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The heart of the matter

Martin B Van Der Weyden
Med J Aust 2007; 186 (6): 273.
Published online: 19 March 2007

When should you call the heart clinic? When you are over 40? When you are overweight? When you are a smoker? When your blood pressure and cholesterol are too high? When your chest is tight? When your breathing is short? When your heart beats irregularly?

While your heart beats . . . before you have a heart attack, not after.

This advertisement, played incessantly on commercial radio, targets the “worried well” and invites them to make contact with a heart check clinic for potential cardiac and vascular testing. Given the commercialisation of medicine, self-referral clinics are to be expected. Medicare provides a reliable revenue stream, and aggressive advertising is the key to throughput and success.

Indeed, the business of heart clinics must be booming. In the past 2 years, Medicare statistics reveal an unprecedented doubling in claims for vascular testing. In turn, the federal Minister for Health is considering instituting a ban on radio advertising for heart testing, noting: “I am far from convinced that [they are] a good thing, on public policy grounds.”

Herein lies the rub. Direct advertising to the public by pharmaceutical firms and doctors is either illegal or unprofessional. In contrast, advertising by commercial concerns is relatively laissez faire, as ads for erectile dysfunction, prostate problems, and attention deficit hyperactivity disorder choke the airwaves.

But more fundamental issues are at stake. Firstly, self-referral clinics usurp the traditional “gatekeeper” role of general practitioners. Secondly, the Medicare Benefits Schedule (MBS) provisions for health screening are readily exploitable.

The solutions are simple. The analysis of Medicare payments needs to be more rapid and focused. More importantly, the MBS provisions for health screening need to be reviewed urgently by informed professionals.

It’s time to get to the heart of the matter.

  • Martin B Van Der Weyden


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