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Update: Doctors, Pharmacies and Medical Imaging Initiatives

July 24, 2019 0 Comments

Our Doctor, Imaging and Pharmacy divisions are ramping up their efforts to support our existing and new clients in the new financial year. In this Update you will find out what key developments are impacting the industries.

Bulk Billing and Rural GP Vacancies, Australian Pharmacy Industry and New Medical Imaging Initiatives 

Bulk Billing Stats and Regional GP Challenges

How the Medical Imaging Industry Grew in 2019

The Power of the Pharmacy: How the Pharmacy Industry Serves Communities

 

Bulk Billing Stats and Regional GP Challenges

After years of the Medicare freeze, between the financial years starting in 2013 and finishing in 2018 the Department of Health’s quarterly and annual statistics have been compiled to see what the numbers seem to be suggesting.

Connecting the wrong statistics can lead to misleading information as is currently debated.

While there have been indications GP bulk billing has increased by 4% up to 2018, it is not the main indicator for the claim of ‘decreasing out-of-pocket expenses for patients’ for example. Some of the statistics need more context to understand what picture they are painting. In this case, the % increase relates more to the number of Bulk-billed items being indexed and not the number of GP consultations fully bulk billed without an out-of-pocket expense.

Measurements of out-of-pocket expenses have also been tracked by the Department of Health’s statistics and those have actually increased by 28% for a GP consultation and by 40% for a Specialist for the same period up to 2018.

This is a complex issue to put in perspective. Because of the Medicare rebate freeze there has been a lack of proper indexation of Medicare items to reflect with the inflation affecting patients. Decisions for indexation as a result were benchmarked against the wage price index instead of the consumer price index.

For metropolitan areas, medical centres operating with a mix of billings for their services could combat this ongoing issue by obviously charging higher out-of-pocket expenses. But that is certainly not the only solution for the time being. Owners could implement strategies to reduce their practice costs, expand the amount of onsite services offered to patients and in some cases also merge and work together with other practices to keep the expenses competitive for patients.

For regional areas this becomes a lot tougher to manage. Telehealth has been increasingly helping remote communities with access to doctors but only the Specialist consultations are eligible for a Medicare rebate and currently limited for the GPs.

Access to more onsite doctors for these regional communities is even tougher. They have been relying on a combination of factors such as hospitals, Flying doctors, Telehealth, local doctors as well as locums. And while some of the Rural Workforce Agencies are anticipating more locally trained doctors by 2022, the ideal scenario for doctors to work in regional cities is still far from perfect.

There is a large portion of overseas-trained doctors working in regional towns for their training and visas. But the conditions for these doctors to settle in permanently and provide the kind of continuity of care that is preferred are still not favourable.

Regional GP

Common issues we hear when speaking to doctors are:

Remuneration and relocation packages attractive enough for a locally trained doctor to stay or for an overseas trained doctor to relocate

Sometimes a doctor is born and raised in a specific part of Australia and has emotional ties to living and working there. But a lot of times, the metropolitan cities lure doctors away with a different kind of lifestyle. This makes it tough to keep doctors working in regional areas after their training or for doctors from other areas to relocate and settle down.

Favourable city amenities and community connections for a doctor’s family to settle in

For a lot of experienced doctors, the decisions about where to live and work also impact their families. If the doctor is happy with the work at a regional medical centre, but the family is not happy with their personal life in that particular city, then it will be hard to keep this doctor for the long term.

Supportive practice staff that can help a doctor to settle in

The staff working at your medical centre also play a valuable role in helping a doctor feel welcome and properly supported. For as many stories as we have heard of doctors clashing with onsite staff and wanting to leave, we have also heard as many stories of doctors absolutely loving their working environments and with no future plans of leaving to work somewhere else.

Network of doctors in the city or nearby that will allow for holiday and fatigue breaks

Having a hospital nearby, ties to the Flying Doctors service, or simply other doctors and nurses in town in different speciality areas can immensely help a doctor who is considering whether to settle down permanently. If a doctor must be on call for 24 hours for more than a week at a time due to a lack of other specialists in town, then this will impact their fatigue as well as a general happiness. It is crucial doctors are well-rested and coming back to the previous point of their families, an occasional holiday would also be nice to have.

New DPA and MMM location restrictions

These are the new changes to workforce shortage areas which were previously called DWS. The locations overseas-trained doctors with restrictions can work have changed around the metropolitan areas of Australia with the aim of encouraging more regional work.

Most likely if more overseas trained doctors joined and more local doctors were trained, there would still be challenges for fully accessible and affordable healthcare to all Australians including very remote areas. There are combining factors that need to collectively create favourable conditions for doctors to pursue their careers in suitable ways, both in regional and metropolitan areas.

Medical Imaging Maschine

How the Medical Imaging Industry Grew in 2019

It is estimated more than 9 million Australians use diagnostic imaging services each year. For a variety of reasons including X-rays, ultrasounds, mammograms, CT scans, echocardiograms and image guided procedures. We have talked to many skilled providers in recent months and have heard about the daily challenges and successes to provide all those services.

Looking back a year, we can see interesting advancements being announced and studies to push medical imaging to the future.

Last year, the Royal Women’s Hospital in Melbourne together with Monash University successfully managed to perform ultrasounds on premature born babies in the Newborn Intensive Care Unit and captured their first breaths ever. It was a special moment for the research scientists and doctors involved who wanted to find out whether the lungs of these babies functioned differently. More findings on this will come in the near future.

Diagnostic neuroimaging for patients with brain ailments had research and funding awarded by the Federal government and contributing partners to incorporate commercial uses for AI in the medical imaging industry. Artificial Intelligence could use accurate de-identified data to create algorithms and influence the treatments for individual patients. Guidelines will also be included to measure the extent to what AI can access and help us with so that it has its own place in the industry.

And speaking of having a place in the industry, more recently the Royal Australian and New Zealand College of Radiologists (RANZCR) published a clinical response with guidelines focused on improving the National Health Interoperability. The guidelines are published around aligning Radiology with the broader digital health sector and improving ways both sides work together in the healthcare industry.

Nursing home residents in parts of SA can also benefit from the recent introduction of Mobile Imaging X-Ray services. South Australia generally has busy ED departments and nursing homes in some areas are requiring the Ambulance service to assist with transferring patients to and from hospitals for X-rays.

The performance of this new initiative will be closely monitored in the coming months, as the benefits of this successfully rolling out will immensely help. The ED and Ambulance services will have pressures eased off them and the nursing home residents will have no out-of-pocket expenses and better access to X-ray services.

Looking at the year ahead, we aim to keep you updated on future findings and advancements. One particular area to keep a close eye on is the Medicare situation for diagnostic imaging. In the past year the government has provided over 50 more units across Australia providing access to state-of-the-art technology in MRI and PET scans. From next year it also aims to index diagnostic radiology and x-ray up to 92% of diagnostic imaging, providing affordable access to bulk billing and reduced out of pocket expenses for a wide range of patients.

While this change is not anticipated until mid-2020, it will be good to start planning ahead in case it leads to any drastic changes to your current role.

man in a medical imaging x-ray

To summarise, here are the key points of growth in Imaging:

More than 9 Million Australians use diagnostic imaging services yearly

All of us will have various reasons to need access to imaging services. Some of the most common reasons include X-rays, Ultrasounds, Mammograms, Scans and Echocardiograms.

Ultrasound has been used to capture the first breaths of premature babies

In Melbourne they have successfully caught the first breaths ever of premature babies using ultrasounds, a great step forward in research to understand the breathing patterns of these babies.

Research and funding have been introduced for Artificial Intelligence (AI) in medical imaging

Diagnostic neuroimaging has research, funding and newly written guidelines to support the use of Artificial Intelligence to a help with patients that have brain ailments.

RANZCR released clinical guidelines in radiology to better align it with the digital health sector

These guidelines have been introduced by the College (RANZCR) to shed light on areas radiology can work closely together with digital health sector.

Nursing homes in parts of SA have had Mobile X-Ray services introduced

New mobile X-ray services in parts of South Australia have been introduced for nursing homes, reducing the need for out-of-pocket expenses for the patients and easing the pressure for the local Ambulance services.

50 more units for MRI and PET scans were provided by the government with future indexation announced on the Medicare Benefits Scheme

The Federal government invested in new units for state-of-the-art Scans across Australia and has announced Medicare indexation for a majority of Radiology and X-ray services.

Pharmacist

The Power of the Pharmacy: How the Pharmacy Industry Serves Communities

Community Pharmacies across Australia are estimated to be a network of 5,700 operating within self-protecting set of rules. It is a complex system that creates protective measures for its framework.

The rules can be complicated to say the least. Unlike the pharmaceutical industry and some of its unethical problems in recent history that we have previously mentioned.

Just the tip of the iceberg here – one of the basic rules is that only registered pharmacists can own a pharmacy, which has excluded bigger companies like Coles and Woolworths for years.

But pharmacies are also protected from each other with location rules. A new pharmacy in a larger urban area must be opened more than 1.5 kilometres away from an existing pharmacy. Adding to that, if the new pharmacy is located 500 metres nearby a small supermarket then there must also be a full-time prescribing medical practitioner in the same area. Not to be confused though, if you are within 500 metres of a larger supermarket, then you do not need to be nearby a doctor.

Would this always be considered fair to their customers? Certainly, the network is enabling access to medicines in many parts of Australia.

Recently even over the counter pill-testing kits in the wake of festival controversies in some parts of NSW. But there is also research that Australia is paying much more for some drugs than other countries like the UK and their framework.

Due to the large number of people the network of pharmacies can reach daily across the country, it is an enviable framework for those who are looking from the outside in.

And as someone similar like that, Chemist Warehouse group told the 2016 Harper review they had nearly 400 wholly owned and franchised stores as well as a successful online operation. They told Harper at the time they were Australia’s 13th largest retailer by turnover. With over 10,000 staff their then sales clocked in at $2.7 billion. That was around 20% of total retail pharmacy sales under the Pharmaceutical Benefits Scheme at the time.

That was years ago, but an indication of the state of where things were and how far things have come for a group which ruffled feathers within the pharmacy industry. And after that those numbers have been on the decline with the Australian Securities and Investments Commission seeing dwindling profits lodged in the financial statements.

Earlier this year it was reported local Brisbane pharmacies were banding together against the influences of Chemist Warehouse and create favourable conditions for themselves in terms of pricing to their customers. A move that had increasingly become a viable one for them and worth exploring.

In Southeast Melbourne a pharmacy owner tried to fight against a 24 hour pharmacy opening attached with a medical centre. They argued the 500 metres location rule and still had to push for a follow up decision. That was another example in recent times to consider looking into.

While being a self-protective framework it does allow for these scenarios to happen. In the UK, only at the end of last year did the General Pharmaceutical Council (GPhC) gain the legal power to conduct covert surveillance of pharmacists and combat illegally sold controlled drugs. The interests of the members should be protected as should every member aim to participate in the best possible ways.

In extreme cases of public health and safety pharmacies have the power to contribute directly to their customers. Like in this US example, New Jersey pharmacies helped combat opioid overdoses by handing out free reversal medication.

To summarise, the impact of pharmacies can be huge:

Accessibility and pricing of medications

Where and how remote are the communities that pharmacies can reach across Australia and how affordable can the medications be.

Location to customers and each other

Where and what are the best locations for pharmacies to reach their customers without having to directly compete with each other.

Proper handling and knowledge of medications

What qualified staff is working at the pharmacy in not just safely handling the medications but also appropriately prescribing it to customers.

Public health and safety impact and communication

Hot topic issues pharmacies can educate their customers about and provide relevant services for when necessary.

Self-protective framework and catching the wrongdoers

The pharmacy industry can protect each other from outside influences but also punish any unethical behaviour.

For medical centres, it can be advantageous to be located with or nearby a pharmacy. The business side complements well with being able to help each other’s customers. We have also seen this from our side in recruitment, with some of our busiest and hard-working clients working together with the nearby pharmacy.

Gorilla Jobs can assist you with exploring a variety of job opportunities across our vast network of clients looking for qualified staff. Our experienced consultants in the Doctor, Imaging and Pharmacy divisions look forward to helping you. 

Speak to one of our Senior Consultants today and find out what career and recruitment advice will help you to navigate through the positions available and which ones are most suited to your situation.

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