Nurse Practitioner Resources Available

I’ve just finalised some of the resources for nurse practitioners working in the private sector! If you have any suggestions to help improve these resources, please feel free to contact me. These resources are provided free of charge to students and nurse practitioner colleagues. Enjoy!

Resources Include:

Brochure: Medicare Benefits for Nurse Practitioners
Handout: Understanding MBS Online for Nurse Practitioners
Handout: Information About Medicare Reimbursement for Professional Attendances by Nurse Practitioners
Diagram: Diagnostic Ultrasonography for Nurse Practitioners
Diagram: Diagnostic Radiography for Nurse Practitioners

My First Publication!

I’m proud to announce my very first “real” publication! 🙂 Apologies to those who’ve been waiting – it took them 7 months to find someone to peer review it! Better late than never, I always say. 🙂

Helms, C., Crookes, J., & Bailey, D. (2014). Financial viability, benefits and challenges of employing a nurse practitioner in general practice. Australian Health Review

GP Copayment Facts and Figures

Boy am I talkative these days. I need to get a life.

Anyway, just wanted to point out that NPs have finally made the spotlight with respects to the newly-proposed $5 copay and GP medicare rebate cut ‘n freeze.

In the above linked Australian Doctor article (poorly written and confusing, IMHO) they point out that GPs spending 9 minutes with a client will get $11.95 whereas an NP will get $20.85, a difference of $8.90. They are outraged they are going to be paid less than an NP. (Imagine the smirk on my face here.)

The article had a factual inaccuracy I’d like to point out in case any of you are asked about this: It stated an NP would get $20.85 for the above 9-minute consultation example. This is incorrect. An NP would get $17.85 based on the 85% reimbursement rate. An NP is only reimbursed at 100% if they are working with a DVA patient, which is not reflective of your “usual” patient in private practice. The true net difference in this example would be $5.90 in favour of the NP.

I also think its interesting they are upset, especially considering the following figures: In the fiscal July 2013 – July 2014 year NPs billed medicare a total of $5,538,937. That’s 5.5 million dollars. In that same fiscal year doctors billed medicare $4,379,791,863. That’s 4.3 billion. So what, you say? Well, consider the following:

NP billings as a reflection of percent time spent with a client

1% spent less than 5 min
32% spent between 5 – 20 min
36% spent between 20 – 45 min
30% spent more than 45 min

VR-GP billings as a reflection of percent time spent with a client

1% spent less than 5 min
74% spent between 5 – 20 min
22% spent between 20 – 45 min
3% spent more than 45 min

As demonstrated above NPs spend more time with their clients as a whole – irrespective of the financial (dis)incentive. They provide the care their clients need. If that takes 45 min to do, well so be it. GPs on the other hand take advantage of huge incentives by having consultation lengths between 5 and 20 minutes. A government trying to trim the fat isn’t going to be looking at NPs and their measly millions – they’re looking at the billions spent on 6-minute medicine and trying to change how doctors practice. It’s probably the first time I’ve seen a policy directed at trying to get doctors to lengthen their consultations and actually spend time with their clients. I find it quite remarkable.

Anyway, the Australian Doctor article completely glosses over the fact that NPs get a pittance for all the time they actually spend with their clients compared to GPs. Oh well. There’s independent reporting for you. 🙂

The GP Copayment – A Pig Dressed in Lipstick?

There has been a lot of news today about the proposed GP copayment, which is meant to come into effect next year. I gotta say, I find this “new” proposal more than a little suspicious given the Coalition government’s earlier $7 copayment proposal, which overtly discriminated against marginalised populations.

You have to wonder if yesterday’s announcement about the $5 copay was actually the original intent, with the obscene $7 proposal meant to soften the blow?

I have no doubt this was the original intention. Instead of the government looking at ways to reduce barriers to practice for nurse practitioners, a health workforce which has the capability to provide affordable, safe and efficacious healthcare and who has yet to meet its full potential in Australia, the government looks at ways of introducing further soft taxes on the public. The intent? The Coalition affirms the new copayment will reduce visits to the doctor, and therefore decrease GDP spent on healthcare.

Where is the proof that these measures will actually improve outcomes and decrease healthcare expenditures? Where has the precedent been set? Nowhere. In fact, there is some discussion that this new measure may actually worsen healthcare outcomes, driving up GDP.

I suppose it’s not all bad: the new proposal increases the standard GP professional attendance requirements to a minimum of 10 minutes. That’s 6 more minutes of consultation time for patients attending large corporate healthcare giants. I wonder if that equates to quality?