Case descriptions
Agreement entered into between Director and person under review
Dr G
General practitioner
Victoria
Medicare Australia asked the Director to review Dr G’s provision of MBS item 4520030 and 1422131 services, and deep wound repairs. Medicare Australia was also concerned with Dr G’s level of prescribing of drugs of dependence.
Dr G has been practising in Victoria as a solo practitioner for 32 years. During the review period Dr G provided 7143 services to 1641 patients for a total Medicare benefit of $252,065.60.
Medicare Australia statistics showed that Dr G provided MBS item 45200 on 23 occasions during the review period. Dr G considered this a receptionist clerical error as he had only performed this item twice.
The medical records Dr G provided for review consisted of a mixture of computer generated and handwritten notes. The Director raised no concerns about Dr G’s documenting of MBS item 14221.
However, while it appeared that Dr G used his computer to record the prescriptions written, little or no other details of other consultations were recorded. Many patients appeared to have been prescribed large doses of Valium, often in conjunction with other benzodiazepines or other psychoactive drugs. The notes did not contain Dr G’s rationale for prescribing such large doses of Valium to his patients. There was a lack of management planning and little evidence of counselling or active psychotherapy for patients receiving long-term benzodiazepines.
At the Director’s review meeting Dr G acknowledged that his note taking was grossly inadequate. Dr G said he was unaware that the need to keep adequate and contemporaneous notes had been a requirement since 1999. Dr G said that having to produce his records for PSR allowed him to see how bad his note taking was. He has now taken the necessary steps to improve his record keeping.
In his submission to the Director, Dr G acknowledged that he had erred in his clinical judgement in prescribing Panadeine Forte and tramadol. Dr G conceded that his peers might consider his prescribing under the PBS inappropriate due to his poor record keeping. Dr G further outlined the steps he has taken to address the Director’s concerns. He showed considerable insight into his behaviour during the review period and was remorseful.
The Director entered into a negotiated agreement with Dr G who agreed to be reprimanded by the Director and to repay $65,000 in Medicare benefits.
- 30 MBS item 45200 is for a skin flap repair of a defect in skin
- 31 MBS item 14221 is implanting a device for delivery of therapeutic agents