Geir O ’ Rourke THE federal Minister for Health says he is “ disappointed ” by the RACGP ’ s exhortation to GPs to abandon universal bulk-billing , saying it ignores his government ’ s investments in health funding .

In an unprecedented move , college president Dr Karen Price urged doctors to privately bill “ as many people as possible ” in a speech at the college ’ s annual general meeting last month .

“ The problem that we have is that we are bulk-billing 90 % of services ,” she said .

“ As far as the government is concerned , the electorate is happy , and that means they don ’ t need to move . “ This is why , as a college , I am exhorting everybody , including my own practice , to move as many people as you can onto private billing .”

But a spokesperson for Greg Hunt said : “ As always , our goal is to put the patient first .

“ It ’ s disappointing that the college doesn ’ t wish to acknowledge the investments from this government during this term .”

This included the indexation of Medicare rebates , the lifting of rural bulk-billing incentives as well as funding for telehealth , the spokesperson said .

“ The introduction of telehealth has revolutionised Australian

healthcare , giving patients more access and choice , as well as providing GPs greater flexibility to see their patients .”

Dr Price ’ s comments came on the back of the government ’ s latest funding plan for GPs now bracing for an upsurge in COVID-19 cases as lockdown restrictions end .

Intended to cover the costs of additional PPE to keep staff safe , doctors can now claim a rebate of $ 25 for treating patients diagnosed with COVID-19 face to face at home , in aged care or at their practice .

But former AMA president Dr Mukesh Haikerwal described the sum as an insult when it was first

College president Dr Karen

Price .

announced .

“ GPs are worried about COVID-19 , but it has just got scarier because Greg Hunt has told millions of people they can visit a general practice if they test positive ,” he said .

“ You could add a zero , make it $ 250 , and I still think it wouldn ’ t be enough for many .”

‘ If the government isn ’ t going to reward GPs … then we need to look for other sources of funding .’

Dr Price acknowledged there was widespread dissatisfaction among GPs with the rebate , particularly given federally funded respiratory clinics were receiving some $ 120 per patient encounter .

Dr Price argued a new strategy for bulk-billing was needed to protect the viability of general practice , particularly given the financial damage wreaked on the specialty by the fouryear

Medicare freeze and the new pressures of the pandemic .

“ The Treasury is saying there is an intergenerational debt coming . We ’ re constantly hearing this kind of language around constraint ,” she said in her speech .

“ But in terms of trying to get funding into general practice , there are only so many avenues .”

“ If the government isn ’ t going to reward GPs as we feel we deserve , then we need to go and look for other sources of funding .”

Heather Saxena A GP has lost his legal battle to stop his practice ’ s medical records being handed to the police after he was accused of writing fake medical exemptions for anti-vaxxers .

Dr Mark Hobart , a vocal opponent of social lockdowns who has promoted ivermectin as a treatment for COVID-19 , has been championed by activists opposed to vaccine mandates .

Last month , officers from the Victorian Department of Health raided his Melbourne practice , seizing an undisclosed number of patient records .

A week later , he fronted the Supreme Court of Victoria asking for an interim injunction to ban the department from sharing them with AHPRA , the police and other regulatory bodies .

His lawyer said the raid , conducted under the state ’ s Public Health and Wellbeing Act , was illegal because the records were seized without a court warrant .

The department argued it needed to investigate claims Dr Hobart had issued fake vaccine exemptions because they would allow unvaccinated people to enter prohibited workplaces and venues and spread COVID-19 .

It launched an investigation into Dr Hobart after an anonymous tip-off that multiple employees at one workplace had presented

exemptions he had allegedly signed suggesting they couldn ’ t be vaccinated because of serious acute medical conditions .

Contraindications to vaccination were extremely rare and usually life-threatening , it said , meaning several vaccine exemptions by the same doctor in a single workplace were “ unlikely to be valid ”.

In refusing Dr Hobart the interim injunction , Justice Stephen O ’ Meara said the law showed the department could act when it believed

‘ It ’ s the sort of behaviour that would only occur in a dictatorship .’

there may be an immediate risk to public health or if it needed to investigate that risk .

Before the case , Dr Hobart said both AHPRA and the Victorian Government were attempting to “ shut me and remove me as a doctor ” because of his criticisms of the lockdowns and his promotion of alternative COVID-19 treatments .

“ As far as I ’ m aware , this has never happened before in Victoria . It ’ s the sort of behaviour that would only occur in a dictatorship ,” he added . ” Yet it ’ s happening here in Victoria right under our noses .”

Kemal Atlay PLATELET-RICH plasma injections for knee osteoarthritis provide no improvement in pain relief or reduction in disease progression compared with placebo , an Australian study shows .

The findings add to growing evidence against the use of autologous blood products to treat musculoskeletal conditions , the researchers say . Intra-articular injections of platelet-rich plasma ( PRP ) can cost up to $ 500 per shot and have been touted as an alternative to pharmacological and surgical interventions for joint pain .

But lead researcher Professor Kim Bennell , from the University of Melbourne , said there was a dearth of high-quality evidence to back

this indication .

“ Our results do not support the use of PRP for people with mild-to-moderate knee osteoarthritis ,” the academic physiotherapist said .

Patients would fare better with proven treatments , such as exercise and weight loss to manage symptoms , she added .

To investigate the benefit of the therapy , the team randomly assigned 288 adults with symptomatic medial knee osteoarthritis ( OA ) ( Kellgren and Lawrence grade 2 or 3 ) to receive three injections at weekly intervals of either PRP or saline placebo .

At 12 months ’ follow-up , they found those in the PRP group had

a 2.1 point reduction in mean pain scores compared with a 1.8 point reduction in the controls , a non-significant difference .

In addition , before-and-after MRIs showed both groups lost about 1 % of cartilage volume .

Among 31 secondary outcomes , PRP recipients reported subjective improvement in knee pain and function compared with controls .

Overall , the results did not differ by BMI , presence of knee effusion , severity or knee alignment , the authors wrote in the Journal of the American Medical Association .

The injections can cost up to $ 500 per shot .

Although the PRP preparations had high concentrations of so-called active ingredients that promoted tissue healing and inhibited inflammation , “ symptom and structural benefits were not evident ”.

Two additional studies in JAMA reached similar conclusions for PRP use in ankle OA and Achilles tendinopathy . And just last month , an Australian-led Cochrane review of 32 studies concluded that PRP and autologous blood injections “ provide little or no benefit for pain or function ” in tennis elbow . JAMA 2021 ; 23 Nov .