Cutting out mandatory GP reconnection points is almost certainly a bad idea.
The ongoing war between patient convenience and clinical safety has opened a new front in the referral field, with the AMA sending a strongly-worded warning to the Department of Health, Disability and Ageing.
The AMA’s chief concern was around extending referral periods to allow for two-year, three-year or “indefinite” referrals.
“While some consumers may wish to access all aspects of the health system without a gatekeeper, the reality is that if government provides this access, there are likely to be unintended consequences that will harm patients,” the medical association wrote in its submission to the government.
“Unfortunately, many consumers do not understand the value of continuity of care to their health.”
It did not pull its punches.
“The move to transactional healthcare interactions, such as getting a referral or medical certificate online from a non-medical practitioner, has changed consumer behaviour and expectations and is promoting ‘fast-food’ healthcare that has higher overall costs and poorer healthcare outcomes,” the AMA said.
The fundamental issue at stake is whether referrals should be viewed as an administrative transaction or as a clinical safety mechanism.
“… The AMA believes that the default validity of GP referrals to non-GP specialists should remain at twelve months,” it wrote.
“Exchange of information between GPs and non-GP specialists on at least a yearly basis is essential for patient safety.
“Details of the patient’s medication, medical and family history and allergies must be kept up to date, along with any changes to the patient’s clinical risk, so the referral recipient can prescribe and treat safely.”
Related
On a more granular level, the AMA supported the DoHDA’s proposals to include detailed information on the Medical Costs Finder and mandated standard wording on how referrals work on referrals, as well as requiring doctors to provide patients with both a hard copy or a digital copy of the referral.
It did not, however, support the department’s suggestion to modify legislation to allow the continuation of treatment under a different practitioner on the same referral or allowing the first and second practitioner to bill initial attendance items in this circumstance.
Doing so could potentially allow an increase in “doctor shopping” driven by wait times rather than clinical appropriateness and facilitate intervention-seeking behaviour in procedural specialties, the AMA argued.
