After hours marketing blitz ahead of ban

4 minute read

General practice Government

By

Julie Lambert

After-hours home-doctor services are reportedly staging last-ditch marketing blitzes before a ban on direct advertising to consumers takes effect

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.

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Anchita karmakar
Anchita karmakar
6 years ago

Does this mean all the non vr drs subjected to this nonsence by people like NHDS are recognised to have been profoundly misled by them by the government?

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Maggie
Maggie
6 years ago

I can see major problems here. “will only be permitted to see the patients of GPs that have a written contract with the MDS”. Firstly how does the MDS know whether the person calling is a patient of a certain GP? Secondly what about patients without a local GP particularly travellers and people new to the area? For many years I worked in a local collective after hours service (as well as being a practice principal and working full time) I estimate that up to 50% of the patients seen were “waifs and strays” with a genuine need for after hours medical care. I found that I (or my general practice staff) spent almost as much time following these patients up (checking results etc.) as I did actually seeing them. They are also setting the bar high for eligibility to work in an after hours service. “at least two years’ post-graduate experience that includes paediatrics, accident and emergency medicine, surgery and general practice” The general practice criteria might be impossible to gain unless the PGPPP program is re-introduced – this however only ever covered small numbers of interns and residents. I will be very happy to see the end of the aggressive marketing which in our area really pushes the “convenience” and the fact that all visits are “free”.

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Lou Lewis
Lou Lewis
6 years ago

I am a solo GP of nearly 40 years experience and the last thing I ever want to do is after-hours house calls.
That having been said I welcomed the ‘free’ ( to the doctor) after hours medical deputising services. I had absolutely no idea that there was such a disparity between VR, non-VR, interns, GPs etc when doing these after hours home visits.
On a more serious topic is the one that seems to have brought the undoing of a lot of these AHMDS, namely the abuse of the ‘urgent’ AHs item numbers. Obviously when I receive a report from one of these MDS on a patient, they are usually for kids who got sick in the middle of the night, usually either with high fevers or ear aches, and treatment or advice administered to these patients has, in my opinion, been appropriate and the usual advice is to follow-up with the GP as soon as is practicable. I don’t know if these people are billed as urgent or nonurgent or whether the doctor saw them was VR or non-VR: all I care was that they received the appropriate management and I was not called in the middle of the night, comfortable in the knowledge that my patients needs were being met.
Unfortunately too many doctors are under the impression that if these MDS no longer exist somehow government will put the massive saving of money into the hands of the GPs. These same doctors must also believe in the tooth fairy!
Of course there are shoddy advertising tactics done by certain MDS and these are what the government is currently addressing, but I certainly do not want to see a return to the old ways when we had to pay hundreds of dollars per annum to these MDS just to register our ( in my case, a solo practice) practices with them.
And let’s be realistic: how many doctors, especially say aged 60 or over, would feel like having their sleep broken, getting dressed, driving in the middle of the night, to see the patient with , for example, a sore ear, and be expected to have in their doctors bag, antibiotics and ear drops ! , and then getting paid a lousy $130 for what in reality is a two hour trip from waking up eventually getting back to bed.
And mind you, I am talking about a non-rural practice. God, I would hate to get up in the middle of the night in, for example midwinter, in a cold country town like Orange and drive in foggy conditions and hazards such as kangaroos on the road. Such GPs would in my opinion deserve at least $300 a home visit .
As you can see I am ambivalent with regards to my opinion on the after hours MDS, but the government should not send them broke and at the same time be more realistic in its item number remuneration.
Cheers
Lou

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