Peak medical organisations have called for greater telehealth flexibility, should Australia’s fuel tank run dry.
In a letter to Health, Disability and Ageing minister Mark Butler, the AMA and RACGP have called on the government to prepare changes to Medicare’s telehealth service limits.
Under the MBS 30/20 prescribed pattern of service rule, practitioners may be subject to regulatory scrutiny if they provide 30 or more telephone consultations per day on 20 or more days in a rolling 12-month period.
The RACGP and AMA recommend retaining the 30 daily telephone consultations limit but extending the 20-day threshold to 50 days if the country moves to Level 3 of the National Fuel Security plan.
As it stands, Australia is at Level 2, “Keeping Australia Moving”.
“While the Professional Services Review (PSR) may consider exceptional circumstances on a case-by-case basis, reliance on retrospective discretion is not sufficient during periods of system-wide disruption and risks avoidable referrals that place significant administrative and psychological burden on practitioners,” the letter read.
RACGP president Dr Michael Wright said that continuity of care must remain the top priority despite any prolonged fuel disruptions.
“If fuel supply constraints make travel more difficult for patients and healthcare professionals, telehealth will play a critical role in maintaining access to care,” Dr Wright said.
“We are asking the Government to plan ahead now so that regulatory settings don’t inadvertently limit access to essential healthcare during a national emergency,” he said.
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AMA president Dr Danielle McMullen said telehealth was a proven tool for ensuring care continuity during disruptions, particularly for patients with chronic conditions or in rural and remote areas.
“This is a sensible, temporary contingency measure that would only apply if the National Fuel Security Plan reaches Level 3. Preparing those arrangements now will ensure the health system can respond quickly if circumstances deteriorate,” Dr McMullen said.
Health practitioner regulator AHPRA have recommended doctors consider telehealth where appropriate during the current fuel crisis.
For RACGP rural chair Associate Professor Clements, whose clinic in Cloncurry is most often attended by patients who live well out of town, the telehealth flexibility in a Level 3 situation would be incredibly beneficial.
“Our rural and remote patients are extremely price-sensitive to fuel price changes, and they have to make decisions regularly about when to purchase their fuel and whether to reduce their shopping trips to town to once a month instead of twice”, he told TMR.
“The main principle is we want the decision about whether a consultation should be face-to-face to remain between a patient and [their regular] GP.”
With existing caveats in telehealth legislation that support rural remote care, he said the RACGP and AMA’s ask was “a very reasonable step”.
MyMedicare registration has different eligibility requirements for MMM6 and MMM7 regions, requiring patients to have at least one face-to-face visit every two years, compared with two visits in all other regions.
“We don’t want to have a doctor in our remote communities demanding that all patients travel to them because they’ve maximised the number of telehealth consultations in the 20-day period,” he said.
ACRRM president and rural generalist Dr Rod Martin said rural patients have routinely had to make 350 kilometre round trips for a 15-to-30-minute GP consultation, costing upwards of $80 in fuel.
“We don’t want patients to have to make a decision about whether to go to a doctor’s appointment because they can’t afford the fuel,” he said.
However, he agreed the expansion should ensure patients continue seeing their regular GP, and that these extensions would apply only whilst the country is at Level 3 to prevent a default to telehealth-only services.
Earlier this week, the federal and Western Australian governments announced a $4 million investment in a pre-feasibility study to build Australia’s first new oil refinery since the 1960s.
