The debate on the uses and alleged abuses of the initial specialist consult MBS item have been long-running. Last week Dr Craig Lilienthal entered the fray once in his AusDoc opinion article.

“I am very embarrassed — nay, pissed off — when I hear that some of the specialists to whom I refer patients often charge initial consultation fees when following up patients for established conditions,” he wrote.

“The specialists do this when the patient’s referral has just been renewed and/ or they haven’t seen them in the previous 12 months.”

Asking why Medicare did not investigate, he added: “To those of us at the bottom of the food chain, this seems like a rip-off.”