Why do GPs fear the PSR?

Dr Linda Calabresi

writer

Dr Linda Calabresi

GP; Medical Editor, Healthed

Claim CPD for this activity

Educational Activities (EA)
0 minutes

These are activities that expand general practice knowledge, skills and attitudes, related to your scope of practice.

Reviewing Performance (RP)
0 minutes

These are activities that require reflection on feedback about your work.

Measuring Outcomes (MO)
0 minutes

These are activities that use your work data to ensure quality results.

EA
0 minutes

These are activities that expand general practice knowledge, skills and attitudes, related to your scope of practice.

RP
0 minutes

These are activities that require reflection on feedback about your work.

MO
0 minutes

These are activities that use your work data to ensure quality results.

Dr Linda Calabresi

 

Receiving a personalised message from the PSR will not be any GP’s idea of a good way to start the day.

The regulatory body whose total existence is to ensure health professionals aren’t misappropriating Medicare do not generally make social calls. Contact almost always means trouble.

Since the PSR was first established in 1994, very few doctors have been prosecuted for intentionally ripping the system off. The vast majority of GPs have totally appropriate billing practices.

But despite this, contact from the PSR is likely to cause anxiety and fear among Australian GPs. A recent Healthed survey of over 1200 GPs showed that just over one in eight GPs (13%) had ever received a communication from the PSR about billing.

However, over 80% of GPs said they would feel anxious if they were to receive such a message, with 36% rating this anxiety as moderately severe or severe. Moreover, 47% of GPs think that fear of the PSR has a negative effect on their ability to deliver good quality care.

The major issue is, of course, confusion exists about exactly where the boundaries are set for appropriate billing and what is viewed as overservicing. The Healthed survey also asked if doctors felt they had a good idea on what the PSR had set as the limits for servicing for items such as telehealth for example. Less than one third of GPs (32.75%) said yes.

GPs are not generally known to be risk-takers.

Given this and the fact that there is widespread uncertainty as to when a billing practice will trigger the attention of the Medicare watchdog, it will come as little surprise that more than three-quarters of the GPs surveyed said they would err on the side of caution and not bill some Medicare item numbers just to be safe. In fact, almost a quarter (23.67%) said they did this regularly.

No doubt this will be seen as a win by the PSR authorities who view saving Medicare money as one of their goals, but it is hardly fair if GPs are not receiving the remuneration to which they are rightly entitled.

Overall, only 15.5% of GPs surveyed believed the PSR was both effective and necessary. The most popular opinion among GPs (44%) was that the PSR was effective but caused a lot of unnecessary harm. And just over a quarter of GPs (27.8%) believed the PSR was ineffective and counterproductive to the health of doctors and their patients. A pretty damning appraisal.

Icon 2

NEXT LIVE Webcast

:
Days
:
Hours
:
Minutes
Seconds
Expert panel - A/Prof Samantha Hocking, Prof John Dixon, facilitated by A/Prof Ralph Audehm

Expert panel - A/Prof Samantha Hocking, Prof John Dixon, facilitated by A/Prof Ralph Audehm

GLP-1 Prescribing Expert Panel Discussion

Prof Rukshen Weerasooriya

Prof Rukshen Weerasooriya

Arrhythmia Management in Primary Care

Dr Rupert Hinds

Dr Rupert Hinds

Infant Allergy Cases

Join us for the next free webcast for GPs and healthcare professionals

High quality lectures delivered by leading independent experts

Share this

Share this

Dr Linda Calabresi

writer

Dr Linda Calabresi

GP; Medical Editor, Healthed

Test your knowledge

Recent articles

Latest GP poll

In general, do you support allowing non-GPs to refer to specialists in certain situations?

Yes, if the referral process involves meaningful collaboration with GPs

0%

Yes

0%

No

0%

Recent podcasts

Listen to expert interviews.
Click to open in a new tab

Find your area of interest

Once you confirm you’ve read this article you can complete a Patient Case Review to earn 0.5 hours CPD in the Reviewing Performance (RP) category.

Select ‘Confirm & learn‘ when you have read this article in its entirety and you will be taken to begin your Patient Case Review.