As part of the effort to increase standards of Indigenous health, doctors and health workers will be expected to find out if their patients of Aboriginal origin despite the appearance or country of birth.
All patients in hospitals, clinics, GP surgeries should be asked whether they are of Aboriginal or Torres Strait Islander origin even if staffs already know the patient of the family background, according to the new guidelines issued by the Australian Institute of Health and Welfare.
The approach is intended to offer a more accurate measure of Indigenous health disadvantage by counting people whose status has previously been unrecorded, in some cases, because they were not asked.
Some Indigenous health experts warn the approach may have unintended consequences by encouraging patients or their GPs to misidentify as Indigenous in order to qualify for Aboriginal-specific health services.
Another risk includes expanded number of healthier people who identify as Indigenous, despite sharing fewer of the socio-economic or other factors that cause Aboriginal people to miss out on healthcare.
This can affect the statistics, making it appear Indigenous health had improved.
All states and territories have agreed to adhere to the guidelines and have them in effect by the end of this year.
Health workers should not assume whether a patient is Aboriginal from looking at them, and Indigenous status can only be determined by asking each client this question, said the AIHW.
Kerryn Pholi, the document co-author said surveys revealed some health workers believed it was discriminatory to ask patients for their Indigenous status, or thought it did not serve a useful purpose.
This is a good news story - this something everyone can do to help close the gap, she said.
Sophie Couzos, public health officer with the National Aboriginal Community Controlled Health Organization said the introduction of a new payment for GPs who sign up Indigenous patients could provide an incentive for misidentification of status by either patients or doctors, although the effect was likely to be relatively small.
It's more beneficial to determine the Aboriginality of your patient population, to increase their immunization status and access to services, she said.
All that far outweighs the possibility of leakage.