Paul Smith THE AMA has called on the

condition of their registration . Under the board ’ s pre-

not in favour of the status quo where there were no

demonstrate adequate reliability , sensitivity and specific-

intellectually advanced group .” But the more sensitive

Medical Board of Australia

ferred model , the checks

health assessments of the

ity to meet the specific needs

screening tools being sug-

to let GPs decide if cognitive

would be carried out by the

7000 doctors currently aged

of this population ,” it said .

gested by the board — specif-

screening of late-career doc-

doctor ’ s GP every three years

70 and over .

“ It is important to note

ically the Montreal Cognitive

tors is necessary under the

before becoming yearly for

But it questioned the

late-career doctors come

Assessment and the Adden-

board ’ s plan for mandatory

doctors aged 80 and over .

board ’ s suggestion that , as

from highly educated back-

brooke ’ s Cognitive Examina-

health checks .

The GP would only be

part of the GP health checks ,

grounds , which impacts

tion — would add “ significant

The board argues that the

expected to notify AHPRA if

late-career doctors would

on the benefit of cognitive

time and cost burden to the

increased rate of notifications

they believed the doctor pre-

undergo cognitive function

screening . For example , the

late-career doctor ”.

for doctors aged 70 and over —

sented a significant risk to

screening .

MMSE is neither highly sensi-

Not all GPs would be famil-

Dr Anne Tonkin .

81 % higher than those under 70 — justifies the introduction of health assessments as a

public safety . In its submission to the board , the AMA said it was

“[ If ] the board decides to implement cognitive screening tests , these tests must

tive nor specific . “ It may not detect cognitive changes in such an

iar with these tests or have subscriptions to them , which placed a financial imposition on

the GPs , it claimed .

This would then force the

older doctor to find a new GP or

seek additional subspecialist

assessment .

It suggested it would be

best to leave it up to the GP to

decide whether to carry out a

cognitive assessment of the

late-career doctor .

“ A better model would not

include specific cognitive function

screening in the health

check , but it would make it

clear in resources for GPs that

‘[ The costs ] add to an already burdensome list of expenses .’

they should consider cognition

and use their clinical judgement

regarding screening and /

or write a referral for formal

assessment if required .”

In an interview with Australian

Doctor following the

publication of the board ’ s consultation

paper in August ,

its chair , Dr Anne Tonkin ,

revealed that the board had not

sought legal advice on its plan .

The AMA said this was

essential , urging the board to

“ seek and publish ” legal advice

on whether it was in danger of

contravening the Age Discrimination

Act 2004 .

“ We would also like advice

on whether section 38 of the

National Law permits the

board to set a registration

standard for a subset of the

profession based on a shared

characteristic , such as age , separate from the profession

or specific individuals .”

It also pointed to the board ’ s

suggestion that older doctors

should pay for the health checks

themselves .

The board ’ s consultation

paper noted that the current

MBS rebates for health assessments

ranged from $ 209 to

$ 296 , but the AMA schedule

fee suggested between $ 455

and $ 570 for prolonged health

checks .

“[ The costs of these

checks ] add to an already burdensome

list of expenses ,

including AHPRA registration

, indemnity insurance and

professional development ,

to name but a few ,” the AMA

said .