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Clueless doctors and the doppler !

Discussion in 'Australia' started by surfboy, Jun 11, 2014.

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  1. surfboy

    surfboy Active Member


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    I had the experience of visiting a Doctor's surgery this week to educate their staff upon their request, as the nursing staff had advised me that they had purchased a Doppler Ultrasound to measure waveforms of Tibialis Posterior and Dorsalis Pedis in their patients, with the intention of claiming the Medicare rebate of $47.85 for doing so (under the "direction" of the doctor). They didn't have a clue how to use the machine.

    Alarmingly, they proceeded to show me how they were measuring for "tibialis posterior", by running the doppler probe upon the far lateral surface of the foot, near the styloid process area. - They were wondering why no doppler signal was being detected...

    They also had literally no clue how to interpret any of the waveforms.

    I am amazed and concerned that the Government allows for Doctors' surgeries to claim MBS item 11610, basic doppler assessment of the TP and DP, billing $47.85 when some clearly have no clue what to do.

    Come on APODC, let's get the ball rolling and show the Government that we are the foot health experts and should be entitled to claim the MBS item 11610 of $47.85, - not the clueless doctor's surgeries!!! :bash:
     
  2. drsarbes

    drsarbes Well-Known Member

    OK

    So where was the "doctor"?
    I would think he would be more than capable of finding a PT artery.

    I've had staff over the years that, until we educated them, really had no clue about basic lower extremity anatomy. This should not surprise anyone.

    The code is for UNDER THE DIRECTION of the doctor. Also the reading itself needs to be interpreted by someone either trained or certified.

    I wouldn't be so hard on the staff. At least they called you in and you did a proper job educating them. I doubt that this inexperienced staff will be reading the results.

    Steve
     
  3. thekwie

    thekwie Active Member

    Surfboy, the doctors don't just refer to you under an EPC for the Dopplers? The onus to show that we are the experts is on ALL of us, not just the APodC, surely?
     
  4. trevor

    trevor Active Member

    Medicare pays a GP $47.85 for just the doppler.
    Medicare pays the Pod $52.95 under EPC and it includes a doppler.

    So yes, where is the APODC or the APOD A.

    No wonder most podiatrists choose not to be members of APOD A.
    I did a head count of podiatrists in several practices
    11 podiatrists and not one was a member of APOD A.
     
  5. APodC

    APodC Active Member

    Hi guys. Here we are!

    We currently have a request before the department to extend several for and on behalf of items to podiatrists including 11610, and it's part of our ongoing lobbying work. You'll find that the arguments for this are is part of a piece of policy work currently being undertaken by the members that have joined our policy committee. Because of this hard work by members, we've now got a reasonable argument to put to the department because in the words of one of my collegues, the department demands more content, less outrage.

    It's unfortunate that more people aren't members as this is really important work for future generations on podiatrists. Fortunately, current podiatrists are enjoying the efforts of previous generations so it'd be good to repay that for the next generation.
     
  6. trevor

    trevor Active Member

    Most of the podiatrists I spoke with, were all once members.
    The last time that I remember something positive happening was when Allison Petchel worked on the S4 campaign. She left some 10 years ago and to my knowledge it is still has not been completed.

    In our practice, all gave up on membership when we could not get a response to emails or get a phone call returned. We expressed our concerns for several years and then voted with our wallets.
    Outrage, I do not think so. Folks who were interested and had the skills to make things happen left.

    Here, we chose to be members of the APMA.

    What is the percentage of podiatrists who are members of APODA by state?

    By the way I doubt that APODA a will get TAC fees reviewed in my lifetime.
    :deadhorse:
     
  7. APodC

    APodC Active Member

    Thanks For the feedback Trevor. I've not seen Allison since shortly after she went over to the department but I'm sure she'd agree that we're heading in the right direction.

    You may have missed that both prescribing and diagnostic imaging was introduced in Qld last week following significant effort. We were on track to finalise prescribing for Tas this year after we used our relationship with the pharmacy guild to remove road blocks. We've had to bring the new minister up to speed following a change of government so I expect we're now heading for next year. In the mean time, members will be aware that we fought to make sure the prescribing project run under the Council of Australian Governments health council didn't diminish the autonomous prescribing status for podiatrists, a very real risk for the profession.

    On TAC, my recent discussions with the APodA suggests that they're working hard on sorting this out. I expect they have a strategy planned.

    Maybe it's time for a rethink on membership!

    Cheers,
    Damian.
     
  8. Paul Bowles

    Paul Bowles Well-Known Member

    I am happy to be corrected with evidence however I do not believe APodC really had anything to do with Scheduled 4 prescription rights for Podiatrists in the past besides possibly standing with the people involved in pushing for it. I can post the original 120+ page document prepared by Podiatrists - a version of which was sent to the Ministers office and sat there whilst several persistent Podiatrists, the ACPS President and Registration Board members kept pestering the Ministers office about it. In fact if my memory servers me correctly (I am getting old now) I believe the key players in that were Dr Paul Tinley, Paul Bours, Mark Gilheany along with several other Podiatrists like Haydar Ozcan, Ozan Amir, Aaron Mehta and Christian Debrennan.

    Trevor said it perfectly above: "Folks who had the skills to get things done left." Our clinic also voted with their wallets - we have had 4 Podiatry staff over the past few years all choose not to renew membership.

    With the current state of the budget and Medicare - the prosperous time where we "could" get things done has passed for the moment. I now cannot personally see that changing in my career.
     
  9. trevor

    trevor Active Member

    Paul,
    You may be correct about S4. it may be the DVA fee project that Allison worked on, with the now minister for small business the Hon B Bilson esq, that I was thinking about.
    I suffer a bit from "oldtimers" with many seniors moments these days.
    However I am not getting old.
    Just a good many years older than you, I think.
    Perhaps it is time for me to start thinking about retiring (for the second time)
     
  10. Tuckersm

    Tuckersm Well-Known Member

    Paul,
    re S4 in Victoria, the A.Pod.A.(Vic) developed the initial submission to Government, and provided the lobbying along with the Reg Board to have endorsed podiatrists included in the State Registration Act, before the national law came into affect.
     
  11. Paul Bowles

    Paul Bowles Well-Known Member

    Hi Stephen - correct I was referring to NSW apologies I should have made that clearer. I remember reading the Vic document.
     
  12. surfboy

    surfboy Active Member

    In NSW I also have voted with my wallet, I have not renewed my membership. I then received an aggressive letter stating that I was in breach of the association terms and conditions by not paying up the money to renew!!
     
  13. Craig Payne

    Craig Payne Moderator

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    As bad as that looks for an organization to treat "ex-members" that way,especially if they want them to return as members, it is quite common for a lot of organizations to have a clause in the rules or constitution that you are technically still a member until you formally resign as a member. Not paying membership dues is not sufficient as a "resignation", so you are technically still a member and owe the dues. When you joined the organization, you do agree to be bound by the rules ..... as bad as what I think this is.
     
  14. Rob Kidd

    Rob Kidd Well-Known Member

    Whether by design or by default, the podiatry association in NSW (at least in my day, finished in 2010), represented the private practitioner. They did not deliberately ignore the public sector employee, they simply did not think about it. I remember the then president talking about the cost of membership and equating it to X amounts of patients treated: they simply did not think public sector.
     
  15. Paul Bowles

    Paul Bowles Well-Known Member

    I haven't been a member for almost 2yrs (after being a director for many many years) and in the last 2 weeks I received an email from their EO pointing out what they believed to be problems with wording on my clinics website stating that they "wouldn’t want the Pod Board to take objection." A hollow threat and not exactly a great way to try and get my membership back......

    Glad to see the MEMBERS hard earned cash is spent on their EO browsing NON MEMBER websites reminding Podiatrists of AHPRAs regulations/guidelines.
     
  16. surfboy

    surfboy Active Member

    Paul, that is the most disgraceful conduct. How dare Janice contact a non-member Podiatrist and make such comments!! She is is no regulatory position. That is absolutely abhorrent. Janice is not a Podoatrist, nor a member of a registration board or authority - This is not acceptable. What is this, the Podiatry Internet police?!! If the behaviour continues I would file for harassment and intimidation.
     
  17. Craig Payne

    Craig Payne Moderator

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    Now thats an idea! :boxing:
     
  18. APodC

    APodC Active Member

    C'mon guys. Members contact the association all the time to raise concerns about other people's web sites and advertising. If the association does nothing, it gets criticised. If it responds, it gets criticised.

    I can say that the last thing association staff spend their days doing is trawling non members web sites and I do think it's entirely unfair to single out any staff member for doing their job.
     
  19. Craig Payne

    Craig Payne Moderator

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    I don't even see what this has to do with the APodA's or APodC :confused: ... the Associations should refer them to the internet police and get on with stuff thats actually important.
     

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  20. APodC

    APodC Active Member

    While I can't comment on specific cases, if your web site says you're a member when you aren't, you can expect the association will write to you. Protecting the use of the APodA and APodC brand is important to members.
     
  21. Craig Payne

    Craig Payne Moderator

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    Thats fair enough, but I get the impression a lot of the complaints about websites relate to someone just not liking the claims being made or things like domain name registration....
     
  22. Craig Payne

    Craig Payne Moderator

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    Paul - I went through your site and can not find a single thing that there is an issue with. What was it about?
    I do see you claiming re APodA membership, but I thought you were a member of APodA (Vic) and NOT NSW - was this what it was about?

    ...if anything, your site is a bloody good example of what a clinical practice's website should be like!
     
  23. surfboy

    surfboy Active Member

    Craig has summed it up perfectly. Providing a Podiatrist is not claiming to be associated with the APODA or APODC when they are not a member, the content of a Podiatrist's website has absolutely nothing at all to do with anyone from the aforementioned bodies. If there is a problem with website content it is a matter for the Podiatry Board of Australia. Perhaps Paul could let us know some more about what is going on.

    The APODA has absolutely no scope to direct or contact non-members regarding their practises.
     
  24. Paul Bowles

    Paul Bowles Well-Known Member

    It was an issue they had with two things: The first was an "accredited Podiatrist" logo which was an issue on their end browser caching as I haven't been an accredited Podiatrist or a member for almost 2 yrs. Once they refreshed their cache and/or they checked the site again after we enforced a code cache refresh it would have vanished for them. Storm in a tea cup really.

    The second issue was a little more ambiguous - A section on our site tries to inform the public of the different scopes of practice within Podiatry - General, Surgical, Sports, High Risk Foot and Gerontology. You know the good stuff about Podiatry about how alot of Podiatrists do more than cut toenails, are highly skilled medical professionals, are well trained medical staff yadda yadda yadda, you know the stuff this organization say that they also supposedly do? They took issue with the wording displayed regarding a sentence in the Sports information in particular with the use of the word "sub specialty" I believe - they then went on to insinuate that I was using that title when in fact AHPRA clearly state no such title exists - hence I was I supposedly "misleading" the public.

    If they had actually read the website as a website and outside of the one sentence they were concentrating on so intently they would have clearly seen that page does not refer to anyone in our clinic - it is merely a page that attempts to delineate and promote the different areas within Podiatry. I had it changed to make it clearer for APodA. However I am sure that they have no concern when their members may use the term "Sports Podiatrist" to describe themselves.....sheesh....

    Is there somewhere on our site that it claims I am still a member Craig? LOL Please let me know I will remove it ASAP - because that is absolutely an error - I wouldn't want to be promoting their organization or my affiliation with it in any way, shape or form at this point. Funny thing is, if it is on our site even APodA didn't pick that up! LOL

    The real issue here isn't alleged errors on our site - it is in fact that a member organization is using MEMBER funds to peruse NON MEMBER websites all for what exact purpose? I have no idea, because as SurfBoy clearly points out that is AHPRAs job, not theirs. Obviously they have nothing better to do...... Which again I think has been pointed out in this thread on a number of occasions.


    EDIT: Craig I just found it LOL - thanks after you mentioned it I trawled through it looking - how funny - they DIDNT even complain about that! Shows how closely they were actually looking..... That line has gladly now been removed :) Thanks again!
     
  25. Craig Payne

    Craig Payne Moderator

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    "All Podiatrists are Members of the Australian Podiatry Association as well as the Australasian Podiatry Council."

    ...on your 'about us' page.
     
  26. Paul Bowles

    Paul Bowles Well-Known Member

  27. Paul Bowles

    Paul Bowles Well-Known Member

    Yep got it and fixed it immediately (a remnant from a year ago when I was indeed a member of Vic. who by the way provided excellent service, advice, education and cheaper membership rates whilst I was with them) - as stated above the email I received a week or so ago didn't seem to care about that.....LOL
     
  28. surfboy

    surfboy Active Member

    Thanks a lot Paul. Errm I find this very disturbing that Janice is apparently behaving in such a way. I reiterate again to all and sundry - The APODA has no right to pursue non-members regarding any aspect of their practise. To do so may constitute harassment and I would advise the APODA to think very carefully about proceeding in this fashion.
     
  29. Craig Payne

    Craig Payne Moderator

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    I don't have a problem with them doing it if thats how they decide to allocate time/resources ...anyone can have a look at members/non-member website and lodge complaints with AHPRA if there is something they have an issue with .... it does however appear petty in Paul's case.

    Just this morning I posted a comment on a Chi running woo meisters website who wrote about foot orthotics - really clear case of Dunning-Kruger effect and making statements 100% the opposite of what the actual scientific evidence say .... if they want to spend time going after "non-compliant" websites, then the members/profession is better served doing these sorts of activities.
     
  30. Paul Bowles

    Paul Bowles Well-Known Member

    I think my comments above indicate exactly how I felt about the situation and how I believe it reflects on the organization in general. IE Doesn't exactly want me to get the credit card out and join again!

    Craig wrote:

    "Just this morning I posted a comment on a Chi running woo meisters website who wrote about foot orthotics - really clear case of Dunning-Kruger effect and making statements 100% the opposite of what the actual scientific evidence say .... if they want to spend time going after "non-compliant" websites, then the members/profession is better served doing these sorts of activities."

    Couldn't agree more...
     
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