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The specialty of Sport & Exercise Medicine (SEM) in Australia and Telehealth. Thread spoiler: SEM physicians have effectively not (yet) been included. For SEM Telehealth, the patient will have to pay the full fee with no rebate.
It is already know that SEM specialists do long consults with few procedures – a very detailed MBS Review document (via SCPCCC) proved this in 2019
SEM is therefore a specialty with good potential to do Telehealth consults, as Exercise Prescription/loading is our signature treatment and can safely be done over Telehealth.
Whilst SEM physicians don’t have skills to treat COVID-19 in hospitals, we could be of great help in keeping back pain/injury patients out of hospitals, Emergency Departments
Back pain, for example, is one of the top five presentations to Emergency Departments in Australia. It is the sort of problem that absolutely should not be going to ED currently
No one would suggest though that a GP-referred back pain case can be managed in 6-10 minutes in either the ED or by a specialist Telehealth consult. It needs 30-60 minutes
However, SEM physicians have only been offered the opportunity to bulk-bill short consults under Telehealth, and have been shut out of (1) charging a gap (2) longer consult item numbers
This means if a SEM physician wants to offer a back pain patient a 30-60 minute Telehealth consult – to keep them out of ED – patient has to pay the full fee. No Medicare rebate
There is still a Medicare rebate for face to face consults, but it is very low ever since Medicare slashed our rebates in 2010…
Basically SEM practice in Australia until a few weeks ago involved patients (referred from GPs) paying 2/3rd of the consultation fee for long consultations and getting back about 1/3rd from Medicare…
Not sure for how long SEM physicians can continue to justify face to face consults when (during the pandemic) we are (correctly) advising people to not leave their house for meetings unless it is absolutely essential
Entering shutdown, SEM physicians now being put in position of running a Telehealth practice completely outside Medicare or going on gardening leave (but needing to fund staff salaries and rent out of no income)
So SEM Telehealth consults could solve an important health system problem (keeping difficult musculoskeletal patients out of the ED) but to date Health Minister doesn’t want this problem solved
From what I can see, important Allied Health groups such as @ESSA_NEWS and @apaphysio have been put in very similar position to @ACSEP_ specialists. Still a strong economic incentive by Medicare to continue face-to-face even though not the best Public Health option
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