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GPs should be paid per 1,000 consultations, says Gerada


Some sense in this suggestion, but many procedures, complex disease management and other appointments need to be provided in 20 minute 'double slots', rather than 10 minute appointments. Paying per consultation will only work if all consultations are 'worth' the same money! A quick 'please could you check the mole on my back' taking a couple of minutes, is not necessarily 'worth' the same as a review of an elderly patient with multiple co-morbidities and polypharmacy attending for a medication and chronic disease review! Paying 'per consultation' might only incentivise GPs to set limits on 'one problem = one consultation', which could have the knock on effect of making appointments even more scarce, and risking even more dissatisfied patients who do not want to keep taking time off work, or another bus from 5 miles away, to return for 'another 10 minute appointment'. I frequently run late in my surgery, because I am aware how difficult it is for a patient to get an appointment in the current climate we are all experiencing, so I DO try to deal with all of their problems in one consultation to save them having to come back - this idea would penalise and not reward me for doing what the patients generally prefer! Perhaps extrapolating the idea to payment by hours of appointment time offered might be fairer, but even that wouldn't pay us for all of the extra work done outside of appointment time! We all spend a lot of time doing things for patients outside of the time they spend in our rooms - how will be remunerated for this? Or will we just stop doing it?! Of course not, because patient care is the fundamental role of a GP, regardless of whether they are with us when we provide it. I can appreciate the idea and sentiment behind it, but fundamentally don't agree that paying GPs on an 'hourly-rate' basis can work (or be costed for, as we'd probably be too expensive!)

Posted date

28 May 2014

Posted time