GP launches petition against ‘unfair’ MBS changes to telehealth

Anastasia Tsirtsakis

8/06/2021 4:07:52 PM

Dr Todd Cameron is adamant mandating use of video technology for consults longer than 20 minutes will create a barrier for patients with chronic and complex health needs.

Person reading petition on their phone.
The petition is raising awareness among GPs and patients, and so far has more than 3400 signatures.

It has been a challenging 15 months since the COVID-19 pandemic was declared, but through the trying circumstances the expansion of telehealth has been lauded as a big win.
But as of 30 June, the current telehealth model is set to change.
To receive Level C and D rebates from the Medicare Benefits Schedule (MBS) a telephone will no longer be adequate, requiring GPs and patients to have access to video technology.
The incoming changes have raised significant concern among some GPs, including Dr Todd Cameron, who fears the policy unfairly targets patients who are already disadvantaged. And if they go ahead, he predicts telehealth use will markedly decline, worsening access to care as a result.
‘I think you’ll see a fairly wholesale abandonment of telehealth,’ Dr Cameron told newsGP.
‘The groups that mostly need healthcare [are] people [who] have social disadvantage and elderly people with mobility issues. They’re not going to go and buy a better phone and upgrade their NBN.
‘And so doctors will abandon that because it’ll all get too hard and they’ll just say to patients “Bad luck, come in” and go back to less convenient healthcare.
‘Then the only people that use it will be the people that … don’t really need it. It becomes about convenience and lifestyle, rather than need. So perversely, we’re creating an outcome, which is opposite to what we want.’
The RACGP’s 2020 Health of the Nation report shows 97% of GP respondents have started providing care via telehealth since the pandemic began, up from just 15%, and 64% believe the service has improved patient access to care.
It also shows that GPs are willing to incorporate new ways of consulting, with 30% having attempted to provide telehealth via video in April. However, only 4% reported that they continued doing so, with many citing a variety of major hurdles, from internet problems and equipment shortages, to patient-end issues.
‘That tells us that there’s a big problem with video,’ Dr Cameron said of the data.
‘Some of the purveyors of video [have] said, “Well it’s the gold standard”. I’m actually not convinced that that’s true. I don’t know that there’s any evidence that it is, and it’s certainly not what patients are saying.
‘The vast majority of people use telephone because it is easier for everybody.
‘Frankly, I think that it would be really hard for the Federal Government to argue [it is achieving] anything other than creating an intentional barrier to good care.’

Dr Todd Cameron fears if the changes go ahead, use of telehealth will decline, further disadvantaging people of a lower socioeconomic background and the elderly. (Image: Supplied) 

Dr Cameron has decided to address the issue head on, by launching an online petition to raise awareness among both his colleagues and, in particular, patients themselves.
To date, it has been signed by more than 3400 people, but the GP has his sights set on at least 100,000 signatures. The importance of telehealth has also once again been drawn into sharp focus by recent events in Melbourne, which is currently in the second week of lockdown amid a new COVID outbreak.
‘There’s a really good opportunity for us to align with patients, we just have to get the message out there,’ Dr Cameron said.
‘There’s 39,000 GPs straightaway [but] that’s not going to make a big dent politically. But if patients get behind this and see that they’re being ripped off, that’s where the goal is.’
While the focus of Dr Cameron’s campaign is on patients, he says flexibility around telehealth also offers clear benefits for GPs when it comes to work–­life balance and believes it could help to make the profession more appealing to graduates.
‘It does actually, for the first time ever, free doctors up to be able to work from home, at least some of the time if they batch that work appropriately,’ he said.
‘We’ve got a far lower portion of medical school graduates choosing general practice [and] that says that general practice is becoming extremely unappealing to graduates, and that healthcare is going to be more American style – it’s going to cost us more and it’s going to provide fewer good quality population-based outcomes.
‘The solution for all of us as GPs is just to charge everybody more … but I don’t think people are really comfortable with that outcome. GPs are pretty empathic people and mostly altruistic, so they kind of tolerate a lot of stuff just at the expense of doing the right thing. But I honestly think that’s pretty close to breaking point.
‘If we don’t start narrating this story … by the time everyone wakes up and realises what’s happened, it’s too late.’
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Dr Sabita Banik   9/06/2021 7:19:39 AM

Changes to video consultations especially for elderly patients will be impossible as they don’t have much technology ideas ,not the upgraded phones .Sometimes need to ring them at their land no

Dr Thomas Christian Henderson   9/06/2021 7:21:54 AM

so are we supposed to terminate the telephone call at 19 minutes and tell the patient to download zoom? why is there a never ending parade of morons pushing the paperwork?

Dr Vito Gaetano Spina   9/06/2021 8:05:43 AM

the telehealth served a purpose - but please all stop acting like children with their favourite blanket that has suddenly been stripped away
you are doctors and the purpose is to examine patients in person - not on the phone or on zoom
encourage your patients to get vaccinated instead and tell them if they need to just chat for 20 minutes they should call a friend
the purpose of the short consult is to determine if they need to be seen or not and that can be ascertained in the first 3 minutes
if they dont need a consult they can wait until they need to be seen

Associate Professor Magdalena Simonis   9/06/2021 8:19:45 AM

Well said Todd! Couldn’t have said it clearer myself.
It’s servicing a need that's existed and is growing, especially with lockdown 4 in Victoria.
Include the women and families suffering domestic violence who rely on making secretive calls to GPs for support, when out shopping or for other activities.

Dr Parvathy Murali   9/06/2021 9:00:04 AM

What about the recent medicare asking GPS to pay back telehealth billings due to non compliance with medicare rules as GPs should have seen them face to face in 12 months time Telehealth created due to pademic restrictions Pateints are stressed and desperstely asking for help How do u tell them i cannot talk to you as i have not seen you face to face in past 12 months!!
We are here to care for our community The whole thing is ridiculous and the rebate they give is nothing for the service we do They can stop the telehealth completely I thing they fo mot care at all

Dr Parvathy Murali   9/06/2021 9:04:57 AM

The telehealth is a good idea in a pandemic situation But the way it is designed and medicare riles for that sound ridiculous Due that many GP S ARE agraid and not interested to do telehealth The pateins will suffer We care but they do not care

Dr David Zhi Qiang Yu   9/06/2021 9:57:03 AM

I support Retain ALL telephone-only MBS item numbers after June 2021.

Dr George Burkitt, Woolgoolga NSW   9/06/2021 12:22:38 PM

I work in a small regional town and only do psychological medicine. Telehealth has been an incredible boon during the COVID epidemic but has made things so much more accessible overall and should be continued. Many of my patients have to drive for at least an hour to get to me and telehealth has transformed my capacity to serve working people. Using FaceTime, which requires an IPhone, allows people to sit in their cars and have a private session with me saving half a day off work. Very few patients seem to be able to navigate Zoom, skype etc, and the older and less tech savvy have no capacity for this at all. I have also found that FaceTime and the other video modalities crash out very often so I have to revert to telephone, the worst times seeming to coincide with when kids are out of school at lunchtimes and after 3pm. This just shows how profoundly out of touch are the policy makers. Support you all the way Todd.

Dr Janaki Gharti-Magar   9/06/2021 1:08:04 PM

It is simply impossible to tell our elderly patients to buy new phone, download zoom or come to the clinic during pandemic.

Dr Maureen Anne Howard   10/06/2021 12:08:30 PM

How can I sign the petition?

Dr Brahmanandan Malapurathattil   10/06/2021 9:20:54 PM

Working in remote areas, phone & internet connectivity is a big issue which will become a burden for older patients to attend in person

Dr Fiona Jane Henneuse-Blunt   12/06/2021 9:01:30 AM

I support the retention of level C and D telehealth item numbers after 30 June . To remove them would be retrograde, as many of my patients need support remotely, and don't have NBN or videochat internet capability. These are patients I know well and would always follow up with FTF consults . However recently I also spent > 60 minutes on the phone sorting out someone who I had seen in surgery ,but needed urgent results and scripts and referrals etc etc so works both ways.

Dr Anony Mous   16/07/2021 7:43:34 AM

Thank you Dr Cameron, yesterday an elderly couple told me they had to purchase smart phones and mobile internet subscription's which they hitherto would not have required in their usual day to day life.