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GPs to warn patients of specialists’ fees under revamp | Australian Doctor

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GPs to warn patients of specialists’ fees under revamp Paul Smith

| 15 February, 2016 |

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GPs will have to inform patients about potential out-of-pocket costs when referring them to a specialist, under a draft revamp of the RACGP's practice standards. Releasing the first draft of the fifth edition standards on Monday, the college has avoided wholesale changes - although some previous recommendations would become mandatory. The college has attempted to beef-up the demands on practices in areas such as preventative care, patient reminders and systems for recalling patients with urgent test results, as well as providing information to patients on healthcare costs. New mandatory requirements outlined in the draft include: • time-critical results identified outside normal opening hours are managed by the practice

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Dr Phil 42 no, I susoect the way governments think is, you should reach into your own pocket and buy a CT scanner (and maybe an MRI as well)... in... Call for CT scans of injured aged-care residents · 1 hour ago Rural GP As per my previous....what fools are still members of the RACGP or the AMA? Govt urged to pilot patient enrolment · 2 hours ago

• practices need to have a reminder system in place for preventative healthcare • a policy on the use of email and social media if used by the practice • informing patients of out-of-pocket costs provided within the practice, and potential out-ofpocket costs relating to referred services • practices required to provide information on health promotion, illness prevention and

Rural GP 1. I am not your secretary. 2. I am not the specialist's secretary. 3. I do not have the time do do this, unless I bill the same as a... RACGP moots forcing GPs to detail specialists' costs · 2 hours ago

preventive health • the documentation of prior consent given by a patient to have a third party (such as a chaperone, registrar, medical student, family relative) present during the consultation The draft standard on out-of-pocket costs says the price of treatment remains a barrier to care for many patients. Current accreditation standards suggest doctors raise the issue of future costs with patients. But this draft says it should become mandatory. “If the patient indicates, or you otherwise know or suspect, that the costs of a suggested referral pose a barrier to the patient, discuss alternatives with them, such as referral to public services,” the draft says. Advertisement

http://www.australiandoctor.com.au/news/latest-news/racgp-moots-forcing-gps-to-det... 15/02/2016

GPs to warn patients of specialists’ fees under revamp | Australian Doctor

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“While it is not necessary for you to know or provide the exact costs of referred and recommended services, you do need to tell patients of the potential for out-of-pocket costs before you make a referral, or recommend services such as pathology, imaging, and specialist or allied health. “If a patient requires exact information about the costs of such services, encourage them to make their own enquiries.” There are new requirements to obtain and document consent for the presence of third parties during a consultation. The draft says: "If an undergraduate student, practice nurse or other health professional is to be present during the consultation...the practice must seek the patient’s permission when the patient makes an appointment, or, failing that, when they arrive at reception. Advertisement

"It is not acceptable to ask permission in the consulting room, as some patients may feel pressured in the presence of the third party, and agree even if they would prefer not to. "Even when prior consent has been given, the practitioner should confirm at the beginning of the consultation that the patient has consented to the presence of any third party." Doctors should record the patient’s consent and the name of the third party in the consultation notes, ot adds. "It may be sufficient to record the initials of a medical student in the notes, if the practice can later provide the student’s full name." The draft standards also say practices must have a reminder system in place for patients. It suggests reminders can be sent by the practice via SMS for preventative health checks. For instance when patients are at a high-risk age for flu prompting them to come to the clinic before the flu season starts, or when patients are due for routine a Pap smear or mammography. However if the reminder is ignored and the patient does not make an appointment, the practice is “not obliged to follow up, but should record the reminder in the patient’s medical notes”. Practices are already required to show they have systems in place to deal with urgent test results. However, under the new draft the college makes an explicit demand that time-critical results identified outside normal opening hours "are managed" by the practice. One controversial issue has been whether practices should be forced to have defibrillators.

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The draft standards recommend that practices should have the equipment - which can cost around $3000 – however it falls short of making them mandatory. While the college admits the issue is contentious, particularly with the current underfunding of general practice, it argues survival rates after sudden cardiac arrest drop 7-10% for every minute without defibrillation. “CPR alone has a 5% survival rate but CPR combined with early defibrillation increases the survival rate to 50%,” the standards say. Another mandatory indicator is that a practice's clinical staff have clinical autonomy. The practice must show that its practitioners are “free, within the parameters of evidence-based care and their credentials” to decide: • the appropriate clinical care of each patient • the specialists and other health professionals to whom they refer patients • the pathology, diagnostic imaging, or other investigations they order and the provider they use • how and when to schedule follow-up appointments with each patient RACGP President Dr Frank Jones (pictured) said: “‘This first draft consultation is just that – a draft of what is a multifaceted set of requirements – and it is an opportunity for all involved in general practice to put forward their thoughts and perspectives in order to shape future drafts and the final version.’ The consultation runs until 1 April. The fifth edition standards, which will be trialed, are expected to be formally signed off by the RACGP next year. More information: Click here to have you say on the RACGP fifth edition draft standards