‘They need to be here forever’: GP reaction to phone consult reprieve

Jolyon Attwooll

17/01/2022 4:38:07 PM

Medicare rebates for longer telehealth consultations by phone have been reinstated until mid-way through this year – but calls remain to make them permanent. 

Sick female patient on a telehealth phone call
There have been several changes to the longer phone consultation rules since they were first introduced. Picture: Getty Images.

The Federal Government announced on Sunday (16 January) that it will reinstate funding for longer phone consultations until at least the end of June.
It is part of a package announced by the Federal Health Minister Greg Hunt, who said the measures will help general practices cope with the high COVID-19 case numbers around the country.
The announcement followed a meeting RACGP President Dr Karen Price and representatives of other peak medical organisations with Minister Hunt and Regional Health Minister David Gillespie last week to discuss the challenges the pandemic is currently presenting general practice.
It means an MBS number allowing patients a rebate for a phone attendance by a GP lasting at least 20 minutes has been temporarily restored. It will also be available nationally rather than in specific COVID hotspots designated by the Chief Medical Officer.
Dr Michael Bonning, the medical director at the Inner West GP-led respiratory clinic in Balmain, describes the change as ‘a win’ that has been driven by the RACGP and other peak bodies.
Also a member of the RACGP Expert Committee – Funding and Health System Reform (REC–FHSR), Dr Bonning said the longer consultations have proved invaluable during the pandemic.
‘We’re often communicating with people for whom we need to take extra time,’ Dr Bonning told newsGP.
‘We’re communicating with people at a time when there’s a high level of anxiety and stress.
‘We’re answering lots of questions on the patient’s own behalf, but they are also concerned about family members, they are concerned about the close contacts rules.
‘We’d much rather someone took that kind of time rather than two or three interactions at different times to deal with a problem a little piece at a time, because we don’t have the telehealth items.’
However, Dr Bonning is also unequivocal in his belief that the MBS numbers for longer phone consultations should continue beyond the end of June and are relevant well beyond the pandemic – provided there is an established link between GP and patient.
While he says most patients want to see their doctors face to face, there are numerous situations where phone-based telehealth works better.
‘[There should be] none of this back and forth about [whether] we keep [MBS numbers] for another six months,’ he said.
‘They need to be here forever. We know that for many things there are patients for whom video consultations just don’t work.’
It is a view shared by Dr Price, who gave a cautious welcome to the Government changes on Sunday, while highlighting that many of the patients who benefit most from telephone consultations often have the poorest access.
‘Video consultations are not suitable for many patients including older people unaccustomed to the technology or those with unreliable internet access,’ Dr Price said.
‘The stark reality is that many of the patients who benefit the most from telehealth are also the most disadvantaged when it comes to internet connectivity and reliability.’
The college will continue advocating for a long-term return for the longer phone consultation rebates, Dr Price said.
‘A six-month restoration of these rebates is welcome; however, we must not stop there – this must be a permanent fixture of telehealth for years to come and the RACGP will continue fighting to make that happen,’ she said.
Of the telehealth items introduced since the beginning of the pandemic, the longer phone consultations have been a particular point of contention.
While they had been available universally when telehealth was first widely introduced in April 2020, the funding was later withdrawn.
In July last year, they were reinstated for areas designated as COVID-19 hotspots, a status conferred on outbreak areas by the Federal Government’s Chief Medical Officer.
Previously, newsGP has covered the difficulties the sudden ending of an area’s status as a hotspot caused general practices.
Other measures announced by the Government on Sunday included a $24million investment to help provide PPE equipment for general practices and other medical specialists.
This includes the distribution of nine million P2/N95 masks for GPs across Australia, with shipments prioritised for rural, regional and remote areas where access to PPE has been hardest.
Dr Bonning said the investment is welcome.
‘We know of some practices that have needed to go out and buy their own PPE at different times,’ he said.
‘PPE is an essential part of keeping general practices doors open. It shouldn’t be that we are having to fight on the open, private market to get standard personal protective equipment.
‘That should be that should be part of our relationship and responsibility with government.’
Other measures included the expansion of the MBS item for GPs caring for COVID positive patients face-to-face to include those that have tested positive through a rapid antigen test (RAT).
Minister Hunt also said Healthdirect will develop a national assessment, triage and notification system to link those who test COVID positive with appropriate care, based on guidelines developed by the RACGP.

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Dr Kirsta Craig   18/01/2022 6:33:57 PM

Are these longer rebates for rural locations only?

Dr Brian Nathan   19/01/2022 7:52:36 AM

Although Greg Hunt announced "these services will be made available nationally rather than targeted to Commonwealth-declared hotspots as they were previously", the MBS item descriptor, as of today, has not changed. Item 92746 still reads: "the service is performed on: (i) a person who is in a COVID-19 Commonwealth declared hotspot; or (ii) a person who is in COVID-19 isolation because of a State or Territory public health order; or (iii) a person who is in COVID-19 quarantine because of a State or Territory public health order; and

Dr Brian Nathan   19/01/2022 1:44:19 PM

Just checked again. The descriptor has been changed; references to hotspots etc have been removed. Also, nothing about rural locations is mentioned.