Worst nudge letter everrr: DoH loses plot while RACGP fails members

4 minute read

Why did the DoH send 500-odd repayment letters to GPs amid the mess of the vaccine rollout and why didn’t the RACGP tell its members what the rule meant?

If you take the time to read one of the letters related to a so-called telehealth rule-breaker GP this week, you’ll quickly become dumbfounded as to why the Department of Health would even consider sending such a letter, given how obviously confusing the telehealth process has been and the dumb logic of their interpretation of the 12-month rule.

The pertinent (and bizarre) detail of the letter includes the fact that the GP in question allegedly failed to realise there had to have been a face-to-face visit within 12 months of each and every telehealth consult, not just the first one. Say you last saw the patient in person on 30 January 2020. You can claim for a telehealth consult on 29 January 2021, but not for a follow-up on 10 February 2021 – you have to see the patient in person before claiming telehealth again. 

The rule was introduced in July last year, at the behest of the RACGP, to protect its members from patient harvesting by pop-up telehealth clinics. The idea was simply to promote good healthcare continuity with a patient, for the sake of better service delivery and safety.

The rule as interpreted by the DoH entirely defeats the spirit in which the RACGP attempted to have it put in place.

What’s worse, it obviously wasn’t very clear to anyone that this was how the rule was to be interpreted. The Medical Republic has asked the DoH to explain where and how they attempted to elucidate this pearl of logic to all GPs, but we are yet to hear back from them.

And it’s not just a series of GPs that have been caught out. The RACGP didn’t understand what was going on at the start either.

It’s very hard to understand what the DoH hopes to achieve with this letter series. It’s so bizarre in its logic and looks so stupidly bureaucratic and ill thought out that the only two conclusions a GP could arrive at are that either the DoH is the depraved and uncontrolled totalitarian regime that some GPs who have been caught out in PSR proceedings and received past nudge letters have come to think it is, or it is massively distracted by the COVID crisis and, let’s say, not thinking clearly.

We guess that, on either interpretation, the DoH is certainly fulfilling its “fill them with fear” goal. Fear that it’s that stupid. Or fear that it really is that bullying and mean.

In what way does sending this letter out help any of the burgeoning issues of mistrust between the GP community and the DoH? How does it result in something productive for the system and for the community overall?

It simply doesn’t. Whoever let it get out of the Canberra postcode needs their head read.

And speaking of needing their heads read, how is it that the RACGP got a heads up on this letter months ago, and still managed to let it still get out to its members?

Worse, how is it that the president of the RACGP, Dr Karen Price, knew of the interpretation, reacted personally by making sure she did a few home visits for her patients – “touched you, ding, I’m back in the telehealth rebate game for a year, ta” – to make sure she herself was within the rule, and yet didn’t let members know at the same time?

In Australian Doctor this week Dr Price is quoted as follows:

“When I realised the way the rule actually worked, I had to go and do a home visit for some of my vulnerable patients, simply so I could continue caring for them.

“It flies in the face of common sense.”

So does not telling your members about the interpretation of the rule immediately.

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