Less relief of chronic pain

THE federal government has slashed $40m from services for the one in five people living with chronic pain, exacerbating lengthy waits for specialist treatment.

And from March 1 people suffering from facet joint pain in their back and neck will no longer be able to get best practice care via a radiofrequency neurotomy, which was previously fully funded by Medicare, doctors claim.

A government review called for restrictions on some pain surgery and radiological procedures because there was little evidence they provided benefit for people.

But doctors said the implementation had been muddled – disadvantaging some patients.

The review also called for Medicare funding to be shifted from hospitalbased care to new community-based pain treatment programs run by pain specialists, but the changes do not fund this type of care.

If the review’s finding had been fully implemented, patients would have been given access to comprehensive coordinated pain management via pain specialists, physiotherapists, occupational therapists and psychologists working together.

The government banked the savings from restricting access to pain procedures but did not provide new Medicare rebates for 35,000 people needing specialist pain treatment, dean of the faculty of pain medicine of the Australian and New Zealand College of Anaesthetists, Associate Professor Michael Vagg, said.

Migraines and back, neck and shoulder pain are four of the top 10 reasons people leave the workforce in prime working years, he said.

Faculty of pain medicine doctors who are not members of the Royal Australasian College of Physicians (RACP) are not able to access a Medicare rebate worth $234, which allows for a one hour complex consultation with a patient including the generation of a pain management plan.

Instead, their patients can only claim a $134.30 Medicare rebate.

“The laws of economics dictate that lower reimbursement means less time can be spent with the patient, or else the out of pocket costs are passed onto the consumer,” Professor Vagg said.

Worse still, the Medicare changes misunderstood how doctors perform radiofrequency neurotomy – an evidence-based pain procedure – to relieve back and neck pain.

New restrictions on access to the therapy only allow it to be performed three times per year, a change specialists support.

However, the Medicare rule changes state only three facet joints can be treated within a 12-month period.