This notice proposes Industrial Action.

 

Keep hurting the system
till we (the KrustyLads) advise you not to.

 

We want:

• To Reign In AHPRA’s excesses.

• Setup to investigate complaints against AHPRA and related entities.

• Reset CME/PD Activities and Protocols,, Accreditation Standards,, and Medical Record Standards.

• More appropriate and “open” fees for Doctor Registration,, doctors approaching Retirement,, . . . . . . Doctors working Part-Time,, Indemnity Insurance.

• Control of Medical Workforce (AHPRA/Medical Boards) by democratically elected representatives with experience in their profession.
  
  

• All Medical Records judgments against doctors working in Accredited Practices to be quashed.
  
  

• As a corollary, any doctor convicted of an offence without a patient complaint as witness to the offence, to be given leave to apply to have the offence quashed - at AHPRA expense. Expenses and compensation to be paid.

We have 3 stages in our Agenda for Action. ( 4 stages if you want to take an active part).

The existing system heavily depends on the good-will and devotion to duty of medical professionals, in an environment where there is denial of basic legal rights and access to justice for these medical professionals.

This fact is the Achilles heel of the Administration of Medicos by AHPRA/ Medical Boards. We can choose not to give them our good will and cooperation. For most Australians, this process is known as Unionism - an activity lacking in the medical industry today.
Unions

 

The stages:

• Vote by circling or marking your choices on the AHPRA Notice. To make your voice heard, send your reply to ALL of :
  • the AMA (Australian Medical Association),
  • RACGP ( or other relevant professional body) and to
  • Us. ( the KrustyLads).

This gives direction, credibility and impetus to these players to inveigle changes into the medical system. (Details of contact numbers/ emails are on this site: GUVNOT.COM ).
To emphasize again what to do, to initiate the change process, send your reply to - ALL of us.
To drive change, we ALL need to know that you want change.

Resend this

WE would also ask you to REPEAT the send-out process in FOUR MONTHS,
and then again at FOUR MONTHS.
Keep the issue on the boil.
Don't let every think its a flash in the pan that can be forgotten.

 

• To create force for change , we need to create a scenario where it is important to listen to us. Look at the site GUVNOT.COM and pick a strategy that will hurt the system - and that does not hurt you, at the same time.

 

As a famous general once said, “You don’t win a war by dying/ suffering for your country. You need to make the other poor dumb bastard die / suffer for his country”.

In short, do things that hurt the system and push it towards collapse. Don’t do things that hurt you or push you towards collapse. Hurt them, and they will listen. Hurt yourself and you can be safely ignored, even laughed at.

 

change

The GUVNOT.COM site details a number of strategies that you can pick to support our campaign and hurt the system. You don’t need to tell anyone else what or how you are doing it. No one need ever know. And you can change your strategy from time to time, just to make it less obvious. (see GUVNOT.COM/2 ).
That’s why our fax/email says I believe other doctors should support these proposals.”.
Support us, but you can do this invisibly, without risk, laughing all the way to the bank.

 

There is nothing in any of our public face that proves that you - the individual – are doing anything other than going about business as usual.

 

You can visit the GUVNOT.COM site: at GUVNOT.COM/1 ( the Fax agenda discussion) or GUVNOT.COM/2 (how to take action).

• for further information and discussion points about each of these proposals,

• to explore Industrial Action strategies that suit your practice , beliefs and circumstances,

• to read some background information about the difficulties we face,

• to send a message or information or your details to Us.
  unions

We suggest you revisit GUVNOT.COM every few months at least. You need to remind yourself what you can do. You need to periodically rethink what you can do. You need to do something to help us all to succeed.

• We need to make sure that no-one hijacks the agenda. So please agree to keep on doing what you’ve chosen to do until you get a fax/ email from US, and
  the GUVNOT.COM site gives notice that a reconciliation has been reached- - - as possible.

Keep hurting the system
till we (the KrustyLads) advise you not to.

 

• A number of the Medical Organisations have fallen into bed with government for only a promise, so let’s agree not to let it happen again.

 

 

 

Allied Health and Nursing
Although this site predominantly focuses on Medical Doctors, aspects of this Industrial action are relevant to Nurses and other Allied Health Workers.

You can use the same form to feedback to your own professional group, to ride along with the wave of changes we are proposing. After all, perhaps some of our proposed changes are relevant to you as well. AHPRA/ the Boards are a menace to everyone, not just doctors.
If they are doing these things to doctors, we can assume that everyone is getting the same treatment.

 

 

Lastly, we can’t fix everything for everyone.
WE all have very specific needs and ideas on what needs to be done.
That’s why the AMA or RACGP are so often stifled in action.
They can’t please all the members , so end up doing nothing to avoid upsetting anyone.

 

• The site BLOODWEAVER.COM bypasses this tendency to the bland, by creating a mechanism for small groups of people to work together and make changes in the world.

The site BLOODWEAVER.COM is there to let groups of people coalesce around new ideas, gather people and financial support and undertake specific actions as your group sees fit, legally.

• Get 5 or 6 of you together with an agenda, (the Bloods)

• agree to pool time and money and resources, ( weave your actions together)

• And you can undertake your own initiatives.

The Government may be huge, but not as large as the people who live within its embrace. It cannot fight every group to the bitter end to enforce its agenda. That is the beauty of democracy in the electronic age. It allows people widely separated in time and space to work together for the common good- on a whole range of issues, not just our medical ones.

 

• If you have specific needs or agendas, The site BLOODWEAVER.COM is there to let you choose an issue and to work for change with the support of groups of like-minded people.

groupwork

 

 

 

GUVNOT.COM/2/2 Summarises how to take action.
Everyone is stuck on earning more money by seeing more patients. But you can do quite well seeing smaller patient numbers as well.

Yes you can do well seeing 6 patients per hour, but many doctors more realistically can only function at 5 patients per hour at most. But consider that if you work at seeing 3 patients @ 20 min each you can earn the same amount of money as someone seeing 5 patients per hour.

The real loser is the doctor who sees 4 patients approximately per hour.
Do the maths.

 

 

So the sensible choice is seeing 3 patients per hour and have an easy life OR
see 5-6 patients per hour, get lots of people upset as you try to keep to time and cause yourself lots of stress.

The system depends on all the Type A personality doctors out there pushing themselves to see lots off patients ( and consequently earning AHPRA’s ire). So make life easy for yourself and create a system wide backlog of patients to stuff the system up. You can earn just as much, have an easy life and avoid the patient’s ire by doing relaxed consultations.

If you want to stuff the system up, pick your own times to do long consult days. You can work a mixture of 6 patients per hour on some days and 3 patients per hour on other days.

Blackboard 3

blackboard 5

Draw your own conclusions about how hard you want to work and how you can exploit the situation. Slowing down may earn you more.
If you don’t count the incentive payment of $20.65, you earn more money doing three long consults per hour than 5 short ones.

As a general Note : you are a fool if you are doing 13–20-minute consults. You are really costing yourself money.

 

Now, years ago, the HIC used to assume everyone work at 10–15-minute appointments and would investigate anyone seeing more than 10% consultations as longs.

But the world has changed.

• Computer timing PROVES the consult lasted 20 minutes.

• Lots more doctors are working slower because they don’t own their own surgeries and don’t need to push the envelope of high volume to make end meet, especially the new generations of part- timers.

• Medicare/HIC recently removed the requirement for long consults to be Complex: the key determinant is time ONLY.

• My guess today is that 30% to 50% of consultations fall in the 20min plus bracket: i.e. they are long consults.

 

Choose a strategy that works for you and creates stress on the system. And you can change your bookings day to day- you don’t have to choose just one single strategy: just choose something that works for you and stresses the system.

Working too hard

And you earn that same amount whether you take your time doing a 20 minute consult or get pushed madly around by patient demands. Remember, our goal is to hurt the system. And you can do it by NOT working too hard. We have a lot of strategies on CONS10.COM about controlling your time and your consultation. Go SLOW hurts the system a lot because the system is built on the exploitation of Type A personalities so prevalent in the medical industry- something exacerbated by our training and life / work experience.

 

The CONS10.com site is designed to teach those doctors working high volume
how to maximise their gain and reduce their time- stress ,
if working 5-6*10-minute consultations.

The key message is to do one thing at a time only and NEVER any more- for your own sake. Doing more leads to future consults being longer and doing more and you not getting paid.

And if you want to really push the envelope of high volume, AI really makes it look like you are working hard. It is amazing the volume of notes it generates. You may never need to worry about AHPRA telling you, that your notes are inadequate.
Time

 

 

 

 

appointments

One very critical issue is to retain the idea of a difference between private cons and public consultations. You need to sell a different product to each market.

You need to make sure that you always treat public / BB patients differently to private / paying patients.

 

This is an active process. You need to actively decide how you are going to differentiate these two products. Otherwise there is no point in having private patients. The co-payment for BB consultation makes it essential to work out how you differentiate the two products to allow you to TREAT and BILL them differently.

 

Other Ways to stuff up the system:

 

Recall

AHPRA and the system demands doctors follow up every result. Print two copies of every pathology or Xray referral and ring every person about results/ ring people who have not had tests done and ask them to do so.

More aggressively, keep no copies of results and ring every person as every batch of results turns up.

Or give results a few days to turn up then ring – and ring every time for every abnormal result.

 

Work Part time:

taking days off: preferable critical days : same as everyone else in your region : e.g. all take Friday afternoon off.
Vs
Work only long consultations on Friday finish early.

 

Referrals:

• Send people to the wrong doctor: after all the patient knows better and
  you should take their opinion into account.

• Send to the wrong specialist

• Send to the wrong public clinic

• All changes of address for the specialist are a phone consult.

• All hospital re-referrals are another consult.

Refer things that are going to cost you money : dressings and fractures/ plasters. ( The fracture referral is an interesting one. The rebate is so low, ( and includes aftercare), that GPs have defaulted to NOT treating any fractures at all. Every one is sent to the public hospital). Many practices no longer even stock plaster and plaster . Serves the government right. If you want a service, no one is going to do the job for nothing. So what are you going to pay . It has to be something that covers the time and effort of doing it-or else no one will do it.
Hence the present government created situation for patient treatment of fractures.

Refer easily and for nuisance complaints. WE have a case presented at one of our meetings. A mother and child were referred to a hospital clinic where one of our members was working. After a goodly and considered consultation, He rang the referring GP as to why they were there. The answer. They were not easy to obtain the relevant information from. So the GP decided quickly that a referral to Hospital Outpatients would be the easiest and quickest way to deal with the matter.
It shows how much the system relies on the goodwill of doctors. And this is not something to be taken for granted.


MedReferral

Refer early with a letter rather than use the computerised referral systems- especially to local public hospitals.

Or Patients need to reattend to give time to do the referral.
(We had a case recently whereby a patient told one of our members that they needed to get a travel vaccine. The doctor made them make a separate appointment for the travel consult - - separate to the first attendance, then made them return for a separate appointment booked with the nurse – while the doctor “supervised” the giving of the vaccine). i.e. That's three consults not the shortcut that many of us may take.

There are people out there who are quite militaristic in forcing patients to do what benefits them most. And sadly, if you don’t and you do own a practice, your own survival can be at stake. So we have a lot of sympathy for doctors forced to practice in this fashion.

It shows how much the system relies on the goodwill of doctors. And this is not something to be taken for granted.

 

Hospital referrals : keep referring as much as possible, anything difficult or uneconomic and make sure you see every patient with every activity relating to every referral – so you get paid for what you are doing.

 

Mental Health: doctors are getting in trouble for trying to save people’s lives by treating them. Refer off everything. Do not treat mental health patients. If a patient is refused , have a form letter for complaint to hospital, news media, administrative authorities. The system either includes GPs or can be forced to deal with the miserly cost savings measures they have instituted themselves. ALL by themselves.

Limit appointment activities. Remember ,you do not have to kill yourself working. Take your time. If there is not enough time , then another appointment is required. Do one thing per consultation - bulk billed consultation that is. ( Can you count to "one" doctor).

 

 

Pathology

Think less about the costs of tests and just do whatever you think it needs. Don’t worry about B12/ Folate/ Urine MCS . The government wants patients to pay for them, so let them pay for them. The patients should know that the government is doing this on their own behalf. Put up some posters in the surgery explain what the government has done.

Every request from pathology for an explanation as to why the test can be justified to be bulk billed, should be a patient phone consult- so you can get paid for your time involved in the government scheme of saving money by reducing services.
OR

For pathology : do only a maximum of three tests at a time , since this is all the government is paying for. His makes it easier to follow up EVERY result, since when three results are in the pathology buffer then you know that all the tests out of a single episode are back.

Or follow the expensive road. The government decided a few years ago that it would save money for steroid injections in joints by knocking off the GP rebate. Send the patients to Xray for their injections with a cost to the system of several hundred dollars vs the $20 they used to pay to GPs.

 

Certificates :

Give more not less. You are not a care-taker of social security or an employment enforcer. Give people time off if they want it and give lots of it.

You can also require a phone appointment if the certificate needs to be altered as the patient is not allowed back to work.

 

 

It shows how much the system relies on the goodwill of doctors. And this is not something to be taken for granted.

 

Keep hurting the system
till we (the KrustyLads) advise you not to.

 

 

 

 

ProtonMail Links:

 

Contact Links:

• Send your Survey response
  Return Faxout Survey / Email survey sheet
  

  

Help Us Covertly

• Give Us Contact Emails/Phone/Fax
  for Media Employees : TV, Radio, Magazines, Journalists
  

• Tell us about problems you have experienced that may be able to be used to charge AHPRA. We especially want to know about any deaths that AHPRA may be responsible for.
  
  

• I have an issue I want to talk about.
  
  

 

Help Us Overtly

• I want to volunteer to be on any committee
  investigating AHPRA/ acting against AHPRA.
  ( send your CV).
  
  

• I want to volunteer to help other doctors with difficulties - by writing supporting statements, by commenting on cases, by testifying about an issue.
  
  

 

General

• I work in an AHPRA administered allied health industry. I would like to give you some suggestions to put on your site relevant to these industries.
  (Please have any proposal written to a cut and paste standard –
  to make it easy for us to use).
  
  

• I have some good ideas to put on our website - about anything e.g.
  about actions to take to cause the system harm.
  about things that should be brought to light.
  (Please have any proposal written to a cut and paste standard – to make it easy for us to use.).

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  Keep hurting the system
  till we (the KrustyLads) advise you not to.

• Don't let everything we do be seen as a flash in the pan : soon to be forgotten.