Too much health

A joke about general practitioners goes something like this. A little old lady who visited her GP every week stopped coming. The GP became worried, fearing he may have caused offence or that she had found someone else. When she returned a week later, the GP asked her where she had been.

“Oh, doctor. I was sick,” the little old lady replied.

While this is a joke, it probably represents the reality for a good portion of the day for the average family doctor.

The Royal Australian College of General Practioners estimates that around a third of patient presentations to a family doctor are what’s known as “psychosomatic ailments”.

This is technical speak for the worried well.

While the Productivity Commission’s report into the medical workforce released in January 2006 suggested that we need more doctors, particularly to supply the rural shortage, it did not look into the kind of work modern doctors are required to do.

The fact is that a good portion of the modern doctor’s work is to appease those who are feeling anxious, lonely or disconnected. They are on the frontline of a community where a large part of the old functions of the family, namely child care, care of elderly people and just plain emotional support, are increasingly being turned over to the market and the state.

The problem here is that doctors, even when they don’t bulk bill, are actually the cheapest form of social worker.

Another medical joke is that a little old lady called her doctor one night for a house call. When he arrived, she said that she needed her light bulb changed. When the doctor asked why he was called, she said that he was cheaper than the electrician.

A large part of the problem is that it is just too cheap to see a doctor. Even for doctors who don’t bulk bill, patients are barely forking out $20 after they receive a rebate. It is no financial disincentive to avoid seeing them.

Of course, this was the reason behind Medicare in the first place. A person shouldn’t have to think twice before consulting advice for their health, or so the reasoning goes.

But the question then arises how much extra health expenditure are we willing to sacrifice as a community in order to make health immune to the forces that make people think about how they spend their money.