This week, hundreds of GPs will receive a warning letter from the federal Department of Health about Medicare claims related to care provided to patients with a mental health condition.
An unintended consequence of this latest departmental campaign – in which some GPs apparently will be asked to pay back Medicare money – will be a lower standard of care for people living with a mental health illness.
The problem appears to be coming from this MBS note:
“If a consultation is for the purpose of a GP Mental Health Treatment Plan, Review or Consultation item, a separate and additional consultation should not be undertaken in conjunction with the mental health consultation, unless it is clinically indicated that a separate problem must be treated immediately.
In other words, if someone goes to the doctor for a mental health issue, GPs are not supposed to claim for general health or wellbeing services provided on the same day (unless it is urgent or an emergency).
In my book, it is unethical to deny treatment of co-morbid health concerns because someone has a mental health condition. It also goes against the latest thinking around the benefits of optimising general wellbeing to improve mental health.
Mental health services across Australia are increasingly focusing on lifestyle and preventive physical health because of strong evidence that this assists their clients’ mental health – but at the same time GPs are not allowed to charge for doing just this.
“Evidence-based and effective lifestyle therapies are indicated for people with mental illness in addition, or as an alternative, to usual care. Strong evidence shows that lifestyle interventions, such as nutrition, movement, sleep, stress management and substance cessation, are efficacious and cost-effective therapies that improve mental health, physical health and quality of life.” Source: Australian Journal of General Practice.
Don’t forget the 10-20 years shorter life expectancy of people living with a chronic mental health condition.
If the GPs, targeted by the department for claiming mental and other health items on the same day, were taking the appropriate time to provide genuine care, they should receive recognition for outstanding services instead of a being treated like racketeers.