Australian Doctor Australian Doctor 24th November 2017 | Page 3

End universal indemnity: MDO
ANTONY SCHOLEFIELD
A
LEADING
medical
defence organisation wants
the right to deny high-risk
doctors indemnity cover to
protect patients from harm.
Universal cover rules were
introduced in the wake of
the 2002 indemnity crisis
and means ‘insurers of last
resort’ must offer insurance
to all doctors registered
with AHPRA.
MDOs are also required
to limit the premium they
charge high-risk doctors to
ensure they can practice.
But the Medical Indem-
nity Protection Society
(MIPS) says the duty to
insure all doctors puts
patients at risk by allow-
ing substandard doctors to
work, particularly in private
practice.
“Universal cover does not
meet current community
expectations,” MIPS says
in its submission to the Fed-
eral Government’s ongoing
indemnity review. “Uni-
versal cover does increase
the likelihood of harm to
‘[Hospitals] are
safer places
for high-risk
practitioners,
where they are
highly visible
and can be
supervised.’
— Dr Troy Browning
MIPS managing
director
patients by otherwise unin-
surable practitioners.”
MIPS managing director
Dr Troy Browning says that
removing universal cover
would see substandard doc-
tors moving into the hospi-
tal system, where employers
would indemnify them.
“These are safer places
for high-risk practitioners
where they are highly visible
and can be supervised,” he
says.
MIPS’ call to scrap uni-
versal cover is not about
the company trying to avoid
expensive payouts and sav-
ing money, he says.
“If you ask a grieving
family or a patient who was
badly injured, would they
say it’s about the money?
“What if there is a coro-
ner that links a series of
misadventures resulting in
death, and someone says
the doctor was only offered
insurance due to universal
cover?”
In Brief
Staff writers
MDA National, which
has not joined the call for
universal cover to end, says
all MDOs are limited to
charging high-risk doctors
a 100% surcharge on their
premiums — double the
amount ordinarily charged
to other practitioners in the
same state and specialty.
With some facing rela-
tively low premiums to
start with, this means even
the most dangerous doc-
tor might only have to pay
a relatively small increased
premium.
Both MIPS and MDA
National said they were
sometimes better placed
than the Medical Board of
Australia to decide which
doctors were fit to practise
because doctors were com-
pelled to report potential
issues with their practice
immediately to their insurer.
Avant encouraged the
medical board to keep uni-
versal cover, saying it was
the board’s job to decide
whether doctors were fit to
practice, not MDOs.
Rural GP forced to repay Medicare $600k
ANTONY SCHOLEFIELD
A RURAL GP who billed
Medicare for reviewing 2100
care plans in the space of
a year has been ordered to
repay almost $600,000 in
rebates.
The care plans reviewed
by Dr William Redmayne
had no information except
the patient’s medications
and allergies, and references
to treatment goals such as
“improve general health” or
“prevent complications”, the
Professional Services Review
found.
With few e xceptions,
patients were not present
when he carried out the
reviews, the PSR said.
Dr Redmayne, based in
Cessnock, NSW, was ordered
to repay all of the rebates
generated by item 732,
totalling $151,000.
Dr Redmayne also
overclaimed on Medicare item
2712 for review of GP mental
health plans.
“These [review] items
were billed like clockwork in
response to reminders that
were set … three months and
one day after the item was
previously billed,” the PSR
reported.
“There was no evidence
that patients were present
in connection with those
services.”
He was also ordered to
repay his billings for writing GP
management plans, team care
arrangements, mental health
and asthma plans.
The watchdog also said
that it was concerned with the
adequacy of Dr Redmayne’s
clinical notes.
“In one case, there was
insufficient evidence that
Dr Redmayne assessed a
patient presenting with a
range of gynaecological
symptoms, who had a
history of miscarriages and
ectopic pregnancies,” it said.
“There was no evidence that
he assessed the patient to
exclude ectopic pregnancy.”
In another case, Dr
Redmayne found a suspected
cancerous lesion, but failed
to undertake a full skin
examination.
The watchdog’s ruling,
handed down on 14
September, was published on
the PSR website last week.
Discontinuity of care
puts elderly at risk
HAVING a regular GP
reduces the risk of
unplanned hospital
admission by more than
half for older people, a
UK study shows. Data
from more than 10,000
primary-care patients found
an inverse relationship
between continuity of care
and risk of emergency
hospital admission. Bristol
University researchers
said the findings had clear
implications for policy on
high-risk elderly patients.
Annals of Family Medicine
2017; online.
Earlier induction of
labour is safer
INDUCING labour in
older first-time mothers
should be brought
forward from the current
recommendation of 41-
42 weeks to 40 weeks
of gestation to reduce
perinatal death, research
suggests. A study of
more than 77,000 UK
women who had their
first child at 35 or older
found that deaths were
less common when labour
was induced at 40 weeks’,
compared with expectant
management.
PLOS Medicine 2017; online.
Mallacoota makes sea change irresistible for new GP
GEIR O’ROURKE
New registrar Dr Butlin
says the community’s
dedication to finding new
doctors is amazing.

A TWO-year nationwide search
has finally netted a small sea-
side community a colleague
for its much-loved GP Dr Sara
Renwick-Lau.
Locals first launched their
Mallacoota Community Doctor
Search campaign in 2015.
They then started travelling to
GP conferences around the
country to spruik the benefits
of moving to their town, about
20km south of Victoria’s
coastal border with NSW.
Facing severe financial
stress, Dr Renwick-Lau
had originally called a town
meeting, warning residents
that she would be forced to
close without their help in
recruiting another GP.
“I told them their services
were going to be vulnerable
and I said, ‘I’m the only doctor
in town and getting another
one is going to take a lot of
effort’,” she recalls.
After knocking up a few
www.australiandoctor.com.au
thousand air miles on the GP
conference circuit, as well as
raising $500,000 to build a new
medical centre, the people of
Mallacoota have recruited their
first registrar Dr Emily Butlin,
who will start her GP training in
Mallacoota in February.
“There were no long-term
rentals through the real estate
agent, but I’ve had two offers
of accommodation from
people through the community
group,” Dr Butlin says. “The
community are pretty amazing.
They got someone and they
made sure that they had
somewhere to live.”
Dr Renwick-Lau is still
looking for another specialist
GP to join her in her practice.
“We are in the middle of
a stretch of 100km of wild
beach, a huge lake with rivers
and some of the best fishing in
the country and a great patient
base that lets you practice at
the full scope of your training,”
she says.
Activity trackers help
lifestyle change
ACTIVITY trackers such as
Fitbit are helping to increase
physical activity levels,
users say. An Australian
study of 237 activity tracker
users found that the devices
were used for an average
of seven months and most
users thought they helped
improve their level of
physical activity. However,
one-third stopped using
them due to breakages or
poor battery life and few
shared their data to social
media.
BMC Social Media 2017;
online.
24 November 2017
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