Christmas ‘kickbacks’?

Are Christmas functions now ‘kickbacks’? The Health Insurance Amendment (Inappropriate and Prohibited Practices and Other Measures) Act 2007 was enacted March 2008, prompting WA providers to examine their festive season arrangements. The bill blocks coercion of someone, or the offer of or request for gifts, goods, services, or rentals that are an inducement for business with a pathology or imaging provider. Nicola Roxon’s additional determinations for permitted benefits seemed to go easy on “Hospitality given for Christmas parties” provided the hospitality is “not given as inducement, consideration, or reward for the beneficiary requesting services from a particular provider”. SKG Radiology’s iconic Matilda Bay foreshore Christmas function has been the first victim of the legislation. With around 7000 referrers on their books, the function was for those most loyal, but the HIC says no more – SKG invitations cannot be related to the value of referral business. Perth Radiological Clinic has never had a Christmas function. Clinipath’s function will continue as usual at Mead’s and General Pathology has a bigger do at Freshwater Bay Yacht Club. Neither Western Diagnostics nor Perth Medical Laboratories hold festive season functions for referring doctors.

GPs losing turf war

In the latest development in the primary care turf war, nurse practitioners are actively wresting control of several routine GP tasks with the opening of Australia’s first nurse-staff retail health clinic. The clinic, opened in November at Booragoon, is the first of twenty that the Revive Group plans for shopping centres around the country. It operates seven days a week, without the need for appointments. Nurses are providing treatments for infections and immunisations, although complex cases are being referred to GPs. Revive Group said its retail health clinics would not replace GP practices but would handle some of the simpler medical procedures to allow doctors to focus on more complex problems. Sound familiar? Reality has finally caught up with the anti-GP rhetoric. Patients seen at the new clinic do not receive Medicare or PBS rebates, but with Nicola Roxon’s stance and the impending review of primary health care funding, this could well change. AMA Federal President Dr Rosanna Capolingua already sees the writing on the wall, saying, “if the government cuts doctors’ rebates to fund these services, we’ll end up with two tiers where only those who can afford it will see a doctor and the rest will see a nurse.”

Just super

As of last month – more than a year since the Labor government took the reins of federal power – only two GP Super Clinics (both in Victoria) had been allocated funding. State Health Minister Kim Hames’ office has confirmed that the WA government would match the federal’s $5m funding commitment, but with sites at Midland and Wanneroo not even picked, let along sod being turned, it could be a long time before the clinic sees the light of day. Dr Alistair Vickery, chair of the Osborne GP Network, has lamented the lack of local GP consultation and believes the Super Clinic will cause GPs to leave the Wanneroo area. He said, “without consultation and collaboration, it would appear that the Wanneroo GP Super Clinic is unlikely to have GPs in it or be ‘super’ – but it may well be a clinic.”

Lonely deaths

Emergency medicine specialists at UWA, A/Prof Daniel Fatovich and A/Prof Ian Jacobs, have concluded a study that found the death rate from trauma in very remote areas of WA is more than four times the death rate in major cities. Almost 5,000 trauma deaths occurred in the study period – 1997 to 2006 – of which 72% were males. The average age at death was 43. People who died in more remote areas tended to be younger than those who died in cities, with transport accidents were the leading cause of trauma death in the bush and self-harm the leading cause of urban deaths, with hanging the most common method.

Understanding the shortfall

Queensland researchers, in partnership with the RACGP, are conducting the Doctors’ e-cohort Study, a longitudinal study that will examine patterns of recruitment and retention (especially the maldistribution) in the doctor workforce nationwide. Job retention rates and the safety and quality of medical practice are influenced by many factors, including the mental and physical health, gender, and varying motivations and expectations of different generations of graduates. The study plans to explore all of these variables, and with the current medico shortfall, the results could make fascinating reading. More information can be found at

A diet fad low

Diet fads have reached a dangerous new low. Diabetes Australia’s report Insulin Misuse for Weight Loss has shown that 1 in 3 Australian type-1 diabetes patients have confessed to skipping or manipulating their insulin for weight control. It was found that 48.5% of those who skip their insulin intake did so daily, while 28.5% did so weekly.

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