GPs anxious over Medicare watchdog

A REVOLT appears to be growing among GPs unhappy at the tactics of the Medicare watchdog that investigates allegations of overservicing

A REVOLT appears to be growing among GPs unhappy at the tactics of the Medicare watchdog that investigates allegations of overservicing.

A poll of doctors has found 90 per cent have no confidence the agency will deliver natural justice.

The Professional Services Review investigates doctors referred to it by Medicare Australia to find out if their claiming patterns -- such as unusually high rates of longer consultations, which qualify for higher Medicare rebates -- are justifiable.

But there appears to be growing anxiety among GPs about the PSR's approach, with some questioning an apparent contradiction in federal government encouragement both of longer consultations for patients with chronic disease and of a more vigilant Medicare auditing process.

Last week a study in the Medical Journal of Australia found the rate of longer consultations fell by between 21 and 30 per cent between 2004 and 2009.

The government had previously attributed the drop to the introduction of other Medicare rebates specifically aimed at chronic disease patients, saying this category took up cases which might otherwise have been made as longer consultations.

The journal found this did not hold water after 2007.

The paper said "audit anxiety" had also been proposed as partly explaining the drop.

The new poll, incorporating responses from over 200 GPs who responded to questions in newsletters and a medical website, found only 2.9 per cent had confidence the PSR would "provide natural justice", while 85.5 per cent said they had no confidence in the agency's director, Tony Webber. Asked if they were confident they would pass a compliance test if they were audited by the PSR, 55 per cent said they were not, and a further 31 per cent said they were unsure.

Caloundra GP Scott Masters said the findings were "an indication of the uneasiness out there" and changes were needed.

"There are three big problems: the Medicare Benefits Schedule needs to be simplified, there needs to be a much clearer audit process that delivers natural justice, and it needs to be sorted out because there's evidence rural doctors are not working as hard as they might because they are worried about being audited."

Dr Webber said the fears of the PSR were being overblown and the chances of any doctor being investigated were "quite remote", with less than 0.1 per cent being audited each year.

"Doctors' fears about being investigated by the PSR are quite unfounded in reality," Dr Webber said.

"Doctors who make use of Medicare are required to play by the rules -- the rules are not always easy to interpret, and I have a certain degree of understanding for that.

"But the vast majority of their colleagues get it right and never come anywhere near the PSR or an audit process -- we see people at the extreme end."

Dr Webber rejected the claim the PSR process denied natural justice, saying doctors had ample opportunity to express their views and court challenges to the agency's approach had repeatedly failed.