can't even spell the word "sure"

bogview wrote: »

Woman or no woman shure its mental to give that for any sort of hair cut Shur Id cut yours and mine for the half of it :P

Big_G

chalkitdown wrote: »

There is no doubt that Irish doctors are grossly overpaid. Another job with huge barriers to entry.

Of course there are barriers to entry. It's not a job that any idiot can do.

L1011

Blue_Wolf wrote: »

You are an idiot! They have really expensive insurance, they pay tonnes and tonnes of tax, they spent over 15years in college (which costs a fortune) They spent 10years working the good guts of 24hour shifts and feck all money.

So ya after all the hard work they spent 25 years learning how to do their job and save lives you have begrudge them just because you didn't bother working hard for something in life.

If anything you should be moaning about tradesmen who spent 3 years learning a trade charge more than doctors do and dont even do the job properly.

Take your head out of your ass.

GPs do not spend 15 years in college, nor do they spend 10 years doing the kind of shifts hospital doctors do post-qualification.

You do a medical degree (generally 5 years), then a 4 year GP training programme - of which the last two years are in a surgery as a GP trainee. After that you are fully qualified.

After 7 years you are a "GP", albeit a trainee and after 9 you're fully qualified. That is a HELL of a long way off the 25 year figure you've pulled from somewhere. The first two years of the GP training programme are the ones with 24 hour shifts in hospitals - not anywhere near the ten years you've suggested either.

You can also work as a GP here with a MB equivalent from another EU country and a CSTAR. You could in theory have both of these done in about 6 years...

AmcD

MYOB wrote: »

GPs do not spend 15 years in college, nor do they spend 10 years doing the kind of shifts hospital doctors do post-qualification.

You do a medical degree (generally 5 years), then a 4 year GP training programme - of which the last two years are in a surgery as a GP trainee. After that you are fully qualified.

After 7 years you are a "GP", albeit a trainee and after 9 you're fully qualified. That is a HELL of a long way off the 25 year figure you've pulled from somewhere. The first two years of the GP training programme are the ones with 24 hour shifts in hospitals - not anywhere near the ten years you've suggested either.

There is the possibility of doing a five year medical degree in most medical schools, but six years is still the average (or certainly is standard for anybody who is currently a GP)
The intern year after medical school is compulsory.
The GP schemes are very competitive. Generally there is a 1 in 3 chance of getting a place each year.
If somebody is fortunate enough to finish intern year and go straight into a training scheme, there is another four years of training. The final two years are spent as a GP trainee, under supervision of a GP trainer.

So I am getting a figure between 10 and 12 years spent in training (12 years for me). Once you have graduated from the GP scheme you can set up in practice as an independent GP.
It seems like a long time to train for one job, but then again the patients would probably prefer somebody who is fully trained.

Blue_Wolf

Perhaps the average doctor doesn't. But, my father spent 12 years in college. I was wrong to generalise but I don't like idiots to put hard working people down. 50euro for 20minutes does not go straight into the pocket. The overheads are huge. People who make stupid comments annoy me.

MYOB wrote: »

GPs do not spend 15 years in college, nor do they spend 10 years doing the kind of shifts hospital doctors do post-qualification.

mikom

Blue_Wolf wrote: »

People who make stupid comments annoy me.

I'm sure your ould lad could prescribe something for that.
Probably give you a discount on the €50 as well.