Official health statistics have confirmed what many Australians already know — it is getting harder to see a GP who bulk-bills.
The latest Medicare figures show the bulk-billing rate dropped from 87 per cent to 83.4 per cent between July and September this year. It was 88.4 per cent late last year.
The data came as no surprise to Queensland GP Sarah McLay, whose practice in Clermont lost money for three consecutive years.
In the past six months, she has been forced to stop bulk-billing patients and has begun charging them fees to keep her business afloat.
"Unfortunately, the situation that I'm facing is a situation that most practices are dealing with, and I don't believe it's going to get any better," Dr McLay said.
"We've been in this horrible dance for such a long time, where we haven't really been able to prioritise what we need as doctors and I think that's why the seesaw has finally tipped, and we just can't do it anymore.
"And now you're seeing this flood of change."
The president of the Royal Australian College of General Practitioners, Nicole Higgins, said the figures only showed the percentage of services that were bulk-billed, not the number of patients who had avoided out-of-pocket costs.
She said the "real level" of bulk-billing was closer to about 66 per cent.
"Bulk-billing rates continue to decline because of the underfunding and undervaluing of general practice by the Australian government," Dr Higgins said.
"The impact that it is having on patient care is a result of the failure of investment.
"For GPs, they need to be able to charge a fee that keeps their doors open. And the Medicare rebate simply doesn't allow for that."
With the rebate failing to keep pace with inflation — increasing just $6 over the past 14 years — Dr Higgins said immediate funding was needed as the sector stared down the prospect of a workforce shortage of 11,000 GPs by the end of the decade.
"General practice is in crisis, and we have got less and less doctors wanting to become GPs, and less staying in the profession," she said.
"My concern is that the general practice system might collapse unless we get some urgent investment in general practice."
Doctors have long called for further federal investment but soaring health costs are already putting enormous pressure on the budget.
However, Consumers Health Forum CEO Elizabeth Devaney said if funding did not increase it could also prove costly, with patients who could afford a GP forced to attend already overstretched emergency departments.
"When you go to see your GP the costs of that are comparatively low compared to hospital treatment," Dr Devaney said.
"But if you can't get in to see your GP and then if you wait a while and things get worse, or you feel you can't wait and you need to get help right away and you go to the emergency department, then the costs to governments, and therefore all of us, are higher."
Health Minister Mark Butler recently named the precarious state of general practice as the "most concerning pressure on the healthcare system" as he held roundtable talks with experts to brainstorm long- and short-term solutions.
In a statement, Mr Butler said he had asked his Department for more information to obtain a "complete and accurate" picture of the state of bulk-billing in Australia.
"Across the country, we hear stories of Australians not being able to get in to see a bulk-billing doctor or GPs changing from bulk-billing to mixed-billing," he said.
"The reality is, after nine years of cuts and neglect from the former government it's never been harder or more expensive for Australians to see a GP."
