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I have encounted free general practice doctor places in Australia that operate on seeing as many patients as possible. Basically useless if you have a difficult

I have encounted free general practice doctor places in Australia that operate on seeing as many patients as possible. Basically useless if you have a difficult to diagnose problem, but very useful for getting a referal, a script for a pill, or antibiotics.

cknight 9y ago
Yeah, pros and cons. GP visits are subsidised a set amount by the govt down here, and while for some doctors that means squeezing in as many visits as possible to get volume, for others it just means they get $X from the government and charge the patient an extra $Y for each visit. Many are happy to pay a premium.
nerdponx 9y ago
This is how many GP offices work in the USA as well, especially in urban areas or offices associated with hospitals. Unless you already know what kind of specialist you need to go see, and you can afford to go see the right one (might involve multiple visits to multiple specialists), you might literally never get help for a chronic problem that is not obvious on a differential diagnosis. There really needs to be two kinds visits available: quick visits and check ups, and diagnostic visits. The first can be over in 10 minutes, the latter should last a solid hour. I'm starting to wonder if "diagnostician" should be a separate specialization. Then I could make an appointment specifically to go see the diagnostician, and not bother the general practitioner, who is evidently too busy to spend more than 15 minutes diagnosing something.
- kaitai 9y ago
  This would only work if there were a mechanism to pay for diagnosis. Internal medicine specialists are supposed to be "diagnosticians," as you envision it -- they have more training than general practitioners if they're internal medicine specialists. But they're one of the lower-paid specialties, in part because it's easy to charge for a stent or injection but in the US the act of diagnosing a problem doesn't really have a code.
- ci5er 9y ago
  My old GP (now retired) called himself a "diagnostician", and never spent less than an hour on any visit. He'd ask a lot of (prying?) questions about home-life and work-life and social-life as part of getting a holistic view of you... He also didn't take insurance - because he didn't want to bother with it. And he wanted to be more honest in his notes than his libertarian heart felt comfortable disclosing to the insurance company or the government payers.
kaitai 9y ago
Isn't that how all non-Veterans Administration medical care in the US works? Genuinely curious -- my understanding is that almost all medical care profit in the US is driven by volume of procedures, and even non-profit care is reimbursed by insurance companies according to procedures.

cknight 9y ago

Yeah, pros and cons. GP visits are subsidised a set amount by the govt down here, and while for some doctors that means squeezing in as many visits as possible to get volume, for others it just means they get $X from the government and charge the patient an extra $Y for each visit. Many are happy to pay a premium.

nerdponx 9y ago

This is how many GP offices work in the USA as well, especially in urban areas or offices associated with hospitals. Unless you already know what kind of specialist you need to go see, and you can afford to go see the right one (might involve multiple visits to multiple specialists), you might literally never get help for a chronic problem that is not obvious on a differential diagnosis. There really needs to be two kinds visits available: quick visits and check ups, and diagnostic visits. The first can be over in 10 minutes, the latter should last a solid hour. I'm starting to wonder if "diagnostician" should be a separate specialization. Then I could make an appointment specifically to go see the diagnostician, and not bother the general practitioner, who is evidently too busy to spend more than 15 minutes diagnosing something.

kaitai 9y ago
This would only work if there were a mechanism to pay for diagnosis. Internal medicine specialists are supposed to be "diagnosticians," as you envision it -- they have more training than general practitioners if they're internal medicine specialists. But they're one of the lower-paid specialties, in part because it's easy to charge for a stent or injection but in the US the act of diagnosing a problem doesn't really have a code.
ci5er 9y ago
My old GP (now retired) called himself a "diagnostician", and never spent less than an hour on any visit. He'd ask a lot of (prying?) questions about home-life and work-life and social-life as part of getting a holistic view of you... He also didn't take insurance - because he didn't want to bother with it. And he wanted to be more honest in his notes than his libertarian heart felt comfortable disclosing to the insurance company or the government payers.

kaitai 9y ago

Isn't that how all non-Veterans Administration medical care in the US works? Genuinely curious -- my understanding is that almost all medical care profit in the US is driven by volume of procedures, and even non-profit care is reimbursed by insurance companies according to procedures.