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Govt slurs on doctors must stop: AMA

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AMA President Professor Brian Owler has called for an end to sustained Federal Government attacks on the medical profession amid mounting evidence that GPs are playing a crucial role in keeping health costs down.

Responding to the latest salvo fired by Health Minister Sussan Ley in which she alluded to widespread misuse of Medicare among general practitioners, Professor Owler said the profession was getting “very weary” of the Minister’s attacks, which he said were aimed at creating the impression GPs were rorting the system as a way to justify cuts to health spending.

“The Government tries to come out with this narrative about GPs doing the wrong thing,” the AMA President told ABC radio. “We’ve seen this from this Government before, and I think it’s about time that this Government actually started to appreciate, particularly their general practitioners, and stop painting the profession as people doing the wrong thing so that they can just find more savings in the Budget.”

Professor Owler made his comments after Ms Ley seized on a report from the Professional Services Review (PSR) agency to claim that that an increase in incorrect Medicare claims by doctors may be just the “tip of the iceberg”.

The agency reported a 40 per cent jump in the number of cases of suspected inappropriate practice referred to it for investigation in 2014-15, from 44 to 62, with much of the increase involving claims made for chronic disease management items.

“The MBS items and their associated rules are necessarily somewhat prescriptive,” the agency said in its Annual Report. “This provides scope for less scrupulous practitioners to populate the clinical record of an attendance with copious ‘generic’ computer template material. PSR committees often find that these are of little apparent relevance to the particular patient.”

“PSR committees frequently find that some practitioners in large practices provide [chronic disease management] services opportunistically despite the lack of clinical relevance.”

The Agency reported that action was taken in 70 per cent of cases referred to it, including ordering 24 doctors to repay $2.6 million of Medicare benefits, fully or partially disqualifying 13 practitioners from Medicare for anything up to 12 months, and issuing six reprimands. A further $1.57 million was refunded in negotiated settlements.

Ms Ley said she was deeply concerned that grey areas and ambiguities in Medicare rules that made it hard to track and prove abuses by less scrupulous practitioners could mean many more instances of misuse and rorting may be going unreported.

“These findings show the importance of having clear, strong rules around the use of individual Medicare items to ensure they are clinically relevant and reflect contemporary practice, but also aren’t misused for financial gain,” the Minister said.

The attack came just weeks after Ms Ley echoed claims that around 30 per cent of services and procedures provided by doctors through the Medicare Benefits Schedule were unnecessary or potentially harmful.

But Professor Owler said the number of practitioners found to have engaged in some form of wrongdoing by the PSR was a tiny fraction of the 100,000 registered doctors working in the country, and it was wrong Ms Ley to attempt to “politicise” the Review.

“The Government has been too eager to use the inappropriate behaviour of a small number of doctors – which the AMA does not condone – to tarnish the reputation of all GPs,” he said.

A major study (see page 8) has found that GPs, far from being a drag on the health system, are playing a crucial role in keeping patients healthy and out of expensive hospital care, and should be a focus for Government investment.

Professor Owler said the results showed that the Government should be praising, rather than bagging, GPs, and, at the very least, should be removing the freeze on Medicare rebates.

“Instead, the Government is regularly engaging in criticism of hardworking GPs, calling them ‘rorters’ in its efforts to sell its cost-cutting MBS review model and in its unbalanced portrayal of the latest Professional Services Review (PSR),” he said.

Adrian Rollins