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3.3.5 Role of the specialist

In most circumstances, medical assessments of drivers of both commercial and private vehicles can be conducted by a general practitioner. However, if doubt exists about a patient’s fitness to drive or if the patient’s particular condition or circumstances are not covered specifically by the standards, review by a specialist experienced in the management of the particular condition is warranted and the general practitioner should refer the patient to such a specialist.

In the case of commercial vehicle drivers, the opinion of a medical specialist is generally required for initial recommendation and periodic review of a conditional licence. The main exceptions to this are set out in this paragraph and in section 4.4.7 What if there is a delay before a specialist can be seen?

This requirement reflects the higher safety risk for commercial vehicle drivers and the consequent importance of expert opinion. In circumstances where access to specialists is limited, once the initial recommendation is made by a specialist, alternative arrangements for subsequent reviews by the general practitioner may be made with the approval of the driver licensing authority and with the agreement of the specialist and the treating general practitioner.

Note: The opinion of a specialist is relevant only to their particular specialty. General practitioners are in a good position to integrate reports from various specialists in the case of multiple disabilities to help the driver licensing authority make a licensing decision. An occupational physician or an authorised health professional may provide a similar role for drivers of commercial vehicles and their employers.

For the purposes of this publication, the term ‘specialist’ refers to a medical or surgical specialist other than a general practitioner, acknowledging that Fellows of the Royal Australian College of General Practitioners have specialist status under current medical registration arrangements (refer to <www.medicalboard.gov.au>).

Box 2: Telehealth

All parties are encouraged to use telemedicine technologies such as videoconferencing to minimise the difficulties associated with limited access to specialists.

People in telehealth-eligible areas of Australia have access to specialist video consultations under Medicare. This provides many patients with easier access to specialists, without the time and expense involved in travelling to major cities.

On 1 November 2012, the MBS telehealth items were amended to require that the patient and remote specialist be at least 15 kilometres apart. Eligibility is determined according to the Australian Standard Geographical Classification Remoteness Area (ASGC-RA) classifications. MBS benefits will now only be available for services provided to patients who are located outside of RA1 – Major Cities.

Further information is available from Medicare at

<https://www.humanservices.gov.au/health-professionals/services/medicare/mbs-and-telehealth>.