The Federal government’s concerns about the rapidly rising cost of after-hours home visits by medical practitioners has led to using the increasingly popular ‘nudge theory’ in an attempt to change the behaviour of doctors making the highest number of claims.

The issue of rising budgetary costs - highlighted previously in GP Speak - is one of the issues being considered by the government’s clinician-led Medicare Benefits Schedule Review Taskforce. The review has recommended that after-hours billing should only be allowed by GPs who normally work during the day and are recalled to work for management of patients needing urgent assessment.

Nudge theory is a concept in behavioural science that employs positive reinforcement and subtle messaging to seek compliance with desirable government policies or social strategies.

It is utilised by various governments, notably in the UK and USA, but also in Australia where it is employed by Behavioural Economics units in NSW and by a team inside the Department of Prime Minister & Cabinet. The ATO has a nudge program to encourage people to “join the millions of Australians who pay their tax to support our country and Australia's way of life”.

This year’s winner of the Nobel Prize for economics, Richard Thaler, is known as the ‘father of the Nudge theory’.

In a story broken by The Australian it was revealed that the Department of Health had adopted the theory to send ‘carefully worded letters’ to 1200 targeted doctors who provide care at night, on weekends and public holidays.

According to internal documents accessed under FOI, “all health professionals who received the letter had significantly reduced their claiming of urgent after-hours items by 19.5 per cent,” which equated to an estimated $11.7m in “behavioural savings (or $9750 per letter sent)”.