In the first week of January, I was sick with COVID-19. Like really sick. My persistent chest pain was starting to freak me out so, not able to enter a GP office and not wanting to clog up a hospital, I tried to make a telehealth appointment.
My regular bulk-billed GP clinic was closed for the holidays all week. So I called another clinic nearby with available slots.
When the receptionist discovered I had not been to the clinic in person within the last 12 months, he told me I was ineligible for telehealth. The five other practices I called all relayed the same message.
Patients are only eligible for GP telehealth services if they have had a face-to-face appointment with that telehealth provider in the 12 months prior.
This means it’s almost impossible for people without a regular GP, people who can’t get appointments at their regular GP, or people who haven’t seen a GP face-to-face during the pandemic to access remote healthcare.
And for immunocompromised people who would risk catching COVID, or those who may have to travel from regional areas, going into a clinic is often not an option.
I was told my only option for free healthcare was to go to hospital. Quite an odd suggestion, considering that would risk spreading COVID to the staff and patients around me — the exact opposite intent of the telehealth concept.
The Medicare-subsidised telehealth program proved a raging success during the pandemic and became a fixture in Australia’s healthcare system in December 2021.
The aim of subsidising telehealth when the pandemic hit was to help and encourage people to access healthcare from home, without risking catching or spreading the virus.
“It came about because of the pandemic, but it has changed the way Australians can access healthcare,” Federal Health Minister Greg Hunt said in December.
More than 86 million telehealth consultations through 89,000 providers were conducted between March 2020 and the end of 2021, but the program is still unnecessarily forcing some people into clinics.
The president of the Royal Australian College of General Practitioners Dr Karen Price wrote an open letter to the Department of Health on Thursday and called for changes to the telehealth compliance rule.
“An exemption from the existing relationship rule for immunocompromised GPs and GPs in isolation for patients known to the practice [eg patients who have been to the practice within the last 24 months] would increase workforce capacity at this critical time,” the letter read.
She emphasised the 12-month rule was impacting immunocompromised people, both patients and doctors. And with the risk of COVID-19 transmission so high since the emergence of Omicron, Price said it was “not pragmatic” for immunocompromised GPs and those in isolation, particularly given the demand for care.
“While the number of immunocompromised GPs or those caring for immunocompromised families is low, the current demand for general practice care is unprecedented, requiring flexibility of rules that were established at a time when the impact of the COVID-19 pandemic was unknown,” Price said.
“Two years into the pandemic, it’s become apparent that this rule doesn’t always work as intended.”
The 12-month rule was put in place in July 2020 to prevent opportunistic “dial-a-doc” practices emerging just to provide the highest number of short appointments as possible in order to capitalise on the Medicare subsidies, Price’s letter explained, but she wrote the program needed more commonsense and flexibility.
So far in 2022 telehealth has represented about 30 per cent of GP services compared with 23 per cent in 2021, suggesting it’s working pretty well for a lot of people.
But with COVID-19 still very much a presence in NSW and Vic in particular, immunocompromised people should not have to risk infection and serious illness every time they need a check-up or a script renewed. No one should be forced to go into a clinic when the telehealth program exists.
After my trip to hospital, I later found out that there was an exemption to the 12-month rule for people with COVID after a doctor friend-of-a-friend passed the information on. But not one receptionist at the half-a-dozen clinics I spoke to knew the exemption existed — somewhere in the massive exemption document.
“We should be doing all we can to maximise our capacity to see patients via telehealth,” Price said.
“Let’s provide an exemption from the 12-month rule and let common sense prevail.”
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