Which bush heart surgeons are doing the best surgery?
In January 2018, the Federal Government announced that all Australian hospitals would be forced to operate on more than half the patients in their care within five years.
In an effort to improve care, the Australian Medical Association (AMA) has proposed a number of reforms that could dramatically improve care for the sickest Australians.
The AMA’s recommendations include: • The introduction of a one-off payment for all surgeries, including elective surgery • All Australian hospitals will be required to offer elective heart surgery, and surgeons will be encouraged to do so in preference to the existing system.
This will make it easier for patients to obtain a cardiac procedure and more affordable to patients.
• The AMA recommends the use of more effective diagnostic techniques, including PET scans, magnetic resonance imaging, ultrasound, and electrocardiography (ECG) scans, and the development of a new device, the CXR, to provide high-quality information about the heart.
This device could help surgeons to assess patients’ heart disease risk and to make the most of their available resources.
AMA chairperson, Dr David Nicholson, said the AMA’s reforms would improve patient care and would help Australians save more than $4 billion a year.
“Patients will be better informed about the risks of their heart disease and will have more information about elective surgeries,” Dr Nicholson said.
A number of hospitals have already been able to benefit from these reforms, with patients having access to elective procedures such as a coronary bypass and heart transplant.
But the AMA says this will not be the case for everyone.
Some hospitals will continue to operate without elective cardiac surgery, despite the AMA recommendation.
The AMA has also suggested that more hospitals should consider alternative payment options.
For example, if patients are receiving elective elective treatment, and they have been refused a surgery by their local hospital, the AMA suggests hospitals could increase the amount of money they are paid.
Another major proposal by the AMA is the introduction of an opt-in, or “no cost” payment model.
The concept of no cost payments was first introduced in New South Wales in 2016.
It was initially used to help hospitals reduce their operational costs and has since been introduced in several states and territories.
But the AMA argues that hospitals are now under a huge financial pressure, and that this could cause hospitals to over-charge patients for elective operations.
In the AMA report, Dr Nicholson says the idea of a no cost payment model is “a critical element in providing a safe and effective care environment for patients”.
“The AMA also believes that in addition to encouraging more hospitals to offer these services, this could lead to a shift in the way patients receive care.”
It is not clear whether any of the AMA recommendations will become law before the end of the year, but some experts have already expressed concern about the potential impact of these reforms.
Dr John Bunn, a cardiologist at the University of Western Australia, said patients with heart disease or other conditions were “too often being turned away from surgery”.
He said there was a “significant gap between what is happening now and what the patients need”.
Dr Bunn said patients who were denied elective cardiovascular surgery could be turned away for “unnecessary and potentially harmful” procedures, such as angioplasty, bypass surgery, coronary bypass, or heart transplant, as well as for electives such as elective coronary bypass or elective implant.
For example, an angioplotteric bypass could be performed by a heart surgeon for a patient who has coronary artery disease, while a coronary valve implant could be done for a heart patient who is unable to do a valve replacement.
An angioplastic bypass, which involves removing the entire coronary artery and reconnecting it to the heart, would likely cost between $600 to $800 per operation.
However, Dr Bunn believes the AMA proposal would make elective surgical procedures more affordable for patients.
He believes this could help patients make the best of their care, and save the hospital money.
Mr McLean said he would like to see more hospital beds open, and to see a more comprehensive approach to cardiology, and said the proposal was a positive step in the right direction.