Sick-note change costing GPs $9m

The following is a front page article from the 2nd May 2008 Medical Observer, Business Magazine for GPs:

"Sick-note change costing GPs $9m"

GPs are missing out on at least $9 million in Medicare rebates annually as thousands of allied health professionals take full advantage of the WorkChoices 2006 legislation that permits tham to write medical certificates.

A recent Australian Physiotherapy Association (APA) survey of 800 of its privately practicing members revealed all were writing an average of one medical certificate a week. The association said the results could be extrapolated to represent 5500 physiotherapists, around half of their membership.

If each of these weekly consultations resulting in a medical certificate is calculated to be the equivalent to a GP standard Level B consultation, worth $32.80 on the MBS, an estimated $9.38 million could be being diverted from GPs each year by physiotherapists alone.

That figure is likely to soar even higher in coming months, with the Pharmacy Guild of Australia recently issuing guidelines on how pharmacists should go about writing such certificates. While no data has been collected, guild president Kos Sclavos said he was personally aware of pharmacists writing them for specific conditions, free of charge.

"One pharmacy has written 20 in the last month for hairdressers with head lice, while another pharmacy I know of writes certificates for food handlers with psoriasis," he said.

AMA Counsil of General Practice chair Dr Rod Pearce argued that the "validity, meaning and value of a medical certificate was enhanced" when it was written by a doctor.

He took umbrage to the terminology itself, and said certificates issued by allied health practitioners shoulder be called allied health certificates or sickness certificates, not "medical".

However, APA national manager for public policy Jonathon Kruger defended the practice and challenged the medical profession to demonstrate it was causing difficulties.

"I'd love to hear from any doctor who's had a problem with a physiotherapist writing a certificate. It highlights the falsehood by the AMA's statement that it would lead to problems - and it hasn't," he said.

"By allowing [allied health to issue certificates], it gives people more control over the healthcare."

The AMA has fought the introduction of the 2006 WorkChoices legislation on the basis that other health professionals did not have the necessary skills to diagnose an injury or condition within their scope of expertise.