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Ask Dr Dave - April 1999 |
| Dear Dr Dave
I read on the net today that Dr Wooldridge met with the gang of four (AMA, RACGP, RDAA and ADGP) last week to fix GPs' incomes. The Minister reportedly wanted them to agree to cutting GP services in exchange for a higher rebate. If I colluded with my colleagues to limit services and force up prices, the ACCC would be down on me like a ton of bricks. How come it's OK for Dr Woolly to do it?
Stunned
Dear Stunned
Fee for service results in the most cost efficient way of delivering services in a free market. Australians, however, believe that people should be treated at least partially on the basis of medical need and therefore health services do not operate in a free market. The government is offering a raft of non-volume based payments to GPs to address issues that arise from the distortion of the medical market place. The appropriateness of these payments is being hotly debated in GP circles.
Government policy is not subject to scrutiny by the ACCC. Remember we are all equal but some are more equal than others.
Dr Dave
Dear Dr Dave
I have a desktop machine at home as well as at work and both machines are slowing down. Laptops are more expensive but it would still be far cheaper to buy one laptop than to replace both desktops. Which way should I go?
Upwardly Mobile
Dear Upwardly Mobile
Laptops have improved in recent years. Their performance is comparable to desktop machines and the price premium is not an issue for many business users.
You still need desktop machines at work, however, and your server requires meticulous care and maintenance. You need to back up your medical data and preferably all your essential server files and you need to secure all your medical data from illegal tampering and theft.
Security is the major problem for laptops. Machines can be lost or stolen from airports, cars or even from home. If your database is unencrypted you have compromised your duty of care to thousands of patients.
In some medical organisations it is company policy not to allow company data to be taken off the premises. However, these companies give their staff access to their databases by dial up networking through a dedicated telephone number or through the internet over what is known as a virtual private network (VPN). Dial up networking is best if you are accessing your databases through a local telephone call. The cost is cheap and security is not an issue. If you are outside the local area call zone, a VPN provides local call access throughout the world through your favoured internet service provider (ISP). You will pay more for your connection through download costs or connection time and there is some performance degradation because of the need to encrypt and decrypt all data on the fly.
There is a trend for data to be universally accessible. As they say on the net, "information wants to be free". These days this includes your own personal data. You can access your email at hotmail.com from any cybercafe. Are you free on the 23rd just check your calender at www.when.com. Want to pick up an extra 10,000 Yahoo shares, log into your account at ozebroker.com.au or etrade.com.au. The US government has released 128 bit encryption to approved foreign customers. Through your bank you can now pay your bills on line with BPay, transfer money to other accounts including credit card and term deposits or order a new cheque book or replacement statement. The truth is of course that you probably don't need a cheque book or a statement. All money transfers will be directly into your vendors account or made at the time with EFTPOS. You will download your statement directly into your computerised cash book and save on all that double entry.
Do you need a laptop? Not necessarily. What you really need is access to the net.
Dr Dave
The big four banks have or will soon have Net banking. Try the following links.
http://commbank.com.au/Netbank/
An excellent demonstration of the capabilities of this technology.
http://www.national.com.au/banking/
This site is currently in beta for existing customers.
http://olb.westpac.com.au/default.asp
Follow the HTML or shockwave guides.
http://www.anz.com.au/pcbank/default.asp
This site is also in beta for existing customers.
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