Cardiologists are amongst those exploiting a dysfunctional Medicare system, says the former head of the body responsible for policing it.
In a scathing critique published in yesterday’s MJA, Dr Tony Webber identified a system “riddled with misdirected incentives” for doctors, with inadequate safeguards to protect against rorting by unscrupulous practitioners.
Webber, who ended a tempestuous six-year tenure as Director of Professional Services Review (PSR) last August, took specific aim at cardiologists and gastroenterologists.
“While most … practice ethically, there are a few practitioners whose repeated use of procedures and investigations in highly questionable in patients whose clinical condition appears not to warrant them,” he wrote.
The comment was related to his criticism of the Medical Benefits Schedule (MBS), which he says fails to stay up to date with technological developments.
“Once items are on the MBS, as long as they are still being used, they are rarely re-evaluated, and they attract the yearly rise in benefit level,” he wrote.
This was despite certain procedures being much quicker, cheaper, and easier to perform than when they were added, with some practitioners charging more than $4000 for procedures that can be performed more than twenty times a day.
“There is no one asking the questions,” he wrote. “Many doctors I have spoken to are disillusioned by the inappropriate claiming and practice they are aware of.”
While there were some instances of rorting, the majority of practitioners were doing the right thing, the President of the AMA, Steve Hambleton, told ABC Radio.
“It seems to me that [Webber] has taken things that he has seen in that role, [in] a very small number of professionals, and perhaps expanded that to the rest of the profession,” he said.
“He has written this for one purpose and that is to get the attention,” he told Cardiology Update’s sister publication, 6minutes.
A statement released on behalf of the Acting Health Minister, Nicola Roxon, said Dr Webber was unable to comment with authority on the issue, since the PSR has no responsibility in health policy or funding.
Dr Webber rejected the assertions, claiming in his tenure to have seen over 20,000 medical records.
“The abuses were widespread,” he told ABC Radio.