Australian Doctor Australian Doctor 29th September 2017 | Page 7

Choosing Wisely’s new X-ray vision
JOCELYN WRIGHT
UNNECESSARY
ordering
of
X-rays is the target of many of
the new Choosing Wisely recom-
mendations released as part of the
scheme’s ongoing campaign against
inappropriate and wasteful medical
practices.
Three of five ‘do not do’ recom-
mendations put forward by pae-
diatricians advise against routinely
undertaking X-rays for the diag-
nosis of bronchiolitis, asthma or to
investigate non-specific abdominal
pain.
Advice against low back X-rays
as part of work-related medical
examinations are also included in
Choosing Wisely recommendations
from occupational and environ-
mental medicine specialists.
Dr Sarah Dalton, president of the
paediatrics and child health division
at the Royal Australian College of
Physicians, said the recommenda-
tions reflected the finding that chest
X-rays changed management in as
‘We have
demonstrated strong
early results, with
recommendations
being formally
adopted by health
services around the
country.’
— Dr Robyn Lindner
Choosing Wisely
few as one in 100 children with
conditions such as bronchiolitis.
“Whilst it is all too easy to slip
back into our routines and order a
test because it is what we’ve always
Softening us up for
after-hours cuts?
Comment
Geir O’Rourke
THE endless heat and
smoke around after-hours
deputising might not contain
much news for doctors, but
that doesn’t mean it serves
no purpose.
Amid a blaze of headlines
last week, Federal Minister
for Health Greg Hunt
launched an investigation
into allegations of low-
quality care in the after-
hours sector, with a specific
focus on its biggest player,
the National Home Doctor
Service.
The probe, to be run
by the Medicare integrity
division of the Department
of Health, was announced
in response to ‘revelations’
in the News Corp tabloids
that non-VR GPs perform
nearly two-thirds of after-
hours visits funded under
Medicare.
None of this is a
revelation to anyone
following the after-hours
saga over the past three
years.
It is well known that
non-VR doctors (IMGs and
junior doctors) have been
the preferred workforce in
the rapidly expanding after-
hours industry.
There were rumours
that the minister’s office
itself sent the shock-horror
Medicare figures to News
Corp.
If true, the likely reason
is that Mr Hunt is simply
preparing voters for big cuts
to after-hours Medicare
funding, which is expected
to be recommended by the
MBS Review Taskforce.
The taskforce met last
month to discuss the
feedback to it s controversial
draft proposals to ban
non-VR GPs from claiming
urgent after-hours MBS
items.
Australian Doctor
understands that the
taskforce, after going
through the frenzied
feedback to this suggestion
— which, according to
some estimates, would
save around $100 million a
year — has yet to draw up
its final plan. And the details
may still change.
The final
recommendations are
expected to land on Mr
Hunt’s desk in the coming
weeks. And it seems there
won’t be much heartache
for the minister in signing
them off.
He told reporters in
Melbourne last week: “I
am very, very drawn to
what I am told are the
likely recommendations for
reform.”
Last week’s revelations
seem to have been about
ensuring that the public are
drawn to them in the same
way.
done, I encourage my colleagues to
pause for a second and ask is this
X-ray really necessary,” she said.
In total, 25 new recommenda-
tions have been produced by five
specialist colleges, adding to the
160 recommendations already
released by the Choosing Wisely
initiative, which is run by NPS
MedicineWise.
“We have demonstrated strong
early results, with recommenda-
tions being formally adopted by
health services around the coun-
try,” said Choosing Wisely spokes-
person Dr Robyn Lindner.
Dr Lindner said that the impact
of the Choosing Wisely program
was being evaluated through
annual surveys conducted by NPS
MedicineWise among health pro-
fessionals and consumers.
“We’re starting to see evidence
of what some of [the] colleges are
doing to support implementation
so that includes things like the
RACGP embedding recommenda-
tions, not just their own, into their
Red Book guidelines for preventive
health,” she added.
The latest lists also include rec-
ommendations from the Internal
Medicine Society of Australia and
New Zealand, the Australasian
Paediatric Endocrine Group and
the Society of Obstetric Medicine
of Australia and New Zealand.
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29 September 2017 | Australian
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