How do you put up with this, doc? Red tape in medical practice

Red tape in medical practice“How do you put up with this, doc?” She looked at me while I was on the phone. We were waiting for almost ten minutes.

Every time she comes in we go through the same ritual: I ring the PBS Authority hotline, we wait, sometimes for a couple of minutes, and sometimes longer – like today. I always get approval, and then print off the script for her. In the meantime other patients are waiting in the waiting room or trying to get an appointment.

According to the AMA thirty per cent of medical practitioners reported spending ten minutes a day or longer waiting for calls to be answered. So here we are: we have a shortage of doctors and we make them jump through bureaucratic hoops instead of seeing patients.

An estimated 25,000 patient consultations are lost every month while doctors are making phone calls to the PBS Authority hotline. At the same time various reviews have shown that this procedure is unnecessary and does not lead to any savings.

I was very pleased to see the Australian Medical Association submission to the National Commision of Audit earlier this month. The AMA states in the introduction:

Though there has been some recent progress in reducing regulatory burdens in a few areas of medical practice, the amount of regulatory burden and red tape remains excessively high without any real justification. Internal AMA research shows that a large number of GPs spend up to nine hours or more each week meeting their red tape obligations. Every hour a GP spends doing paperwork equates to around four patients who are denied access to their doctor.

The submission focuses on six areas:

  1. PBS phone authorisations.
  2. Medicare provider numbers
  3. Medicare payments
  4. Personally Controlled Electronic Health Records (PCEHR) registration for medical practices
  5. Centrelink and Department of Veterans’ Affairs documentation requirements
  6. Chronic Disease Management items under the MBS

Although there are lots of other areas that need improvement, this seems like a good start.

6 thoughts on “How do you put up with this, doc? Red tape in medical practice

  1. So true. My ‘regular authority script patients’ know to just sit back and wait. A few weeks ago I was even given the message that they were so busy that I wasn’t able to talk to anyone at all. There were complex instructions for authority scripts for certain drugs, but if you wanted increased amounts (which I did), you had to ring back another day!

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  2. As an ex-PBS authority call line worker I hated having to take longer than was otherwise necessary to get an approval number out, my average handling time was just over 40 seconds (this average was including the odd 30min call from an oncologist and the stupendously long introduction/security checks). Then suddenly they had a freeze on recruitment; natural attrition took its toll and wait times steadily increased. This had the affect of making each and every call a very irate GP on the other end and the need to step away from the phone every now and then to cope.

    Hopefully they will push more and more conditions to the streamline system and increase the number of well trained staff on the phones, god knows that GPs have better things to do!

    (And from my own experience I bet the majority of the 2.8% of calls that dealt with rejected authorities were to do with the Champix/Zyban 12 month funding restrictions and nothing to do with clinical restrictions)

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    • Thanks Shane I always wondered what it was like to be on ‘the other side’. Fully agree with your suggestion re streamlined authorities as this will take away the need for doctors to make the call.

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      • The worst interaction I had with the authority line was when I was doing palliative care for a patient at home with a morphine syringe driver – They would not authorise the increased quantities of morphine for the patient (who died days later) despite my bets efforts to explain to thme that he was riddled with cancer and needed higher doses to control his pain. The supervisor came on and started quizzing me about what type of syringe driver I was using. When I asked her if she has ever actually seen a syringe driver she admitted to not having a clue what it looked like – she was basically just grandstanding and hoping I would go away. I finally got the authority and looked after him for the next 72h until he passed away

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