General practitioners in Australia will soon be asked to assume increased responsibility for the diagnosis of Attention Deficit Hyperactivity Disorder (ADHD). A majority of them are complaining loudly about the expected costs associated with these nominations. The cost to patients was a key focus for Dr. Naomi Rutten, a mental health GP in Gawler, South Australia. As a result, they are met with significant out-of-pocket costs for necessary tests.
Patients presently pay $135 for a 70-minute long appointment with Dr. Rutten. This new fee is indicative of a larger trend across the industry. As a result, many people are currently stuck with thousands of dollars in bills from remote psychiatric appointments. Unsurprisingly, when rising costs inhibit access to timely and effective treatment, health outcomes suffer. This challenge is especially acute, given ADHD diagnoses have skyrocketed across Australia in recent years.
Pilot Programs Improve Wait Times
Dr. Tim Jones, who spent two years developing a pilot program at Royal Hobart Hospital, has made strides in improving access to care for children with suspected ADHD. The program worked – cutting wait times for a transplant from two years down to under four months. Dr. Jones emphasized the importance of thoughtful prescribing practices when it comes to stimulants for adults. He cautioned that these drugs are not harmless and may have serious adverse reactions.
“They’ll be able to get diagnosed, trial some medication, and if it helps improve their function, it’s going to make a world of difference to their capability to work, parent and be well in themselves.” – Dr. Rutten
The pilot program’s success has since ignited conversations to expand the program across the healthcare system. ADHD diagnoses have soared in recent years. We need to come together to figure out how we ensure equitable access to this new care and how we pay for that new care.
Financial Implications for Patients
Dr. Rutten points out that comprehensive ADHD evaluations can run up to $405. This exorbitant fee only worsens the impending costs patients like them are already concerned about. Under the current model, GPs receive just $158 for a 60-minute visit. As soon as they’re faced with seeing many patients each hour, this payment model breaks down as those detailed evaluations require more time and care.
If a diagnosis is made in Tasmania, patients have trouble filling scripts when they go back to other states. This is an issue that has gained support on both sides of politics in Tasmania. Lawmakers and advocates alike are urging action to safeguard the validity of prescriptions across state borders.
Mr. Ouizeman expressed hesitancy regarding the proposed changes, stating, “I’m not sure it’s the right thing to do at this stage.” Instead, he proposed that Congress watch how well the current frameworks are doing first before making more changes.
Future Directions for ADHD Care
As GPs start to assume more responsibility for diagnosing ADHD, training will be essential. In New South Wales, GPs trained in the new guidelines will start resupplying ADHD medications as of September. This year the federal government more than tripled incentives for GPs to bulk-bill patients. This shrewd move seeks to alleviate the heavy financial impact felt nationwide by people pursuing the care they need.
Yet there is still concern that overcharging will be an issue and that GPs need the right incentives. Mr. Ouizeman stated, “We think there should be some formalised structures in place to prevent the general public from being overcharged.” Most importantly, we have to make sure that GPs are compensated appropriately. With this support, they’ll be able to reach more families and fill the equity gap in ADHD treatment.
She said the solution lay in strong cooperative arrangements between private general practitioners and pediatricians. “The only way I can see the equity gap being fully addressed is getting more GPs working in collaborative partnerships in public healthcare services,” he noted.
