Thanks for your responses guys, and sorry Sin for my late reply to your question from yesterday.
In my experience, bulk-billing clinics are still viable. My partner and I ran a very profitable rural bulk-billing clinic from 2007-2019, during the freeze period. Sold 3 months before COVID hit
. Like a lot of businesses, economies of scale is vital. A solo GP BB clinic is not viable, but a 4+ FTE (full time equivalent) GP clinic is.
The sole reason why we sold was the difficulty recruiting GPs. If there was an ample supply of GPs, we would still have the clinic and most likely would have opened several more around the country. I heard the other day that only 10% of medical graduates are choosing GP as a specialty. That's a disastrous figure and a major reason why BBing is in decline. Graduates can pick and choose where they work, and most choose plush areas in major cities rather than rural areas, and certainly private fee clinics in front of BBing clinics.
Ours was the "walk in walk out" GP model whereby GPs could easily start practicing (everything was provided, the building, staff, nurses, IT, equipment, patients), and when they wanted to move on, they simply gave a few months notice. We provided everything, and all the GPs had to do was practice. We would simply deduct a management fee of around 25-35% of their billings.
We had GPs earning over $450K+ working M-F 9-5...once again, during the freeze period. There was no rorting, overbilling whatsoever but BB GPs need to work harder by utilising higher billing item numbers such as chronic disease management, case conferences (with other providers) and mental health. This actually provides a higher level of patient care, compared to private fee doctors who don't need to engage in CDM etc. as they just generally charge time-based item 23 (6-20 minutes) and 36 (21-40 minutes). My local GP charges $86 for item 23 and $126 for item 36. Our GPs also received a BB incentive of about $12 per consult, but as of November last year, it's increased to about $33.
I never had much to do with the RACGP and AMA, they were more for the GPs. The AMA is an extremely strong quasi-union and have both sides of the government in their pocket. They strongly advocate for private billing to their members, and publish rates in which they should charge patients.
Main reasons why BB in in decline:
1. Doctor shortage
2. Decline in med grads choosing GP as a specialty.
3. Mental health is now the largest presentation at GP clinics, and many GPs don't like, or don't have the quals to deal with it. Dedicated MH clinics, like the recently dedicated Urgent Care Clinics would definitely assist GPs.
4. When we opened our BB GP clinic, the current waiting time for a consult was 3 weeks for a private fee clinic. The only effect we had on the private fee clinics was reducing their waiting time to about 1 week, but that didn't stop them from smearing our clinic, suggesting the BB GPs are inferior to private fee GPs. Complete nonsense of course. We had to lawyer up for a couple. This perception orchestrated by private fee GPs and the AMA turns GP off BBing.
I could go on for hours about this, but the bottom line is the MBS fee freeze didn't destroy bulk-billing. To suggest that it did is lazy and simply incorrect.
If you live in a capital city or major population centre (most of us do), you will have no trouble finding bulk billing for GP visits, pathology and radiology. Are they on every corner? No, but if you are prepared to do some research, and maybe drive/bus/ride 10 minutes more, I guarantee you can get bulk billed.
www.macrobusiness.com.au
