‘Just insulting’: RACGP demands ECG restriction reversal

Millions of vulnerable patients have gone without potentially lifesaving electrocardiograms (ECGs) following Medicare funding cuts – a decision the RACGP says must be reversed.
 
The RACGP is doubling down on its calls for funding to be immediately restored, following the 2020 review of Medicare Benefits Schedule (MBS) which meant item numbers for interpretation of an ECG could only be accessed by physicians, pushing out GPs.
 
On Monday, the college revealed more than 2.2 million ECGs were not delivered by GPs between 2020–22, specifically due to these funding cuts, leaving patient lives at risk.
 
With the latest round of consultation on the change winding up just weeks ago and now being reviewed, the RACGP specifically recommended the revised ECG MBS items 11714 and 11707 be introduced ‘without further delay’.
 
It comes as GPs across Australia continue to call for the change, with a recent newsGP poll finding 84% of respondents say the reintroduction of MBS items for GPs to trace and report on ECGs would be beneficial to patients.
 
RACGP Acting Rural Chair Dr Rodney Omond said this lack of support for ECGs in practices means rural patients are being forced to travel considerable distances for basic care, and many are simply choosing to go without.
 
‘This is just insulting to specialist GPs who are not being recognised as able to read an ECG,’ he told newsGP.
 
‘It’s so expensive for patients to get the service elsewhere, it costs them both time and money to get the test done, and patients would be much happier to have a rebate and pay for the service inside the general practice.
 
‘For many patients, it should be a very regular part of their chronic disease review or annual review, particularly as they get older, so the fact that it’s harder to get because it’s not being paid for by Medicare is just really very poor planning for the care of patients.’
 
An updated ‘Electrocardiogram Post-implementation Review’ from the MBS Review Advisory Committee (MRAC) confirmed the reduction in ECG services, especially for those living outside Australia’s major cities.
 
‘It is also possible that the MBS item changes have disincentivised some private general practices from performing appropriate ECGs, especially in rural and remote areas,’ it said.
 
Dr Omond said given cardiovascular disease is the biggest killer of Australians, having access to the simple, painless, and quick test as a baseline screening service is essential for general practices and patients.
 
‘Certainly, for the rural sector, it’s an essential thing for rural GPs in small towns to have in their practice, and for them to be funded properly to be able to do the service,’ he said.
 
‘The ECG is a really sensitive baseline for monitoring ischemic heart disease, and if it’s easy to get and in the practice, then a patient would agree to have one.
 
‘But if they had to travel at all or even go to a nearby hospital to get it done, they might not bother, or not have the transport to do it, and older patients might be too frail or unable to drive.’
 
The RACGP’s calls for change come as, according to the Heart Foundation, more than 67,000 heart attacks, strokes, and deaths over five years would be prevented through ECGs being undertaken in general practice.
 
RACGP President Dr Nicole Higgins said the situation has now created a ‘ticking time bomb’.
 
‘Funding needs to be restored immediately for Australians to get this care from their GP,’ she said.
 
‘It’s been almost four years since the Federal Government cut this funding, and the risk of people with life threatening problems being missed since then is huge.
 
‘The RACGP strongly opposed the funding cut which restricted certain ECG services to non-GP specialists and consultant physicians, which costs patients much more.’
 
MRAC is due to hand down its final report in late 2024.
 
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