New push for GPs to certify glucose monitors

The parliamentary inquiry into diabetes offers a fresh opportunity to draw attention to the rules governing continuous glucose monitoring devices.

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GPs are meant to be the most accessible health professionals, and yet they’re not authorised to certify patients for continuous glucose monitoring devices.  

Including GPs in the authorised practitioner group is one of the recommendations the RACGP has made in its submission to the parliamentary inquiry into diabetes in Australia. 

Since The Medical Republic last checked on inquiry submissions almost a month ago, the list has almost doubled in size, reaching 446 submissions at time of writing.  

The inability for GPs to certify the forms required by patients to access subsidised CGM technology has been a thorn in the side of the college since the program was expanded to all Australians with type 1 diabetes in July 2022. 

Currently, only credentialled diabetes educators, endocrinologists, nurse practitioners, some specialist physicians and paediatricians are allowed to certify the forms. 

Previous president Adjunct Professor Karen Price even wrote to Department of Health and Aged Care deputy secretary Penny Shakespeare at the time, urging the government to recognise GPs as part of specialist teams managing diabetes. 

The position of organisations like the Australian Diabetes Society, the Australian Diabetes Educators Association and the National Diabetes Services Scheme at the time was that the field of diabetes technology was rapidly evolving and that authorised certifiers needed to be keeping abreast of changes.  

The RACGP continues to oppose any mandates for GPs to complete additional educational requirements to join the authorised group.  

Unlike the RACP, the GP college did not recommend the addition of any new MBS items for obesity management in primary care, but instead looked at a nationally coordinated plan for primary care to address obesity. 

Such a plan, it said, would need clear referral pathways to programs promoting behavioural changes and evidence-based weight management strategies.  

Funding for complex care in general practice – say, giving a 20% boost to consultations over 20 minutes – was also on the RACGP’s wish list.  

“There is no single curative intervention that will ‘fix’ diabetes,” the college said.  

“Addressing the broader impacts of diabetes requires a multifaceted approach, including public health interventions, policy changes, education, and support for individuals and families affected by the disease.  

“Reducing the burden and impact of diabetes will be strongly influenced by the routine systems in place to provide chronic disease care, which must have a focus on investment to develop and sustain a robust specialist GP and primary care system.” 

ACRRM, for its part, didn’t mention CGM certifications in its submission to the inquiry, but did talk about the need for increased investment in preventative care, especially given the escalating rates of potentially avoidable deaths relating to chronic disease in regional and remote areas.   

The rural college identified obesity management as a solid potential starting point for the introduction of block funding via MyMedicare. 

“In addition to realistic MBS patient rebates which reflect to cost of services in rural and remote areas, blended funding models would provide a funding source particularly for the management of chronic and complex diseases such as diabetes,” ACRRM said.  

“Funding should incentivise provision of care by a locally based practice and locally based practitioners able to provide in-person care as required, and support continuity of doctor-patient relationships.”