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Members’ Forum – December 16

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AMA President Dr Steve Hambleton said doctors should have confidence in the reformed Professional Services Review scheme, which had been changed and improved with considerable input from the AMA. One AMA member shares their view.

Do these changes alter the deliberate and embedded bias of the legisislation? It allows total reliance on what is recorded in the file to decide what really happened in a consultation, small, statistically invalid samples of patients to be used to make generalisations about how a doctor practices, and to determine penalties. Adherence to edicts such as Benzodiazepines are for short term use only, which is contrary to the reality that most doctors have to deal with, but it puts us in jeopardy every day. My impression, having being a victim of Dr Webber was that the whole system will remain a denial of natural justice when the authorites make up the rules to suit themselves. The AMA was of no assistance to me at the time at all.
Submitted by Tony Michaelson (not verified)

Department of Health figures show that 85 per cent of Australians visited a GP at least once during 2012-13, and two reports have reinforced the leadership role played by GPs in Australia’s health system. An AMA member expresses their concern about elderly patients.

I am very concerned about how my elderly patients are going to fare next year when MBS items for chronic disease management, specifically health assessments and enhanced primary care plans are no longer going to be able to be billed at the same time as other items. This either means GPs will again have to do more without getting paid, or that patients will be asked to come back for an extra visit to see the GP, so that these items can be claimed separately from the acute presentation of the patient. At the moment, when a patient who comes to me who has complex care needs attends for any acute event, I take the opportunity to go through their care plan. This has always been a satisfactory approach for patients who don’t want to return for another visit. Often these elderly or disabled folk are poor and cannot even afford the travel costs to see their doctor. I certainly would not like to inflict extra burden on our already stressed and disadvantaged patients. With the proposed changes to the item numbers coming into effect from November 2014 that prohibit the co-charging of these items, it would be a step back for chronic disease management and proactive care. Please lobby the Government to change their policy on this.
Submitted by Aline Smith (not verified)

Recent reports suggest that Australian children are consuming less carbonated sweet drink and eating more fruit and vegetables. It has also been observed that rates of childhood overweight and obesity have plateaued. Despite these fairly positive indications, overweight and obesity continue to be a significant public health issue in Australia. One AMA member shares his suggestion.

The development of safe, well-designed walking and separated cycling paths in our suburbs and rural towns is an essential strategy in addressing our obesity and overweight rates. Encouraging students to walk or cycle to school, university or TAFE is a simple but very effective way of ensuring 30 minutes of active exercise daily. Welcoming streetscapes make this experience more enjoyable and has a mental health benefit. Cycle stations, with lock up facilities for bikes, showers and lockers near public transport, allow a cycle and commute habit to build. This not only improves health but reduces road congestion. Coordinated public transport timetables is an essential part of this process. It takes organisation and promotion to make this work. The experience of Amsterdam, Copenhagen, New York and Chicago, for example, shows how successfully people can be drawn to cycling and walking again. Forty per cent of Amsterdamers cycle daily, mainly commuting to work and education.
Submitted by Dr Tim Denton (not verified)

The AMA has called on the Commonwealth to axe the PBS authority prescription system, give doctors a single Medicare provider number, streamline Medicare payments and reform Medicare Locals as part of a review of the role and scope of Government. One member shares their experience with their current provider number system.

I am a pirate psychiatrist providing remote location visits in far north Queensland and I would like to backup with telehealth sessions, on a needs basis, between three-monthly visits from my base in Melbourne. The current provider number system requires me to have a separate number for each location that I visit. It is much more time and cost effective if I have a provider number that follows me around to the half dozen towns that I will be visiting. Is it possible to have a special needs arrangement where the service is being provided to areas of need, at the very least? I would welcome any improvement to the current system so that I can more efficiently provide a service to these areas of need.
Submitted by Dr Jan Steel (not verified)