The loss of old favourites such as urea, total protein, gamma GT, will not
rationalise the provision of diagnostic services. The marginal cost and
effort in providing these inexpensive and relible analyses is small by
comparison with the total cost, pre lab, preanalytical, analytical,
postanalytical, and the associated inconvenience of adding them back where
they are of proven value makes the exercise of questionable use. It is
naive to imagine that if the consumption of these reagents falls
dramatically nationally, that our providers will not recoup the lost
revenue by putting up the price of what they do provide. They will have
no other option.
Some laboratories in Australia employ accountants whose specific role is
to recommend requesting patterns that maximise the Medicare rebate to the
pathology provider. This has little to do with clinical excellencce and
degenerates into a struggle between healthcare administrators and
pathology providers in their efforts to resist each other's predations.
Let us not throw out the baby with the bath water!
David
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