After-hours home-doctor services are not going down quietly, with some businesses reportedly staging last-ditch marketing blitzes before a ban on direct advertising to consumers takes effect next month.
The government this week revealed new rules for medical deputising services (MDS) that provide home visits, including a ban on direct advertising. Those that do not comply run the risk of losing accreditation and their ability to employ non-vocationally registered doctors.
Coinciding with the crackdown, AHPRA has released a new self-assessment tool for all health services to check their advertising and ensure it was compliant.
RACGP President Dr Bastian Seidel welcomed the ban on direct marketing by MDSs, saying the practice had become “inappropriate and unacceptable”.
“Advertising and marketing campaigns that unnecessarily divert patients from daytime general practice into the after-hours period represent a pathway to fragmented care and potentially poorer outcomes for patients,” Dr Seidel said.
“Banning direct-to-consumer advertising in this sector is a common-sense decision that has been made in the best interest of Australian patients.”
The after-hours sector has grown rapidly in the space of six years, fuelled in part by aggressive marketing tactics that emphasised the convenience for patients and “free” bulk-billed services, at considerable cost to Medicare.
Under the government’s revised Approved Medical Deputising Service (AMDS) Program, an after-hours service will only be permitted to see the patients of GPs that have a written contract with the MDS.
In another key restriction, after-hours services will have to submit triage plans to the Department of Health and undertake to refer patients back to GPs for routine care that is outside the MDS scope.
The after-hours sector has grown rapidly in the space of six years, fuelled in part by aggressive marketing tactics that emphasised their convenience for patients and “free” services at considerable cost to Medicare.
Dr Nathan Pinskier, president of the GP Deputising Association, which represents seven after-hours providers, said the changes were well-flagged by government and the response among members was “broadly very supportive”.
The obligation to work with regular general daytime general practices would bring after-hours services closer to the traditional model, he said.
The GPDA was meeting today to examine the new guidelines and ensure there were no “unintended consequences”, he said.
The association, which broke away from a larger group led by industry giant National Home Doctor Service, would seek clarification on a rule concerning the need for on-site call centres.
The Medical Republic has been told that patients in Western Australia, Tasmania and other states have been targeted with stepped-up letter-box campaigns and SMS messages from after-hours medical service providers since the new guidelines were revealed on Monday.
The guidelines say the purpose of the AMDS program is to offer medical practitioners the opportunity to gain general practice experience in the after-hours setting by allowing them to work in supervised deputised positions.
By allowing non-VR doctors access to MBS items, the program significantly increases the eligible workforce for after-hours clinics and home visits.
The program provides this opportunity “on the basis that they are consulting patients at the request of their normal general practitioner” and that the MDS provides the service for the entire after-hours period.
Participating doctors must demonstrate that they are working towards fellowship of the RACGP or ACRRM and will become a VR GP within six years, the maximum time they can work on the program.
They must also have at least two years’ post-graduate experience that includes paediatrics, accident and emergency medicine, surgery and general practice. Temporary residents are eligible.
Service providers must be “stand-alone” operations with an on-site communications centre to take patients’ calls – a rule designed to block “virtual” practices.
An MDS will be obligated to return patient reports to the practice principal within 24 hours.
The ban on direct marketing to patients includes text and SMS messaging, emails, online advertising, social media advertising, database marketing, fliers, catalogue distribution, promotional letters or events, newspaper and magazine advertisements, targeted television and outdoor advertising.