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Thread on Sport & Exercise Medicine (SEM) specialists in Australia and Telehealth. SEM physicians need to be included in Greg Hunt's plan for Telehealth and I'll explain why..... 1/thread
Example: Low back pain accounts for 2% of all Australian Emergency Dept visits ncbi.nlm.nih.gov/pmc/articles/P… that is 160,000 ED visits annually or 400 per day; back pain is the 5th most common ED diagnosis aihw.gov.au/reports/hospit…
Far too many ED patients get medications and scans (although some need these) and far too few get prescribed exercise ncbi.nlm.nih.gov/pmc/articles/P… researchgate.net/publication/33… thelancet.com/series/low-bac… but in the current climate the worst thing about LBP is unnecessary clogging of EDs
40 SEM physicians (if rebated fairly under MBS/Telehealth) could actually do 10 back pain Telehealth consults per day for city/country patients and remotely manage almost all of the daily ED back pain visits, traige-ing who needs outpatient MRI, doing virtual prescriptions etc
...BUT trying to avoid doing so in many cases and instead prescribe exercise/moderate loading, which is actually the correct treatment. SEM physicians are ideally placed to take a huge burden of the Emergency Dept visits for back pain at a time where EDs need "all hands on deck".
Two similar governments to Australia (UK and NZ) that have entered "full lockdown" have made one of the only exceptions to leaving one's house: to be able to do personal outdoor exercise once per day. This is totally necessary but you MUST have medical support for exercise
The problem is: under Australia's Medicare system, MBS rebates for SEM physicians were slashed in 2010 and this has never been fixed smh.com.au/sport/australi… with SEM now a "specialty for the well-off only" croakey.org/equity-for-spo…
If the Telehealth plan is "specialists must bulk-bill" and Greg Hunt doesn't allow SEM physicians to have fair bulk-billing rebates, as recommended a year ago by SCPCCC MBS Review, we'll be excluded from Telehealth
If SEM physicians get excluded from Telehealth under Medicare, SEM physicians will go either to Private full-fee only Telehealth or take gardening leave at a time when the health system most needs them to assist public patients.
Medicare needs to finally fully fund SEM specialists as a way to (1) keep population active medicalrepublic.com.au/exercise-needs… (2) keep them out of Emergency Departments at a time when EDs are overwhelmed
@ACSEP_ SEM Physicians get rebates 3x higher in NZ under Jacinda Ardern than they do in Australia. NZ has locked down the population, but insisted they stay exercising plus the Ardern government fully funds SEM physicians. nzherald.co.nz/nz/news/articl… - Aust needs to follow suit.
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