GP fee plan 'to hurt patient relationship'

Doctors are worried their relationship with patients could flatline if they are forced to pass on the optional $5 fee announced by the federal government.

The government ditched its proposed $7 GP co-payment this week, and its new fee will be charged at the discretion of doctors to make up for a reduction in the rebate they receive from Medicare.

Medicos say the prime minister has put them in the awkward and ethically fraught position of having to decide whether to charge non-healthcare card holders the fee.

Australian Medical Association GP spokesman Dr Brian Morton says doctor-patient relationships could be affected by the plan, which puts the onus on the doctors to decide whether to charge non-concessional patients the co-payment.

"It would be awkward," Dr Morton says.

"You have a good relationship with your patients. The usual GP has seen the patient for years often, so you don't want to tarnish or put a barrier between you and the patient."

Royal Australian College of General Practitioners president Dr Frank Jones says the decision to charge non-concessional patients would be an ethical problem for most doctors.

"The decision will come down to two things, in my opinion. One, it will be a personal decision for the GP at the time - he or she will make an assessment of that patient's needs," he said.

"If someone is acutely unwell, say with pneumonia, you want to sort them out as quickly as possible. The last thing in your mind is to exchange money, so I think it will become an individual GP decision depending on the clinical context.

"At an individual level, it will certainly give doctors on the front line ethical issues as to what to do."

Despite the plan being spruiked as a $5 "discretionary fee" that doctors may opt to absorb themselves, Health Minister Peter Dutton has admitted the majority of non-healthcare card holders will end up paying it.

IF YOU ARE BULK-BILLED AND DON'T HAVE A CONCESSION CARD:

* You will pay the $5 co-payment at the discretion of your doctor (from July).

* For the GP: a doctor who charges the most common standard consultation (Level B) will have to spend between 10 and 20 minutes with a patient (from January). The Medicare rebate for Level B consultation is is $37.05. This will change to $32.05.

IF YOU ARE A BULK-BILLED PATIENT THAT HAS A CONCESSION CARD, OR ARE UNDER 16 YEARS OF AGE:

* You won't be affected.

* For the GP: no change for doctors for visits between 10 and 20 minutes. GPs will continue to receive $37.05 plus the incentives of between $6.15 and $9.25 a patient for bulk-billing.

IF YOU ARE NOT BULK-BILLED:

* The Medicare rebate you receive will be reduced by $5. At present, such a visit could attract a rebate of $37.05. This will change to $32.05.

* For the GP: no change.