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The $ 14 million debt GPs want paid
GEIR O ’ ROURKE A MEDICAL debt collector is crediting the Medicare freeze with driving a boom in the number of GPs coming to him for restitution .
And Roger Mendelson , whose company Prushka collects about $ 14 million in unpaid doctors ’ fees every year , says GPs are becoming increasingly important to his business as average co-payments increase .
“ Practices we haven ’ t heard from in decades are getting in touch and asking for help with gap debts ,” he says .
The Melbourne lawyer , who has been collecting debts since 1977 , says that business from GPs is better now than at any time since the introduction of Medicare .
“ General practices are finding that while one unpaid gap might not change the
Mandatory reporting win for doctors
RACHEL WORSLEY VICTORIA is the latest state to back changes to mandatory reporting laws to encourage more impaired doctors to seek help .
The move follows a cluster of doctor suicides in the past two years .
It has been claimed that impaired doctors have avoided seeking help because of fears their treating doctors will have to report them to AHPRA under mandatory reporting laws .
In a major victory for those doctors who have been calling for the laws to be changed , Victoria ’ s Minister for Health Jill Hennessy said she would support a revamp when state , territory and federal health ministers meet at COAG next month .
She made the announcement to the applause of doctors at an AMA Victoria dinner last week .
AMA Victoria president Dr Lorraine Baker said the minister ’ s decision was influenced by discussions around the mental health of doctors and the argument that the laws had to be changed to encourage doctors to seek help without fear .
But Dr Baker said the minister warned that “ there may be states [ that ] may not align with the idea of changing the laws ”. Without universal agreement among ministers , national reform will not happen . However , individual states could introduce their own changes .
Ms Hennessy ’ s pledge follows a similar commitment from NSW Health Minister Brad Hazzard to look again at the reporting laws , which were introduced in 2010 with the creation of AHPRA .
Australian Doctor understands Mr Hazzard backs the WA mandatory reporting model , which exempts treating doctors from reporting their impaired colleagues to AHPRA .
The federal Minister for Health , Greg Hunt , has also committed to establishing “ a common national standard to protect the mental health of doctors ”.
Earlier this year , Mr Hunt pledged $ 1 million in funding for doctors ’ health programs .
Tattoo-linked lesion a dead ringer for SCC
MICHAEL WOODHEAD VIGILANCE is needed for a skin lesion that may arise soon after someone has a tattoo and can be difficult to distinguish from SCC , dermatologists say .
Eruptive keratoacanthomas may be due to a hypersensitivity reaction to the tattooing process , especially red ink , say Queensland clinicians who describe two recent cases that were referred to them by GPs .
According to their report , the eruptive nodules occurred within two weeks of having a new tattoo and were biopsied when patients presented to their GP .
While initially reported as well-differentiated SCCs , the lesions were subsequently found to be keratoacanthomas ( KA ),
Photo courtesy Dr Leith Banney world , when you add them up over a month , it becomes worth chasing .”
Bulk-billing is at record levels , but Department of Health statistics reveal the average patient gap payment has risen more than 5 % since March last year ,
write the dermatologists from Nambour Hospital .
Pathologists who reviewed the biopsies of the lesions said it was difficult to distinguish between KA and SCC on the basis of histology alone .
“ KA has a distinctive reaching $ 36.77 for GP attendances .
“ Smaller debts are where we are seeing our biggest growth , and we are very happy to work on gaps despite the perception that we are only interested in big sums ,” says Mr Mendelson .
crateriform architecture , with a proliferation of mildly atypical squamous cells around the base of the crater ,” they noted .
“ Where there is difficulty distinguishing KA from SCC , an expert dermatopathology
Business from GPs is the best it ’ s been since the introduction of Medicare , says medical debt collector Roger Mendelson .
However , other specialists still send the lion ’ s share of the 40,000 debts received by the company each year , with an average of $ 350 per debt .
It ’ s a far cry from the situation in the US , where hundreds of thousands of people declare bankruptcy
DOCTORS ARE HUMAN TOO For support on suicide prevention call : Lifeline 13 11 14 .
The eruptive nodules occurred within two weeks of the tattoo .
opinion may be helpful ,” they suggested .
The patients ’ lesions eventually resolved after several months of acitretin therapy . Australasian Journal of Dermatology 2017 ; online . each year because of medical bills .
However , Mr Mendelson estimates that despite significant government funding , Australia ’ s health sector has been saddled with about $ 126 million in bad debts in the past 12 months .
Of that number , about 90 % is written-off because practices are unwilling or unable to collect , he says .
“ Doctors won ’ t outsource their debts unless they are happy that it isn ’ t going to impinge on their reputation ,” he says .
“ It needs tact and an understanding of healthcare funds and work cover , so it is very different from normal debt collection .
“ I needed that tact from the very first debt I ever collected , which was a cheque for $ 8 from a priest in North Melbourne .”
Companies like Prushka , which is named after a
ANTONY SCHOLEFIELD IT was a GP super clinic with ( almost ) everything — 21 consulting rooms , a surgical wing , a sleep apnoea clinic and even a library .
The only thing missing from the $ 6.2 million Gunnedah Rural Health Centre — an hour ’ s drive from Tamworth , NSW — was a GP .
This month , the clinic was put into administration , and at risk of becoming one more concrete memorial to another more Federal Government health policy bungle .
The clinic was among more than 60 built under the Rudd Government ’ s infamous GP Super Clinic Program , which consumed more than $ 650 million despite repeated warnings that new GPs , not new GP clinics , were needed in Australia .
As news emerged that the Gunnedah clinic would have to close its doors , the administrator said in a statement : “ The vision that local doctors would practise from the state-of-the-art facility has proved difficult and did not eventuate .”
The clinic was opened in 2012 to serve a community of around 10,000 people , as well as those in neighbouring stuffed penguin belonging to Mr Mendelson ’ s wife , operate a ‘ no recovery no charge ’ service , instead taking a cut from whatever is collected .
But not everyone is convinced that outsourcing debt collection is worthwhile , and the AMA has warned practices to tread with caution due to privacy laws .
The AMA ’ s 2014 Privacy and Health Record Resource Handbook urges practices to ensure patients sign a carefully worded consent form that explicitly reserves the practice ’ s right to pass on details to debt collectors .
“ It seems it is not generally permissible to disclose a patient ’ s name and address to a debt collection agency to recover a bad debt , although it may arguably be a permitted general situation involving pursuing a legal or equitable claim ,” the handbook states .
Multimillion dollar super clinic in trouble
The last remaining GP left earlier this month .
towns . But two of its GPs , concerned about the business model , quit in 2015 to set up their own successful clinic across the road .
The last remaining GP left earlier this month , two days after the administrators took over , because the clinic could no longer pay him , according to the Namoi Valley Independent .
It is the latest of several GP super clinics to run into trouble .
Planned clinics in Darwin and Tasmania were scrapped and one Queensland clinic required a high-profile multimillion dollar bailout .
The Rudd Government also faced accusations that it picked the super clinic locations as a means of pork-barreling politically important areas .
4 | Australian Doctor | 28 July 2017 www . australiandoctor . com . au