Pathologists may diagnose, select tests

Pathologists will be given greater involvement in the diagnosis of patients along with the ability to decide the best test for patients' conditions, under a series of reform being examined by the Federal Government. The government has launched a detailed review of pathology in an attempt to contain costs. It will examine whether to roll back fee-for-service for pathology tests, with providers competing for fixed-term contracts to provide selected services. The paper also suggests "greater pathologist involvement in the diagnosis process" — partly in an attempt to reduce the number of inappropriate tests being ordered. "To encourage greater involvement by the pathologist in the clinical diagnosis of patients, a fee could be included on the MBS to allow the pathologist to be consulted by the referring doctors on the most appropriate test for a particular condition," the paper states. "Alternatively, a request from a medical practitioner could simply ask for the most appropriate tests for a suspected illness or disease, leaving the pathologist to determine what the appropriate test would be." According to the paper, this would ensure the "expertise of the pathologist [would] be better utilised, the correct test to be undertaken, with potentially better outcomes for the patient". The review comes at a time of growing pressure on the pathology budget. The number of Medicare-funded pathology tests ordered has risen by 54% between 2000-01 to 2007-08, an increase from 62.1 million to 95.7 million. Over the same period, pathology costs to Medicare went from $1.1 billion to almost $1.9 billion. The Federal Government, which is to set up a Pathology Review Consultation Committee, is expected to start introducing funding changes from the 2011-12 budget. The deadline for submissions to the discussion paper is 30 April. A second discussion paper will be released in the middle of the year....