The Department of Health, Disability and Ageing is considering expanding the reach of the PSR to include informed financial consent. Maybe not such a good idea, says the AMA.
The AMA has rejected nearly all of the Department of Health, Disability and Ageing’s proposals to tighten up informed financial consent, arguing that the current focus on doctors’ fees is distressing clinicians to the point that they consider leaving the profession.
As part of broader work addressing non-GP specialist doctor fees – the other components being referral reform and the Medical Costs Finder transparency legislation – the DoHDA is also looking at strengthening the laws on informed financial consent.
Some ideas floated in its consultation document included expanding the remit of either the PSR, the ACCC or the DoHDA compliance team to handle informed financial consent complaints, having AHPRA enforce informed financial consent standards under national law and establishing a new regulator.
In its submission to the consultation, which was released today, the AMA cautioned against all of these approaches.
Instead, it said, the most effective approach to informed financial consent was patient and provider education.
“Given the multitude of regulatory and complaints mechanisms already in place across the country affecting medical practitioners, strong consideration must be given to the impacts of an increasingly complex regulatory/complaints environment on both practitioners and patients,” the association wrote.
It also flagged the potential impact that the passing of new laws or regulations may have on doctors, given the risk that the public may form the impression that a large number of clinicians were dishonest.
“Many [doctors] are already feeling disheartened, distressed (and in some cases, on the verge of leaving the profession) by recent adverse publicity around specialist fees, when we know that there are very few who charge egregious fees that their colleagues would see as unreasonable,” the AMA wrote.
“Furthermore, the reality is that out-of-pocket costs are driven by a range of factors that go beyond the doctor’s fees and extend to MBS rebates, insurer fee schedules, practice costs and the complexity of care being provided.”
Creating new avenues specifically for complaints related to informed financial consent, the AMA said, could inadvertently encourage trivial or vexatious complaints.
These, it pointed out, could potentially lead to doctors spending more money resolving disputes and consequently raising their fees.
Related
The other big problem with tightening informed consent laws, according to the AMA, was practical.
Medical treatment often followed an uncertain course, especially in the case of complications or emergencies, making it difficult to accurately estimate how much a given treatment will cost.
Then there was the added complexity where private health insurance benefits were involved, given that practitioners did not always have access to detailed insurance information.
“Given these practical impediments to obtaining [informed financial consent] before a medical service is provided in 100 per cent of cases, the AMA believes that significant caution should be taken if the government decides to develop an overarching legislative framework regarding informed financial consent,” the AMA wrote.
“We continue to promote an educative approach and would emphasise that any government intervention would need to be proportional and founded on a peer review process, recognising that the delivery of care is complex and at times uncertain.”
What the association did support, however, was a profession-led model that focussed on education rather than punishment.
It has an existing position statement on informed financial consent.
