Aleisha Orr
Single mid-life health assessment could replace disease-specific consults
Rolling some disease-specific health assessment items into one mid-life assessment could reduce duplication and provide a more holistic approach to care, an MBS review has found.
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Aleisha Orr
Undertaken to identify barriers to delivering effective preventative care, a Review of MBS Health Assessment Services recommended assessment items for menopause and perimenopause, chronic disease risk, type 2 diabetes risk and heart health be combined into a single mid-life assessment.
It found efficiencies could be possible through a more flexible approach that removed duplication for GPs.
The benefits of a more flexible, holistic approach outweighed a condition-specific approach to health assessments, especially for conditions that share multiple common risk factors such as cardiovascular disease and type 2 diabetes.
"In these instances, having multiple health assessments addressing the same or similar underlying risk factors for specific conditions increases the potential for duplication of assessments and confusion for patients," the report stated.
In a submission to the review the AMA said health assessments should remain general and non-specific, adding that assessment items specific to disease does not align with comprehensive GP care.
"It is impractical on a system level and our clinicians advise this approach does not bring about the intended patient health outcomes."
The RACGP's submission noted that singling out specific conditions upon which to base eligibility creates a hierarchy of diseases.
Dr Sunita Chelva, co-founder of Hera Menopause and Women’s Health, said considering multiple health factors alongside menopause made sense.
“The shift for women physiologically is huge. It shouldn't be seen as an event that happens in isolation, it's an event that colours every single thing that happens in a woman's life, therefore it will affect any underlying chronic diseases that they have."
She said menopause caused an abrupt loss of hormones which could make chronic diseases more apparent and increase cardiovascular risk.
Dr Chelva has a special interest in menopause and women's health and has focused on this area after initially starting in a general practice setting. Based on her experience, she felt general practice had become less about preventative health, but having a wider view in assessments she said GPs could better integrate prevention into their consults.
She already discusses chronic disease, heart health and diabetes in her menopause and perimenopause consults.
“We would be screening people for those things anyway, but it's not articulated at a national level. I think it's just something that we do as a mid-life check, so I think it would make a lot of sense for capturing people around this time," Dr Chelva said.
"GPs need to be remunerated for their time and work. There's a lot of work that goes into preventative health and it can't be done in a GP session that's 15 or 20 minutes."
A menopause-specific MBS item was introduced in July last year. GP consults that assess a patient’s experience of early menopause, perimenopause, menopause, or premature ovarian insufficiency can attract a $101.90 rebate under the item.
The assessment must last 20 minutes or more and include history-taking, blood pressure measurement and a basic physical examination.
Dr Chelva said her clinic had not been using the menopause-specific item because the 20-minute consult time did not reflect what was needed in practice, but she would consider the use of a mid-life assessment item.