Who will get a pathology requesting letter

We use data from the Medical Benefits Schedule (MBS) to calculate pathology requesting rates. GPs who meet specific criteria receive a letter.

Criteria to receive a letter

To receive a pathology requesting letter, GPs must have met both of the following criteria:

  • Their requesting rate of certain combinations of pathology tests was in the top 10% of GPs practicing in Australia.
  • Their requesting rate of 2 or more combinations was also in the top 10%.

Data used to calculate the rate

We use data from the Medicare Benefits Schedule (MBS) to calculate a GP’s pathology requesting rate. This includes data on the number of:

  • pathology requests that resulted in at least one service being rendered by a pathologist and claimed under the MBS
  • consultations you billed to the MBS.

Requesting rate calculation

Your requesting rate is based on the number of pathology tests that you requested for your patients over a 2-year period between 1 July 2019 and 30 June 2021. We only included requests that led to an MBS service being rendered by a pathologist.

Included pathology requests

The pathology requests included were:

  • Thyroid Stimulating Hormone TSH (MBS item 66716)
  • Thyroid Function Test TFT (MBS item 66719)
  • Vitamin B12 serum (MBS item 66838) and/or Vitamin B12 quantification (MBS item 66839)
  • Iron studies (MBS item 66596)
  • Vitamin D (MBS item 66833).

While there are many pathology tests available, we have focused on a small number of specific tests that have been repeatedly requested in combination. Recent studies suggest that these tests are often requested in the absence of clinical indications ("red flags"). It is also uncommon for a patient to present with symptoms indicating more than one of these tests are required at a time.

GP categories

We used the Modified Monash Model (MMM) to categorise GPs as:

  • Metropolitan – practice located in MM 1 area
  • Regional and rural – practice located in MM 2 to MM 7 area.

We determined your MMM classification based on your primary practice address as at 11 November 2021.

To determine your requesting percentile, we compared your requesting rate with other GPs within the same category. 

Resources

We have worked with professional associations to develop a list of resources to support improved pathology requesting. See Pathology requesting resources and guidance.

Last updated: 
6 May 2022

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