The MBS (Medicare Benefits Scheme) review taskforce announcement has been surrounded with discussion of the necessity for medical tests with a high profile ABC Four Corners episode highlighting many issues.
The team at Rehab Outcomes regularly sees over use of diagnostic tests that in themselves may not be to harmful, certainly costly but have hidden side effects that can often derail the normal recovery from a minor disorder.
Most commonly is MRI or Xray for low back pain. The story often goes like this: patient scared/frustrated/not happy with progress, doctor quite rightly re-assesses flags (read more about musculoskeletal flags here) and active therapy and rehabilitation is put on hold, progress stalls further and patient anxiety increases. Worst case scenario results in loss of work capacity long term, joblessness, family and community burdens.
The review poses lots of challenges not least of which include helping doctors, treatment providers and anyone else connected to someone injured having the difficult conversations that turn away from medicine. Payment systems and easier access to costly diagnostics might just be following our western consumerist culture, while these still need to be there for the important cases and issues.
In the world of workplace rehabilitation and early intervention we stand by the view that 'injury' is a complex biopsychosocial phenomenon and not just biomedical. This means tackling the medicine and psychosocial aspects at the same time, not in serial and if this review goes towards highlighting these issues then it's good for workers and the community.
Physiotherapist & Director