9 April 2024 / Sydney: Monday night’s episode of ABC Television’s Four Corners titled ‘Pain Factory’ profiled a number of patients living with chronic pain and a review undertaken by private companies that aired unverified allegations of the misuse of Medicare. There is a lack of transparency in the availability and interpretation of that data that alleged self-interest above patient interest. The ASA feels deeply for the patients who told their story in good faith.
Allegations of misuse of Medicare damage the reputation of the health care system and cause unnecessary concern for patients. These claims were investigated by the Health Minister last year and the subsequent report could not substantiate what was alleged [see link below].
Missing in the broadcast were details around the process by which Medicare and private health insurers can and do validate claims. Cross checking of times and consultations can be, and often are, audited by private health insurers and the Professional Services Review department of government. Patient records were the other missing link in completing the clinical picture in an effort to bring into disrepute a highly skilled, ethical, and patient focused specialty.
Some of the broad-brush claims made, not by the impacted patients, were inflammatory and try to bring into disrepute the work done by anaesthetists around Australia on a daily basis.
This highlights the importance of seeking input from bodies such as the ASA, where there are concerns, before going public with incomplete and potentially inaccurate information. For example, the quote of 87% of anaesthetists overstating time appears to be based on a gross misinterpretation of the Medicare items claimed for anaesthesia. The vast majority of the anaesthesia time claims are likely to be correct.
The ASA is actively involved with the government and private health insurers to ensure the integrity of systems which lead to the high-quality care and patient outcomes which anaesthetists provide. The ASA is part of a multi-agency incident reporting system that continues to be a world leader in the care provided by anaesthetists.
Where a patient raises concerns about the care provided – there are avenues through (at a local level) with the hospital or (at a national level) through Australian Health Practitioner Regulation Agency (AHPRA) available to have issues investigated and appropriately responded to.
The support the profession receives from all levels of government is testament to the hard work, dedication, and professionalism of the five thousand anaesthetists across the country. Federal Government Response to Medicare non-compliance and fraud costing Australians
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About the ASA:
Formed in 1934, the Australian Society of Anaesthetists is a not-for-profit member-funded organisation dedicated to supporting and connecting Australian anaesthetists in the provision of safe and high-quality care for patients. We work with and for our members to ensure the high standards of the profession that ultimately lead to public benefit.
