What is preventive health care?
Preventive healthcare aims to prevent illness and assist in the early detection of specific diseases whilst encouraging the promotion and maintenance of good health.
How can I provide preventive healthcare through the MBS?
In 2010, the item descriptions for Level B, C, and D consultations were changed to include ‘providing appropriate preventive health care’. These changes were made support patient access to preventive based clinical activities. Patients are eligible to claim Medicare rebates for attendances when preventive healthcare has been provided.
Full Medicare item descriptors can be found on the MBS online website.
Joe presents to his GP who he last visited a year ago with a lacerated hand. That visit was entirely focused on cleaning and suturing the wound. Joe is 52 years old and separated from his wife 2 years ago. They have two adult children. He has maintained regular work as a plumber. His new partner Julie has a 5 year old child and has urged him to get a check-up.
Joe says he feels well and is happy in his new relationship. His GP is pleased to have the opportunity to perform a medical assessment and advise on preventive health approaches.
After taking a screening history, including asking about issues with sexual functioning, the GP enquires about smoking, nutrition, alcohol and physical exercise. The GP conducts a general physical exam including height, weight, BMI, waist circumference, BP and urinalysis. Because of the outdoor work performed by Joe, skin cancer risks are discussed and a full skin check is offered.
Screening for bowel and prostate cancer are also discussed and Joe opts to have a prostate examination. A lipid profile and fasting BGL is arranged.
This consultation takes 30 minutes and is billed as an Item 36, as preventive healthcare is now included in the descriptors for consultation items in the MBS.
- The SNAP guidelines developed by the RACGP are designed to address lifestyle health issues that can be raised in the context of a preventive health consultation or in connection with chronic disease management.
- There is strong evidence to support annual screening for obesity, hypertension and kidney disease. Bowel cancer screening by FOBT is recommended every 2 years from age 50. Fasting blood glucose should be screened every 3 years from age 40 and more often in higher risk groups. Lipids should be screened every 5 years from age 45 and more often in higher risk groups. A full list of evidence based preventive health checks is included in the RACGP ‘red book’.
- Prostate screening requires a patient centred approach and discussion of the potential benefits and harms.