Medical Specialist Appointments

Health & Body
1

I am currently waiting to go to a nerve specialist. Needless to say that there is a reason for this. I need to find out why I hurt at times for unexplained reasons.
This in itself is not the problem. The problem is that the waiting time to see a specialist is 6 to 8 weeks so I have to go around hurting for that time with no chance to find out why.
Is there anything we can do about the prolonged waiting list at specialists? I know I am not in a unique position. It is virtually all specialists that has this kind of waiting list. In a society like the Australian that should not happen.

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2

Seeing a specialist can take time and you are not different to majority of Australians.

Options include see you GP and see if they can provide a referral to a specialist with lower wait times (you may have to do a phone around to ask the question of specialist clinics).

If it urgent (e.g. potentially life threatening), let the clinic know as they are likely to bring forward any appointments.

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3

There are possibles to cutting waiting times and there are uinlikelys.

Possibles include
Pay more so a Specialist will prefer you over others
Train more Doctors and subsequently train more of those to be Specialists

Unlikely includes:
Spending more efficiently in the Health Care system so that prevention becomes the main thrust so that less “emergency” treatment for preventable illnesses is required.

There are more but really it is a matter of funding, where and how that funding is spent and encouraging young people to want to become Doctors, Nurses, and other health professionals. As the old saying goes an ounce of prevention is worth a pound of cure (sorry to metric system).

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4

I was in no doubt that you could do something if it is life threatening. You could even just go to a hospital emergency in that case.

My gripe is that it is like that. If it is not life or death then you have to wait until it is. Bad for your health and bad economy for the society.

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5

I waited FOUR YEARS to see an orthopod about my knees. 6-8 weeks is peanuts.

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6

I know 6 to 8 weeks is not long compared to other things but it is too long anyway.
In all, you just make my case stronger.
It is NOT OK in a society like this that we should have those waiting times.
If that means paying a bit more tax then so be it.

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7

One of the issues with waiting times is economics, but the other is demand. It is impossible to create more specialists in less than a decade without importing them from other countries where their training may be better, as good, or sometimes not to our top standards so they work under conditions for a while.

Even in the USA where specialists charge well above anything most of us could contemplate, it is common to need to wait for a month to see a some specialists. ‘Shopping around’ might find a nearer term booking, but the same can apply here. Our system of referrals can make it cumbersome to do so.

How many of us tell the GP who often provides an initial referral that we will go shopping and will need a new referral, and the GP has to be supportive (I suspect most would be, although with another consult sometimes?)?

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8

An article today on this subject.

Since the Government changed the PBS rules regarding some pain killers, I can now only get 3 x 20 tablets at a time, one month’s supply, and I have to visit my GP who then has to ring the PBS to get the approval number.

It is only Tramadol, not Endone or morphine, and I used to get a script with 3 repeats.

It wastes my time, my GP’s time, and costs the Government over $400 a year.

You just can’t help stupid.

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9

As the US goes, so goes Australia. This is not the first ‘follow along’ nor will it be the last. :frowning:

Although not 1:1 this time.

Tramadol prescriptions in the U.S. may now only be refilled up to five times within a six month period after the date on which the prescription was written. After five refills or after six months, whichever occurs first, a new prescription is required.

I could not find easy to understand dosage, but the US max looks like 300mg per day, with the tablets being available in 100, 200, and 300mg forms.

We have had a number of medicines reigned in, including OTC codeine+[analgesics].

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10

So in the US, they can get 6 months supply on 1 prescription whilst In Australia, we have gone from 4 months to just 1.

Mine are only SR (slow release) 50mg so 100mg daily.

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11

Fascinating differences
 this may be the first time I have seen we seem to be more strict rather than following along.

If you discover the background please post it. I am now curious.

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12

Mine is a somewhat higher dosage but I get monthly rolls with them and my pharmacist arranges with the doctor the script renewals so no visits other than reviews every so often are needed. My Targin is only a 28 day amount allowed so a visit every 26 days or so and every 12 months the Dr must have the need reviewed by a second Dr. Nor can the Targin be inserted in the rolls.

@PhilT I think it links into changes that created Regulation 49 (used to be Reg. 24) & our response to Drugs of Addiction.

" Regulation 49

Under regulation 49 (previously referred to as regulation 24), original and repeat supplies of pharmaceutical benefits can be supplied at the one time if a medical practitioner, a midwife or a nurse practitioner is first satisfied that certain conditions apply, then endorses the PBS prescription ‘one supply’. RPBS prescriptions may be endorsed ‘hardship conditions apply’.

The medical practitioner, midwife or nurse practitioner must first be satisfied all the following conditions apply:

  • the maximum PBS quantity is insufficient for the patient’s treatment; AND
  • the patient has a chronic illness or lives in a remote area where access to PBS supplies is limited; AND
  • the patient would suffer great hardship trying to get the pharmaceutical benefit on separate occasions.

Drugs of addiction

Prescribers must heed State/Territory laws when prescribing drugs listed as narcotic, specified or restricted and must notify, or receive approval from, the appropriate health authority.

When a PBS/RPBS authority application is for a drug of addiction (other than dexamphetamine sulfate), the following guidelines apply:

  • the maximum quantity authorised is generally for one month’s therapy (e.g., one week’s therapy with three repeats);
  • where supply for a longer period is warranted, quantities are usually for up to three months’ therapy;
  • telephone approvals are limited to one month’s therapy.

Prescribers should also state the interval of repeat where repeats are called for, and ensure State/Territory health authorities are notified about ongoing treatment."

My Pharmacist informed me that Antibiotics are going to be permanently single dispenses with no repeats unless with an Authority Script (already temporarily are due to COVID responses). So no more will we see 2 or 3 repeats on our scripts for them.

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13

We are coming up on 2 years on the waiting list for a public paediatrician appointment in country WA (referred by school). We’re nearly past the “early intervention” threshold if there does turn out to be an issue (which I doubt, which is why I’m not stressed about it enough to pay thousands and travel to Perth for an earlier private appointment). We’re lucky that its only a “slight possible problem”, and not a family really struggling waiting two years to even be seen, and then find out their child is not eligible for the same level of assistance because they’ve passed the “early intervention” threshold. I know a couple of families that has happened to here.

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14

May I generalise & suggest that when the system is not adequately funded by the Government then the medical practitioners will focus on the best revenue streams. Some move out of ‘mainstream’ medicine into niche/trendy/created specializations removing them from the ‘general pool’ of availability. Others will (as has been mentioned) give priority to full fee paying customers. I have heard of quite a few older doctors either selling up or just closing their practices down because it was not financially viable to keep working.

The ‘temporary Medicare freeze’ was introduced in 2013, and has remained in place since then.

I believe until the Government adequately recompense the medical profession, the wait time for public patients and the patient contributions will continue to escalate. Perhaps now that COVID has occurred, Governments may realize how important it is to have a healthy (pun intended) and efficient medical system in place to serve Australia.

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