PSR Annual Report 2007-08

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Case descriptions

Decision to take no further action

Dr AB
General practitioner
New South Wales

Dr AB was previously referred to PSR in 2001 as Medicare Australia had held concerns about his high volume of daily services and his rendering of MBS item 23, 36, 37,3 444 and 475 services. No further action was taken, as a possibility existed that Medicare Australia’s referral to PSR may have been invalid.

In June 2007 Medicare Australia held further concerns about Dr AB’s rendering of services per patient and MBS item 11700,6 117127 and 117088 services.

Dr AB was in the 95th percentile for services per patient, in the 98th percentile for MBS item 11700, and the 99th percentile for MBS items 11708 and 11712.

The Director decided to review Dr AB’s provision of MBS item 23, 36, 37, 44, 11700 and 41764 services, and his prescribing of temazepam and nitrazepam during the review period.

From examination of the records, the Director considered that most services met the MBS requirements and he held no concerns about Dr AB’s prescribing of temazepam and nitrazepam during the review period. The Director noted, however, that in some cases entries in the medical records were illegible due to Dr AB’s poor handwriting.

Through discussions with Dr AB about Medicare Australia’s concerns the Director learned that Dr AB regularly attends conferences to maintain his continuing education; has a very low referral rate to specialists – he has, for example, an interest in cardiovascular conditions and performs electrocardiograms (ECGs), Holter monitors and exercise stress tests, thereby reducing the need to refer patients to specialists for these investigations; deals with his patients’ conditions in an in-depth manner; undertakes intensive investigations on behalf of patients; and provides follow-up care.

Although Dr AB’s medical records were full and detailed, his poor handwriting made assessment of some consultation items difficult. At the meeting the Director gave Dr AB the opportunity to read from some patient records his recording of the consultation. It became clear that Dr AB had undertaken these services appropriately.

It was the Director’s opinion that Dr AB was a competent doctor who needed to improve his handwriting. Dr AB was advised to improve his handwriting, as patient care could suffer if another practitioner needed to take care of his patients.

The Director considered that no further action was required and the matter was resolved under section 91 of the Health Insurance Act 1973.

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