GPs urge patience while they gear up for diagnosing and treating ADHD

The organisation that represents community doctors is looking forward to changes in February that will allow GPs to diagnose and treat ADHD patients.

But the General Practice Owners’ Association is cautioning that the transition could take time and is urging patience while doctors gear up for the new service.

Last June the Ministry of Health gave the green light to GPs and nurse practitioners to initiate treatment for adults with ADHD, starting February 1 this year. Currently GPs can only prescribe ADHD medicines to patients already being treated by a paediatrician or psychiatrist, meaning long delays for access to treatments such as Ritalin.

GenPro Chair Dr Angus Chambers says GPs are keen to help ADHD patients and reduce wait times, but the transition will require public understanding about what the changes will mean in February.

“There will be no big bang on day one. While welcome, the changes are not going to have an impact as quickly as some patients would like.  Although specialist GPs will, after appropriate training, be able to offer an ADHD service, it’s likely only a small number of GPs will have the training required to diagnose ADHD on February 1. 

“Indeed, most GPs will likely never be trained to provide ADHD diagnostic or treatment. They won't have the time, finances, interest, or capacity to proactively take on this extra responsibility and additional workload.

“The assessments will need diagnostic rigour to appropriate standards and will typically take more than an hour over several visits, roughly the same as seeing a psychologist or psychiatrist.

“As well, the GPs doing ADHD assessments will reduce their ‘normal’ general practice work to fit in assessments, so access to GPs for other care could deteriorate.

“Importantly, there is currently no funding allocation to GPs and primary health care to cover GP training and diagnosis of ADHD - it sits outside our current public funding model. So time spent on ADHD will be unsubsidised and therefore fully patient funded.

“GenPro is concerned that patients might think that they can be treated in a standard 10- or 15-minute consultation for as little as $19.50 and leave with a script for Ritalin, which is a controlled amphetamine stimulant. This won’t happen.”

"At typical private GP rates, the cost of an ADHD assessment is likely to be comparable to the current consultation fee of a private psychiatrist or psychologist, typically between $800 to $2,000.

“I repeat that GPs are looking forward to providing this service for patients, but it’s not as simple a process as some might assume. And while a minority of trained GPs will have the competency to offer ADHD treatment, this won’t immediately improve access and lower cost for patients compared to the current system,” Dr Chambers says.