Case descriptions
Agreement entered into between Director and person under review
Dr R
General practitioner
New South Wales
PSR reviewed Dr R’s behaviour, as Medicare Australia was concerned with his prescribing of benzodiazepines; he was in the 97th percentile.
Dr R produced samples of his medical records for review. The records examined in relation to MBS item 36 services were found to be brief and lacking in clinical detail. The notes lacked sufficient evidence about complexity levels, detailed history, examination of multiple systems and management planning to justify the item claimed. Notes recorded simple presentation and did not support the consultation lasting more than 20 minutes.
Dr R’s prescribing of diazepam was considered inappropriate. The Director held concerns about the other addictive medications also being prescribed to some patients. There appeared to be a lack of management planning, with little evidence of counselling recorded in the notes for patients receiving long-term benzodiazepine. Notes for many consultations for these patients only recorded prescriptions written.
As part of his review the Director met with Dr R to discuss his concerns. Dr R is a general practitioner who has worked in rural New South Wales since 1971. Dr R provides regular nursing home and home visits.
Dr R advised that during the review period he had merged his solo practice with a local medical centre. The merger had involved a variety of significant changes to his practice and as a consequence his note taking had suffered. Dr R assured the Director that he had taken steps to reduce his prescribing of benzodiazepine.
The Director considered this matter was appropriate to resolve by negotiated agreement. Dr R agreed to be reprimanded by the Director and to repay $17,908 in Medicare benefits.