A general practitioner in Western Australia is refusing to treat new mental health patients, prompting concern from the Australian Medical Association (AMA).
Dr Andrew Thompson, the sole practitioner of the Kingsley Medical Group, told 720 ABC Perth he made the decision because of the personal toll treating mental health patients had taken on him.
“I never have been, and hopefully never will be, a doctor that walks home at the end of the day and forgets about their clients,” he said.
“What I found was, these were the very patients that I was taking home with me in my head, these were the patients that were arising at dinner-time conversation when I should be talking to my friends and family and loved ones, these were the things that were keeping me awake at night.
“I found the whole process quite stressful to the point where I took time off work. And as a single practitioner in a single practitioner clinic, obviously that means I had to shut the clinic.”
Chair of the Council of General Practice at AMA WA, Steve Wilson, said the move disadvantaged a large part of the population.
“Ethically they’re on a tightrope there. I’m very concerned about that,” he said.
“I also think just at a moral level, particularly as a medical practitioner, it really is a case of ‘come one, come all,’ and we will treat what comes through the door.”
Sometimes the best care comes from another doctor: GP
Dr Thompson said new patients were advised when making an appointment that the clinic did not deal with mental health patients.
He said if it was determined a patient had a mental health condition during the course of a consultation they would be referred on to another GP who had agreed to take such patients.
Dr Thompson said it was part of ensuring patients received the best care, and sometimes that came from another provider.
“All GPs, we all sub-specialise, I get a lot of my referrals, probably 50 per cent of the patients that come to me are referred by other GPs for spinal pain, musculoskeletal,” he said.
“Likewise we have to acknowledge our limitations, our strengths and weaknesses and say ‘hold on a sec, this is a problem that can be best dealt with by another GP.”
Dr Thompson said a broader conversation between GPs was needed.
“Perhaps a more open dialogue will eventuate if we can extrapolate beyond just mental health,” he said.
“Perhaps we will see GP clinics that say look, we don’t treat migraine patients here, we don’t treat back pain here, simply saying there are better places to go.
“I think it might broaden GPs to be pragmatic about what they do well and what they don’t.”
Financial motivation to move away from mental health: AMA
Dr Wilson suggested the move away from treating mental health patients may have been financially motivated because rebates were too low.
“General practice itself has become I suppose the lower end of the income spectrum for doctors,” he said.
“Mental health is a very good example. If I spend 45 minutes with someone who has a mental health problem I might get $80 for that before tax and all expenses etc, which are huge. So I can see why practices don’t want to do it.”
But Dr Thompson rejected that argument.
“A mental health patient, whether they spend 15 minutes with me or 30 minutes, they pay exactly the same as a patient with a sore toe who spends 15 minutes or 30 minutes with me,” he said.
“The medical rebate I get, the money the patient has to pay out of pocket is exactly the same, so there is no difference in the income generated for me whether I have 100 per cent of my case load as mental health or 100 per cent not.”