Sports Doctors Get Medicare Recognition

Kent · Jul 4, 2010

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Sports and exercise physicians to gain speciality status under Medicare from November which means all referrals to sports docs will have to go through the GP. This is from the Australian:

IN his small office in the headquarters of the Sydney Roosters rugby league club, John Orchard sits surrounded by piles of sports bags, each filled to overflowing with a mix of equipment, bandages, medicines and other medical paraphernalia.
Outside the door, stairs lead down to a room full of gym machines worth tens of thousands of dollars. That's where players are working out in preparation for the weekend's game against the New Zealand Warriors.

For doctors whose job it is to work with professional sportsmen, this state-of-the art equipment is all part of the business of keeping high-profile athletes such as the Roosters' Aidan Guerra in peak condition, Orchard says.

In November this year, those doctors, known as sport and exercise physicians, finally are due to jump the final hurdle of formal recognition of their status as specialists under Medicare.

Sports medicine is a business in which Australian doctors excel. Some claim our sports medicine is the best in the world. Certainly, that's what one of Orchard's colleagues, Socceroos doctor Peter Brukner, was told recently when recruited by English Premier League football team Liverpool.

"I think in many ways Australia leads the world in sports medicine and I guess that's reflected by my appointment," Brukner told ABC radio before leaving for the soccer World Cup in South Africa. "Liverpool tells me they did a worldwide search and basically decided that Australian sports medicine was the best in the world and that's why they wanted an Australian."

That excellence -- which provides a competitive advantage to our sporting teams and athletes competing in arenas such as the Olympics and Commonwealth Games -- is thanks to a variety of factors, Orchard says. Those elements include the fact that in our sports-mad country, physicians with an interest in sports have an opportunity to work with athletes in a range of codes, from netball and ballet to rugby league, AFL and beyond. On the day we meet, Orchard is wearing a Cricket Australia jacket.

Another important factor in the specialty's success is the funding that was poured into sports science and medicine when the Australian Institute of Sport was established to help turn around the country's failing sporting reputation in the early 1980s.

Perhaps most significant, Orchard says, is that for 20 years Australia has had a world-leading training program for sports doctors.

Although that four-year program has been training doctors since 1992, it is only in the past couple of years that sport and exercise medicine has been recognised as a specialty, and it won't be until November this year, when the latest revisions to Medicare are rolled out, that this recognition will be reflected in the operation of the health system.

That it's taken so long for their specialty to be formally recognised is a sore point with sports physicians. While they've waited, other countries that have modelled their set-ups on the Australian system, including New Zealand and Britain, have leapfrogged ahead by making sports medicine a recognised specialty.

"It has been a hard road and it's one that we're very pleased to be almost at the end of," says Andrew Garnham, president of the Australasian College of Sports Physicians, the body that represents Australia's 121 sports doctors. "We really look forward to the community generally being able to reap the benefits of that."

The establishment of the specialty -- to be known formally as sport and exercise medicine -- will mean patients will need a referral from their GP to see a sport physician.

But Garnham and his colleagues argue it will help spread the excellence of Australia's sports specialists from the elite athletes down to the weekend warriors.

"By having a referral-based system, we establish communication with the general practitioner," he says, adding that, in fact, most minor sporting injuries are appropriately treated by GPs and allied health professionals such as physiotherapists.

Even in those cases, sport physicians can help, say, by conducting conferences aimed at providing GPs with chances to increase their knowledge, Garnham says.

"Part of the specialist's role is to help upskill the general practitioner. So there's an educational role there and we will see the wider benefit across all patients."

For Orchard, any reforms that widen the availability of sports medicine can't come soon enough, particularly for those without private health insurance.

"In terms of private sports medicine, we've got the best set-up and infrastructure in the world," he says. "But we cater very poorly to the person who hasn't got money who gets injured playing sport. In the public system, people with sports injuries are treated like second-class citizens."

In June, Orchard and others compared the sports medicine and public health capacities of the nine countries bidding to host the FIFA World Cup in 2018. They found that while Australia punched far above its weight in terms of sports medicine research output, it did relatively poorly on other scales such as the percentage of health expenditure going to public health and prevention.

Overall, this meant Australia scored a total of 52 points out of a maximum 90. England, by comparison, topped the ranking with a score of 64, largely thanks to efforts made as part of the country's bid for the 2012 Olympics.

While governments have done a good job of funding sports medicine research through the Australian Institute of Sport in Canberra and state sports institutes, there's been too little emphasis on exercise in the wider health system, Orchard says.

"There are very few sports physicians employed by public hospitals and, because Medicare rebates fail to allow for the cost of provision of specialist services, there's very little bulk-billing."

There are thought to be more than a million sports-related injuries in Australia each year, more than 10 per cent of which affect the knee. For a younger person who suffers a serious injury such as a rupture of the anterior cruciate ligament in their knee, being able to afford appropriate treatment could mean the difference between an active, healthy life and one permanently limited by that injury, Orchard argues.

Even with treatment, the effects of sporting injuries can be substantial. In 2008, Victorian researchers reported that a high proportion of people who suffer major sporting injuries are feeling the consequences a year later.

"Should we be saying you should be forking out large amounts of money for the right to do sport?" Orchard asks. " The mentality of our system is that you've done that to yourself so you must pay. We have to spin that completely around."

The neglect of sports medicine is a symptom of a wider neglect of exercise in the health system, he claims. In his view, the government and health system haven't reacted to the fact that exercise is critical for the nation's health.

Research published in 2005 found the proportion of Australian children who were physically active dropped from the mid-80s to the late 90s. Among boys aged 10-13, participation in at least one sport dropped from 87 per cent to 76 per cent. For girls of the same age, rates fell from 80 per cent to 71 per cent. Those children said only 30 per cent of their parents exercised regularly.

"We're sitting back saying it's OK for 50 per cent of the population not to be exercising," Orchard says. "We should be aiming for 85 per cent of the population who are actively exercising."

At the Australian Institute of Sport, head of sports medicine Keiran Fallon agrees the health benefits of exercise aren't being felt by the community at large.

"There's an enormous amount of evidence that exercise is beneficial, but there's enormous resistance to getting out and doing something," he says. "The key issue for sport and exercise medicine is infiltrating the minds of the well people in our community to maintain their health . . . by getting out and doing exercise."

Orchard couldn't agree more. As he packs one of his bags of medical supplies and heads out to treat a Roosters player, he says one reason our sports doctors are so effective in the professional world is players pay attention to their advice. If the rest of us did the same, the inference is, we could all be in better shape to tackle whatever life throws our way.
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Sports Doctors Get Medicare Recognition

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Sports Doctors Get Medicare Recognition

Kent Active Member

Teamleader Sports Podiatry unit - Qatar

Want to work in sports podiatry? Come Explore New Zealand

Postural Distortions Linked to Compromised Performance in Sports

Neurocognitive function and musculoskeletal injury risk in sports

Influence of sports background on the bouncing mechanism of running

Do you want a free post graduate degree in "Sports Medicine"?

Book: Athletic Footwear and Orthoses in Sports Medicine, 2nd Ed

Share This Page

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