Thread by @KarenMagraith

What prevents perimenopausal and menopausal people from accessing the health care they need?
Doctor education and gender bias are not the biggest factors (though they are v important and need to be improved).

Structural barriers to long consultations are most important. 1/8

Our Medicare system is set up to incentivise short consults for one simple problem. It penalises patients (and their doctors) for needing longer consults for more complex issues.
And it makes it harder to access longer consults, especially in rural or disadvantaged areas. 2/8

Medicare rebates for patients have not kept up with inflation. GPs are under pressure to increase throughput and find it increasingly difficult to offer longer appointments.
I know this may bring out the cries of ‘greedy GPs’, but stay with me. 3/8

For example, Medicare pays 3 times as much for 3 consults of 6 minutes each, as it does for 1 consult of 18 minutes. (Even more if you take bulk billing incentives into account.)
Funding issues also contribute to a maldistribution of GPs, affecting access. 4/8

At menopause women often have a range of issues that need to be dealt with, and these can be complex. They need a comprehensive assessment, addressing their concerns. And they need to receive accurate information and participate in shared decision-making. 5/8

Chopping this up into several short consults just doesn’t work. GPs who provide longer appointments and comprehensive care face financial penalties. These GPs are often (but not always) women. Their patients also often face bigger gap payments. 6/8

This applies to my area of interest, menopause, but equally applies to other areas where patients need longer consults. Mental health is just one example. 7/8

So when we consider how to improve health care for Australians we need to think about how to change the structural factors in the system. We need to promote longer consults and patient-centred care.

This is the way to improve access to good health care. 8/8
#Menopause