The Australian government is currently taking steps to ensure that patients who need a doctor after hours will receive the best quality of care through Medicare.
Some Medical Deputising Service (MDS) providers have said that emergency departments may become overrun with extra patients as some MDS centres will be forced to close; however current hard data suggests this is false. MDS visits will only be for urgent and unexpected illnesses and are not expected to deliver emergency-type care.
The government has also introduced a ban on direct advertising to patients by Approved Medical Deputising Service (AMDS) in an effort to control the unjustified growth of Medicare expenditures. There are serious concerns that these advertisements are deliberately targeting patients, which is encouraging them to access MDS services for convenience over urgent needs.
Some experts suggest that the regular usage of MDS over primary GPs may compromise the health and safety of patients. All MSD providers are required to refer any routine GP-type care back to the relevant GP practice and should provide patient notes for any patient treatment encounters by the next working day.
To reduce the overall Medicare expenditure and also improve the quality of the after-hours sector, the government has reduced the Medicare rebate for doctors who are working in MDS. As a result, doctors who are recognised Fellows by the RACGP will be entitled to claim a higher amount for carrying out home visits over those doctors who do not hold this qualification. This move is targeted at those MDS companies which have been using inexperienced and poorly qualified junior doctors.
The after-hours reform has also redefined the term ‘urgent’, which is relevant to Medicare item use. The term now relates to the need for an urgent assessment of the patient. This also considers whether the patient can wait until the next working hours for their GP to conduct an assessment.
If GPs would like their practice patients to use the MDS service they have an arrangement with, they need to ensure that they clearly display and pass out relevant brochures amongst their patients with the appropriate information for after-hours support. Additionally, if they have any patients who are more likely to require after-hours support, they should talk to them directly to make sure they know that their MDS provider will be able to offer them both the best health outcomes and continuity of care. Some clinics choose to proactively send out letters to patients to educate them about their preferred MDS service and how this can benefit them to ensure better continuity of care.
MDS call centres should be available to GPs who are registered with them at any time, although the after-hours consulting period begins after 6:00 pm Monday to Friday, after 12:00 pm on Saturday, and all day on Sunday and any public holidays.
Make sure that the after-hours MDS service you are using holds a certificate of accreditation. This will ensure that the service you’re using meets all the compliance requirements for being an AMDS provider.
For any more information regarding the after-hours reform, you can email the Department of Health at AMDS@health.gov.au.