23/11/2025
Supporting people with type 1 diabetes shouldn’t depend on postcode or whether they can physically get to an appointment.
I’ve been working with one of my long-term clients — let’s call her K — since November 2017. She came to see me face-to-face early on, but since then we’ve used telehealth for almost all her diabetes care. Not because she lives remotely, but because she works full-time here in Canberra and simply can’t take hours out of her day to travel, wait, and travel back again.
Even in Canberra, taking time off work for a medical appointment can mean hours of lost productivity and stress.
For type 1 diabetes, this shouldn’t be necessary. We have access to CGM data, pump downloads, shared platforms and everything we need to provide safe, effective care via video or phone. And if something does need in-person review, we organise it.
K has managed her diabetes incredibly well with this model — consistently achieving 70%+ Time in Range.
This week I’ve been preparing her insulin pump upgrade: reviewing data, updating settings, gathering required details, and ensuring she’ll start her new pump in automated mode straight away.
But because of the 1 November telehealth changes for Nurse Practitioners, none of this work can be Medicare-billed unless she attends face-to-face.
By the time she comes in, I’ll have already completed over $350 worth of work for free — work that is essential for safety and continuity.
She will come in for the pump start — not because it’s clinically required, but because it’s now the only way to access Medicare rebates.
Everything that leads up to that… the reviewing, the interpreting, the settings, the safety checks, the time, the conversations, the care… is now unreimbursed.
I’ll always show up for my clients, rebate or no rebate — because that’s what healthcare should look like.
But people living with chronic conditions deserve better than this, and so does Australia.