CURRENT methods of helping GPs identify “doctor shoppers” are inadequate, and a national real-time monitoring system must be introduced, Dr David Outridge says.
Subscribe now for unlimited access.
or signup to continue reading
The Hunter Valley GP said doctors were “working in the dark” when it came to identifying skilled doctor shoppers, as information collected through the Australian Government’s Prescription Shopping Programme (PSP) was three-to-six months out of date, and took a minimum of six weeks to receive.
Prescription, or doctor, shopping is when a patient gets more medicine than they need, and visits many different doctors without telling them about their other consultations.
The Newcastle Herald recently reported that some Hunter GPs were refusing to prescribe addictive medications such as benzodiazepines and opioids in a bid to prevent doctor shoppers selling them on the black market for upwards of $50 a tablet.
“One the problems GPs have with any medication of addiction is that we don’t know who has prescribed the same medication the same day,” Dr Outridge said.
The threshold for a person to be placed on the PSP’s doctor shopper list was high, and doctors were not automatically notified when someone reached that threshold, Dr Outridge said.
“If someone comes in asking for some Valium, and I wanted to check on who they’ve seen before, there is no way of doing that unless we can get them to sign a release of information, send off the paperwork, and then when we get something back – six weeks later – it’s at least three months out of date,” he said.
Dr Outridge said private prescriptions, and any quantities of the medications that did not attract a Pharmaceutical Benefits Scheme (PBS) benefit, were not recorded in the system.
He said a real-time medication monitoring system, similar to those used for codeine and pseudoephedrine sales, was essential.
“But it must include all prescriptions, not just PBS items – which will require significant funding, and it must be a national system to prevent cross-border anomalies,” Dr Outridge said.
He said more information should be made available on the PSP’s hotline, and that the NSW Health Department needed to better regulate prescribing practices.
Services for people with opioid and benzodiazepine dependence should be increased, he said, and pharmacists should be offered incentives to provide a “staged supply” of medications to prevent over-use.
“GPs are working in the dark when it comes to some skilled ‘doctor shoppers’ or addicted people who can take advantage of the busyness of GPs and the natural tendency to want to reduce suffering,” Dr Outridge said.
“In general, the more pathological the lying, the more effective it appears to be, so not easy to pick.”
