Stroke

Controversial stroke screening service still operating


An ultrasound stroke screening service that has been condemned by the Chief Medical Officer is still operating in NSW, a leading vascular surgeon says.

Last year medical charity Strokecheck was lambasted over its bulk-billed program that used ultrasound to check for carotid artery stenosis, offered to the public through Amcal Chemists.

The program was dropped by the pharmacy chain after being widely condemned by medical experts. The Stroke Foundation said the premise was “highly controversial” and not recommended by guidelines, while Chief Medical Officer Professor Brendan Murphy warned such screening would do more harm than good.

Now the vascular surgeon who first sounded the alarm, Dr Bernard Bourke, says a similar screening program is being offered to the public in venues such as bowling clubs and a retirement village on NSW’s central coast, with three of his patients taking part.

Dr Bourke, president of the Australian and New Zealand Society for Vascular Surgery, said the free screening model being used appeared identical to the one previously used by Strokecheck.

Participants first see a junior doctor who uses their Medicare provider number to refer the patient for an ultrasound scan, performed in a chair in about 10 minutes.

Ultrasound scans at three locations (neck, abdomen and ankle) have three separate Medicare items worth over $400, and results are sent to a radiologist who reports on the results remotely.

“These scans would normally take an accredited cardiovascular laboratory an hour-and-a-half to two hours to perform,” Dr Bourke told the limbic.

“They do it in ten minutes, as a scam.”

How such programs are funded is unclear; in article published in The Age in 2017 Strokecheck gave conflicting accounts about whether it claimed items through Medicare.

It is also unclear who is behind the recent scanning program on the central coast.

Last year, medical recruiter HealthCare Australia advertised for sonographers with ‘carotid experience’ to work for a mobile Strokecheck service, offering $40 per scan (25-35 patients) for one day in Newcastle. Similar ads targeted Melbourne, Sydney and Darwin. The same company advertised for PGY2 doctors to join offering $1200 a day.

Peter Treacy, senior healthcare consultant at recruitment agency Healthcare Australia, told the limbic the agency had not dealt with the Strokecheck program “for a long time”, and could not confirm whether it was still involved in recruiting for similar programs.

Dr Bourke said radiology reports featured logos for companies other than Strokecheck however; “We believe it’s the same company in the background, it’s the same format,” he said.

“I have reported this to the department of health and also the MBS Review”.

The legal firm listed as the contact for Strokecheck did not return calls from the limbic.

A spokesperson for the federal department of health said it took allegations of unnecessary screening and incorrect MBS claiming “very seriously, however [it] is not able to comment whether individual providers or practices are under investigation due to the secrecy provisions of the Health Insurance Act 1973”.

“Providers who engage in inappropriate practice are referred to the Professional Services Review, and where there is evidence of fraud, the Department will refer the provider to the Commonwealth Director of Public Prosecutions for potential prosecution.”

Meanwhile the Royal Australian and New Zealand College of Radiologists has advised members to avoid reporting on imaging that has been done as part of an unapproved screening program.

A spokesman said medical imaging should be used judiciously and only when clinically appropriate, after careful assessment by a referring doctor.

“RANZCR believes that imaging services should only be provided in a clinical setting where there is evidence to support the use of imaging,” the spokesman said.

“It is also the role of the clinical radiologist to advocate for appropriate use of imaging. RANZCR believes there is no evidence that people without symptoms benefit from an ultrasound screening test for stroke prevention. Use of ultrasound in this setting is not endorsed by RANZCR, the Stroke Foundation or the Australian and New Zealand Society for Vascular Surgery.”

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