ASPS on Medicare & Abdominoplasty

ASPS share good news for women who suffer from muscle separation following pregnancy!
BREAKING NEWS! Is the Abdominoplasty with Muscle Repair Item Number coming back???
Check out our chat with ASPS Vice President Dr Nicola Dean, and ASPS Community Representative, Kerrie Edwards, who are leading the campaign to have this procedure reinstated to the Medicare benefits schedule more than 5 years after it was removed in 2016. #PowerOfThePeople #repairthegap
Hit the link in our bio to listen now and for more from ASPS, check out their page @plasticsocietyaustralia

Transcript: ASPS on Medicare & Abdominoplasty

Trish

Hello everyone and welcome. Today I’m joined with Dr. Nicola Dean who’s the Vice President of the Australian Society of Plastic Surgeons or ASPS and Kerrie Edwards who is the ASPS Community Representative. So Hi and Welcome, ladies. 

Nicola and Kerrie

Hi. 

Trish

Lovely ASPS has just announced that Australian women who suffer negative physical consequences of pregnancy due to abdominal muscle separation may be able to have reconstructive correctional surgery funded by Medicare later next year after campaigned by women and surgeons to have the procedure reinstated to the Medicare benefits schedule more than five years after was removed, which was in 2016. This is fantastic news for a number of women who are suffering through this pain and trauma. And today on the Aesthetics Uncensored podcast, we’re going to talk about it. 

So welcome, ladies, thank you so much for joining us tonight. And this is just so exciting I’m so happy to be part of this. And I’ll just gonna ask the first question to you, Nicola, if you don’t mind before we talk about the recent support from the Medicare advisory committee and what that means for women. Can you explain to listeners what abdominoplasty with the surgical repair of muscle separation following pregnancy is and why it was removed from the Medicare schedule in the first place.

Nicola

So thanks, Trish. Look, the term abdominoplasty as a kind of overall term just means to reshape the tummy wall or reshape the tummy. And it can be done for a number of reasons. It can be done for cosmetic reasons, for improving the look on the tummy. It can sometimes be done for people that have terrible rashes and problems after they’ve lost a lot of weight and have a big sort of an apron overhanging. But sometimes it can be done because there are structural problems with the muscles of the abdominal wall. And that can sometimes be after major surgery rarely, but much more commonly, it can be done after the abdominal wall muscles separate, and then fail to go back together again, properly after the end of a pregnancy. And that can sometimes cause people to have back pain and other symptoms. And most moms that give birth, they have a bit of muscle separation, and it goes back together fine and they don’t need any operations, which is, of course the normal course of events, but just for a few women, and they don’t have the muscles going back together. And a small proportion of those women that have the muscles going back together, get some really significant symptoms from it and so they’re really the target of this sort of process to get this back on the Medicare schedule and why was removed from the Medicare schedule in the first place? Look, I think the wording of the original Medicare item number was pretty bleak. And Medicare was looking to find ways to make sure that the will now item numbers being used for cosmetic surgery, because Medicare is really the federal government’s way of making sure that functional operations are available to everybody that needs them. But it’s not there for cosmetic surgery and Medicare were a little bit worried that perhaps some of the people having this surgery were really not functional patients say they weren’t having cosmetic surgery now. There was really not a lot of evidence on that. But really, they felt that they would rather stop the item number and then reevaluate everything

Trish

Was gonna ask you why it was removed from the NBS and what the consequences of that were as well.

Nicola

Yeah, well, I think the problem with removing it from the NBS is that they didn’t really have the insight to realize how badly it would affect the health of a significant number of women. And I think that the women that have them or anybody that had had massive weight loss, so they’d lost 50 kilos and they were having rashes under the skin were still entitled to have the abdominoplasty if they met the criteria about the weight loss in the rashes. But those women who have the pain and discomfort and real problems, after the muscle separations in pregnancy, were really not able to access treatment. So we felt very strongly in the Australian Society of Plastic Surgeons, that it was really important to go sort of an advocate for those women to get that returned to the the sort of funding of Medicare so that women who couldn’t afford to self fund, of course, would still be able to get that surgery.

Trish

And you know, it’s really funny, because you’re saying a certain percentage of the population suffers. I think there’s a massive percentage that don’t even realize that it’s a thing that can happen, and they spend a lifetime suffering because I have spoken to women, that’s the case as well. So that in itself is scary as well. And so Kerri, can we ask you, so I spoke to you over a year ago, just a few days before your petition to the House of Representatives closing, can you just take us back to why you decided to petition at that time, and the result of that petition as well.

Kerrie

Um, so I had my twins back in 2016. And they were big babies. So I suffered a really large separation. And for a long time, I sort of couldn’t come up with two new babies. But I realized I had a significant problem. So I started seeing a physiotherapist. I spent a huge amount of money on physiotherapy treatments, and private health, and it covers so much. Yeah, so a huge amount of money was spent on that. And then I got to a point where my physio basically said, you know, you can’t fix it anymore. This is basically what you have to live with unless you have surgery. And so I did some, I looked into surgery, and $15,000 or more out of pocket, I knew that the item had come off the Medicare schedule. And so then I just sort of started listening into the conversations in some of the Facebook groups that I’m in like moms of multiples and various moms groups, and started some conversations about it and realize that I wasn’t alone, there were quite a few women out there that were really suffering from this and what really upset me was that so many had refinanced their homes, they had drawn their superannuation to pay for the surgery. And those things have such great impacts on families financially. Women have already taken a hit to their superannuation when they take a break from work, for having children so I kind of got the feeling that there would be a lot of support. And we were in lockdown this time last year, around about that time, when I decided to start the petition. And I got a lot of support from moms of multiples, and then people shared it all over the place. I sent it to all sorts of media organizations and then once a couple of media organizations ran a story on it, then it really got out there. And it became apparent that that the problem is there for these particular women that Nicola was talking about. Yeah, so the petition went really well, we got over 13,000 signatures. And then, towards the end of that, that’s been a surgeon that I had reached out to who, who was involved in some, in some studies, referred me to the Australian Society of Plastic Surgeons to chat with them. And yeah, then they fill me in on the fact that they have been fighting this for a long time and that they were going to put in a renewed application. So it was very serendipitous, I guess, my petition and what they were doing and yeah, 

Trish

And hold on because it’s really funny because speaking from a consumers point of view, or a mom who’s someone who’s been through it, we can help people to understand that. That it is a real thing, even though, someone can say as much as they like, but unless you speak to someone who’s been through it, and most of that, you totally understand it. Nicola, so ASPS launched a survey in April this year, encouraging women to share their stories about the effects of abdominal separation, post pregnancy, and you received over 1400 responses to this survey. So do you think the voice of these women combined with Kerrie’s petition added extra weight to the application?

Nicola  

Absolutely, I think the really great thing about this whole campaign, it’s been really the theme of collaboration, I mean, ASPS, really tries to understand and incorporate the voice of the community and continuous and that’s why we have a consumer rep one on Council. And actually, we didn’t want Medicare thinking all this is just plastic surgeons trying to push their own agenda because they want to earn more money or something, we thought, we really want to help the government understand that this is about helping everyday moms that are struggling to lift up their toddlers. I’ve been there, I’ve had two kids, and I know that lifting up the top was hard at the best of times. But you know, it really causes a significant impairment and quality of life and I think that this sort of technical aspect of doing one of these applications is enormous. I mean, it’s a kind of three year thing, just to even apply to the Medical Services Advisory Committee and we’re not a big pharmaceutical company or anybody like that so we would just try to have to learn the mechanics of that part of the process. But then, we thought that it was really important to have the consumer voice in there is this part of the medical services advisory committee process where community members and stakeholders can put in a survey or an email or something to give their perspective on it? And to their credit, that the Medical Services Advisory Committee? And do you listen to that, and I think that that does make a difference and so I think it’s, it’s been a fantastic collaboration we’ve had Kerrie, and we’ve had xxxxxxxxxxxxxx he’s the person in the office that helps you all decide to number stuff and Dan Kennedy in May, and Tim Taylor says a few different people. And I think that the collaboration effort around it, and the involvement of the community, and it speaks to such a real thing to hear somebody’s story that actually I can’t get on the floor and play with my kids and play with it. Lego, that’s the kind of thing it’s not about looking like some movie star, it’s about being able to do normal stuff. Yeah.

Trish

It’s so funny, because I had my muscle repair and tummy tuck after my second baby, which is 24 years now, and in those days, I had no idea about the muscle separation, someone said to me, You should go and have a look at that. And when it was pointed out to me, I was like, Oh, my God, is that what it is? And like, you can feel it, like it’s a physical thing, as well. Like, you can feel it physically, but you can also put your hands in and have a feel of it as well. And you can see that so yeah, I’m just I get surprised at some women actually bounce back from that because like really, you probably rip right open your belly comes out like this and it’s just remarkable. But anyway, I was going to ask you as well, Nicola, now that MSEC, which is the it’s the Medicare Services Advisory Committee, isn’t it? 

Nicola  

Yeah, that’s right. Yeah. 

Trish

Yeah. So now that MSAC has recommended the reinstatement of an item number. The big question that I guess women will be asking at home right now is, how do I know if I’m eligible?

Nicola  

Yeah, so look, there are a couple of stages before it’s definitely rubber stamped or going ahead and so the Medical Services Advisory Committee, they basically give their advice to the government and to that the Minister of Health, the government then has to approve it. And then there has to be money allocated for it in the budget, so it doesn’t get approved until those steps have taken place. And then once it’s been allocated funding in the budget, then they decide a start date. So it could still be 18 months or two years before there is a, what we call an item number where it means that you can be covered by your private health insurance. And so there are a few steps to go and there is a little bit of waiting to double check that it’s definitely going to go ahead so it’s not quite a done deal at this stage and as well as that. We abdominoplasty item number for Diastasis recti correction, which is this muscle separation, the technical term is recti diastasis. There are certain criteria, so the first thing you should probably do is to see your local doctor and get them to have a look at you and to assess what your symptoms are like and also the amount of muscle separation that you have. The criteria within the item number say that it has to be three centimeters or more, as measured with an ultrasound. So there’s a few middle steps, so my advice would be to get assessed. And if there’s an ultrasound scan that you can have, perhaps from your GP, then that’s the first first step. And then it may still be quite a long time before the item number is active and you can actually get a reimbursement for it certainly not but everybody that wants an abdominoplasty, those that want a cosmetic abdominoplasty and don’t have the muscle separation will not be eligible. And that’s really important that everybody knows that.

Trish 

And I guess for the women that do have it, it just gives that little bit of a light at the end of the tunnel that, it’s not today, and it may not be this year, but it could be next year or the year after. So there’s a lot going to happen in that time. So this gives them that bit of hope.

Nicola   

And I know, it’s so frustrating for people, but it’s such a long time. And they might have already been waiting since 2016 and it is really upsetting and really frustrating. But I can also see the government side of things that they’re trying to make sure that taxpayers aren’t funding things that shouldn’t be funded. And so they’re just kind of dotting the i’s and crossing the T’s to make sure that’s the case.

Trish 

Yeah, that makes sense to that if we’re to help not to fund desire, I guess, for want of a better word and Nicola, I was just gonna ask you one more thing. What can someone like me, like what can we do to prepare for the surgery while awaiting its availability? Like you have a little bit of like going to the doctor, is there anything else that way?

Nicola   

I think that whenever you’re thinking that you might need any surgery, it’s really good just to think about your general health, certainly. We know that smokers don’t heal nearly so as non smokers. So it’s an excellent incentive for quitting smoking and having a healthy diet, which is eating fruit and veg and trying to stay reasonably fit. I know, it’s hard and a lockdown, isn’t it? But you know, I think just doing some exercise every day is a great thing to prepare for any surgery, because it helps you get quicker through the anesthetic and the surgical recovery, so those are the things that I would say.

Trish 

Yep. And then surgery because I’ve seen it once again, time and time again waste if someone’s uber healthy going into surgery, I mean, surgery is a serious thing and I never to be taken lightly. But for someone who is exercising regularly, eating properly, like the recovery just sent tends to seem quicker. It just does like in fact, if that’s something that I could say that I’ve seen as an outsider, because I’m not a professional, professional consumer, but I’m not a professional in any way, shape, or form, but I’ve seen the same sort of thing over again, you get healthy and healthy Rob, generally the better you will recover from surgery. And Kerrie, like so where do you reckon women can go for reliable and trustworthy information on the procedure and what this new item number may mean for them?

Kerrie

So assuming that they’ve already been to their GP to discuss all of this, and the ASPS or  Australian Society of Plastic Surgeons website is such a good resource for information on not only abdominal repair surgery, but all surgeries that fall under their umbrella. And this, you’ll find information on the application process that they’ve been through for getting this back on the NBS and all sorts of information, that would be really, really helpful for them in going down this route, if that’s what they qualify for, yeah.

Trish 

Yeah. And here, we are now near the end of 2021. So it could be like the end of 22, or maybe even early 2023?

Nicola   

That will be my guess. I mean, they seem to make these announcements a couple of times a year. So I’d be surprised if it was early next year, put it that way, I would expect, like 22 or 23, hopefully, but unfortunately, I don’t have a crystal ball about that. So we just have to wait and see.

Kerrie

If people want to keep updated on the process, they can put in their details on the Australian Society of Plastic Surgeons website and they’ll be kept up to date about the progress of everything.

Trish 

Yeah, fantastic and what I might do, as well as I might actually put a link to that on the blog that goes with this some with this podcast and video so that people can actually just click on it and go straight there, that would be really helpful actually, to be updated on that would be amazing. So just before we go, just to run through the process, so if you are one of these women who is unlucky enough to have that, really bad muscle separation, where you would be entire so your first step would be, go to your local GP, get yourself or first of all have a not inspection, what do you call it, like a consultation with them, and determine whether they can refer you to a plastic surgeon. And a lot of women I find these days already know where they want to go because they’ve done so much research online before or they find out about people here and there. Isn’t that right, Kerrie, it is my downline. Hey. Yeah. So, um, and would it be too early to preempt? Like, say, for example, if you saw a plastic surgeon early next year, would that be too soon to actually see one? Should you just wait for the item number to come in and then get the ball rolling? Or can you kind of start now? Not now, but in the next few months?

Nicola   

Look, I think that that varies a bit. I think it’s better for us not to dictate that either way. But, and I think that it’s important to know that it may be better to wait until the item numbers there. But certainly this plastic surgeon can’t talk to you for surgery until there’s an item number there. So that’s important to know, that they can’t really give you a date until the item number is out.

Trish  

Yeah. And for the people that don’t know, so why are item numbers good as well as because that way, you have that Medicare item number, which means that, depending on your health coverage, that you have the hospitals covered, and there’s a certain level of cover, so you don’t have those extra extra expenses, that’s pretty much the benefit of it. Hey,

Nicola   

Yeah, and I think it is important if you’re thinking about this to look at your cover into private health insurance, because unfortunately, there are some types of private health insurance that don’t cover all sorts of things that you would think would be essential, but there are different levels of private health insurance so it’s worth having a look at that fairly early. And I think it is really important to keep an open mind and that we might not be eligible. I know that’s really hard to think about but don’t put your life on hold, make sure that you’re still looking after yourself and doing everything else that you can because there is still quite a lot of uncertainty. So whilst it is great to have a bit of hope that this is going to come in it’s also really important not to you know, hang up your whole life waiting for this one magic thing, it’s really important to look after your health overall and and you may not be eligible so just keep that.

Trish 

Yeah, very well said that’s so true because whether you are eligible or what the future holds. So that’s a very good point in there, because I’ll be the one that gets excited and so that’s been really helpful. So just before we go, is there anything Kerrie, you first, anything that you would add that women should know that they don’t already kind of know? That could be beneficial for them? Or, like, have you actually had the procedure done yourself?

Kerrie

And no, I haven’t had the procedure done. 

Trish   

And you want those waiting?

Kerrie 

Look, it’s something that I will consider. It’s quite serious surgery so it’s not something to take lightly but yeah, my symptoms, my lower back pain really impacts my life. I can vacuum half a room before I have to put the vacuum grinded down, because I’m struggling and I just have zero abdominals and core strength. And my abdominals don’t function so yes, I’m considering it. But obviously, I’m really, really happy for the people that for the women that I’m talking about, drawing on their superannuation and refinancing their mortgages and all that sort of stuff, because this will really, really change, change their lives and change their family’s lives. So I’m just really hopeful, but everything runs smoothly from here on in and it’s great that we have this support from the medical services, advisory committees. So yeah, fingers crossed, everything goes smoothly for me.

Trish   

Yeah, fantastic. And look, I’ve got to say, to both of you, ladies, well done for pioneering this for so long because it’s like, there would have been times where you think, Oh, my God, this is just too hard. I’m doing this, but to just keep going with it, and getting all those women together, and all those videos and the petition signatures, and like, all of those little things have ultimately hopefully led to something that shouldn’t have been removed in the first place. But obviously, I don’t know how many women were on that board, but yeah.

Nicola 

Oh, I think that’s a very good question. And I just want to say that I think that I hope there wasn’t any element of discrimination. But I think it’s really good that this is something that is affecting women disproportionately. And I think it’s great that we’ve been able to win it back for them and I just say that it’s a great story of teamwork. I mean, I’m really proud of everybody that has contributed to this. I mean, a lot of our plastic surgeon members in ASPS have helped a lot because they helped to send some surveys and got patients and survey sites. So you know, our individual members have done a huge amount, the women in the community have done a great amount. And it’s a great story of we’re not a big pharmaceutical company. We’re not one of these people that are kitted out to find huge applications, but we’ve done it by collaboration and persistence, which is great.

Trish   

Work, persistence, you’re right. Persistence is key without a doubt. Yeah, awesome. Well, thank you so much, ladies, for joining us tonight, that has just been absolutely awesome. I am so excited and proud and actually honoured to be able to share this success really with you the fact that it’s able to go on to that next level, where it was wiped out. And now it’s like, hey, this could come back so kudos to you, especially you guys. Kudos to you ladies and everyone else out there who’s been a part of it. So well done. 

Nicola and Kerrie

Thanks Trish.

Trish   

Awesome. So listeners, look, I’m gonna I’m going to put a link in the blog here as well so if you do want to find out, stay updated with what’s going on, you can actually click on that link and be updated. So thank you so much for joining us tonight ladies. Thank you. 

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Well, like all good quickies it's time to dust off and get back to our day jobs! If you liked the podcast please rate us because we need the validation for our fragile hearts. If you have a story to share or have a burning question you would like us to cover please slide into our DM’s on Instagram at @transformingbodiespodcast. Stay positive, keep your boobs and chins high until we chat again xoxo Trish