Adelaide GPs say they now need to stress pain when making a referral
GPs say they are being forced to stress their patients are in pain for the referrals to be accepted, as a leaked SA Health email suggests surgeons reject referrals for old people.
SA News
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GPs say they are feeling pressured to highlight patients’ pain to make sure they are seen by public hospital specialists, after apparent changes in referral protocols.
They warn that some patients now face getting sicker before they can get the treatment to make them better.
The claim comes as a SA Health email leaked to the ABC from a program manager to surgeons suggests they “say no” to GPs referring patients who are elderly or have multiple health conditions.
“We also expect that where the person is old or has many comorbidities, you might suggest to the GP that is not necessarily in their best interests,” the email reads.
“Please use your wealth of consultant experience and start to say ‘no’ when clearly not sensible and high value care.”
GPs say they are now having referrals rejected regardless of the patient’s age unless they stress the person is in serious pain and risks further damage.
Happy Valley GP Dr Daniel Byrne, a former chair of the Royal Australian College of General Practitioners Chair for SA & NT said it has happened with him on multiple occasions recently and he knows of the same thing happening with colleagues.
“We are having to add the magic words – that he patient is in pain and there will be further damage and their quality of life is impaired unless they are seen,” he said.
“(Health Minister) Stephen Wade has been a good friend of GPs but now a bureaucrat is undoing that goodwill – they are basically saying the patient is not sick enough, that they have to get worse before they will be seen, which goes against normal care that prevention is better than cure.”
Dr Byrne stressed that GPs make considered decisions about making a referral.
“An elderly patient may say they don’t want surgery, that it too dangerous and they will live with the pain – we don’t write a referral for the fun of it,” he said.
“We know that outpatient departments have been told to crack down on accepting referrals, not just those for older people, because the waiting lists are out of control.”
Dr David Pope of the SA Salaried Medical Officers Association has also blamed long waiting lists for the push to reject some referrals.
However, Central Adelaide Local Health Network Medical Lead for Surgery, Professor Jane Andrews, rejected the notion that patients are being turned away based on age, saying it is instead about ensuring vulnerable people are not put on a waiting list for surgery which would be of no benefit and may instead prove fatal.
“Referrals from GPs, who know their patients best, need to include sufficient information so our specialists can accurately triage consumers to ensure no one is left without advice or care,” she said.
Prime Minister Scott Morrison told FIVEaa he hoped it was “a very carelessly worded memo.”
“Clinicians have to exercise their duty of care, regardless of a person’s age or their circumstances or anything like that,” Mr Morrison said. “I have no doubt … that’s what clinicians would do.
“It doesn’t matter where you are in Australia, what age you are, you deserve the best possible medical care and treatment and every single life is precious.”
Opposition health spokesman Chris Picton said: “All South Australians, regardless of age or their health, have a right to access high quality public health services. We need a health system that is putting people first.”