GPs are being offered thousands of dollars in bribes to provide fake Covid vaccine certificates, while others have reported being abused and in some cases threatened by anti-vaxxers demanding doctored paperwork to overcome mandates.
“Lots of patients have [offered cash],” Dr Catherine Orr, a GP specialising in Covid-19 management in Melbourne, said.
“The state community health organisations have a collaborative, and $3,000 is the highest that as a collaborative we have been offered. For my individual clinic, I think the ‘best’ offer was $500. Clearly we refuse.”
The issue of patients pressuring their GPs to provide illegitimate vaccine exemptions is so pervasive that the Medical Council of NSW has published an article with guidelines for medical practitioners, to make them aware of the strict criteria for exemptions.
The president of the Royal Australian College of General Practitioners, Dr Karen Price, said misinformation about Covid-19 vaccines was leading some people to seek exemptions from their GP without medical grounds.
“This is a significant issue and it’s affecting GPs and practice teams across the country,” Price told Guardian Australia.
“There are some patients who are strongly against vaccination and heavily influenced by misinformation. Some patients are aggressive and abusive, demanding an exemption when not fitting the clear criteria. It is not just GPs, but our hard-working receptionists and other practice team members who’ve bore the brunt of this, and it does add to our stress levels.”
Victoria has one of the strictest vaccine mandates in the world, with the premier, Daniel Andrews, saying unvaccinated people without a genuine exemption will be barred from accessing most services until 2023. Once 90% of people age 16 and above are vaccinated, this mandate will also include children age 12 and above.
In New South Wales, vaccination rules have applied for staff and customers aged 16 years and over since 11 October, when eligible businesses began to reopen. These rules will lift for unvaccinated people by 1 December.
However, there are certain industries and professions for which the states and territories have made vaccination compulsory to continue to work, and some businesses, such as Woolworths, Coles, Aldi, Qantas, BHP and others, are also mandating vaccinations for staff.
Price said when patients approached their doctor seeking an exemption, doctors tried to find out what their concerns were and explain the benefits of vaccination.
“I’ve heard numerous stories of GPs who’ve had frank discussions with hesitant patients and have allayed their fears by providing evidence-based information, and they’ve gone on to receive the vaccine,” she said.
“That takes courage and we thank those people for listening with an open mind.”
The Medical Council’s president, Dr John Sammut, said: “A Covid-19 vaccination exemption is strictly limited and must be related to a health contraindication, for which evidence is required, to ensure a doctor is satisfied and can appropriately sign an exemption.”
A NSW doctor who signs a Covid-19 vaccination exemption for a patient who is not eligible faces the risk of regulatory action.
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There are few circumstances in which an exemption can be provided. Exemptions can only be issued by a doctor if the patient meets a specific health contraindication included in the Australian Technical Advisory Group on Immunisation clinical guidance. In order to be permanently exempted from the vaccination, a patient must have medical contraindications to all three available vaccine brands in Australia.
The president of the NSW branch of the Australian Medical Association, Dr Danielle McMullen, is a GP working in Sydney and said that very few people were actually vaccine-deniers. Most people who were unsure simply had questions and needed reassurance, she said.
“My patients know that I am very pro-vaccine, and so it’s quite rewarding when they still feel comfortable sharing their worries and asking questions,” she said. “There is also a group of people who thought they couldn’t get any vaccine because they’d had an anaphylaxis reaction to something else before. So we talk patients through all of that.”
A GP working in Queensland, who did not want to be named, said the few people that believed ‘Covid isn’t real’, or that the vaccine is ‘experimental gene therapy’ “can’t really be reasoned with”.
“I think the best approach with those patients is to explain the strict exemption criteria and that they don’t qualify and leave it at that,” they said.
“GPs should be aware that doctors have been reporting GPs to AHPRA [the Australian Health Practitioner Regulation Agency] for providing exemptions against guidelines, so any GP giving an exemption in order to get a difficult or abusive patient out of their office is taking a big risk professionally.”