Australian specialists’ fees revealed for the first time

The fees of medical specialists around the country have been revealed publicly for the first time, with psychiatrists, obstetricians and paediatricians charging some of the highest fees in the nation | SEE HOW MUCH THEY CHARGE

An online referral database has revealed medical specialists' fees for the first time.

The fees of medical specialists around the country have been revealed publicly for the first time in an online referral database that shows psychiatrists, obstetricians and paediatricians are charging some of the highest specialist fees in the nation.

The new website confirms patients face hefty out of pocket costs for consultations in all types of medicine amid indications that the rising cost of healthcare and difficulty accessing appointments is a major deterrent for millions of Australians seeking medical care.

Patients often have zero visibility on the costs they face before booking to a specialist, adding to the complicated, frustrating and time-consuming task of navigating their healthcare. Bill shock is a major cause of financial stress for families.

Now initial consultation costs of the majority of medical specialists nationwide are contained and published in a digital database launched by the healthtech start-up Zable Health, aimed at GPs and patients, which also compiles out of pocket costs, wait times and specific expertise for medical specialities as commercial health technology start ups step in where government attempts at transparency have failed.

While many of the fees charged by doctors are broadly similar within each specialty, there are some outliers that reveal patterns of price gouging by a small minority, likely related to trends such as telepsychiatry and expensive assessments for ADHD and autism. The highest price for a psychiatry consultation in Sydney, for instance, is $900 for an initial consultation.

The digital database shows that initial consultation fees for private psychiatry range from a median of $450 in Adelaide to a high of $600 in Perth, with a Medicare rebate of $247.25. The highest price for a psychiatrist initial consult in the country was recorded at the Sunshine Coast at a price of $950. Obstetrician and gynaecologist fees were also high for patients, with an initial consult only attracting a Medicare rebate of $81.30 but costing between $236 and $336 on average depending on location. The highest prices being charged for obstetrics are in Melbourne, where the highest fee recorded is $650 for the initial consult.

“We think it’s great to see this potential level of fee transparency from medical practitioners,” said Consumers Health Forum of Australia CEO Elizabeth Deveny.

“What we know is health consumers want to know how much their care will cost as part of the decision as to when and where they’ll have that procedure undertaken. It’s not unreasonable for people to want to know what something costs before they do it.

“In most other parts of our life, it’s pretty straightforward, but in health, it’s unfortunately been very complex. But of course price, ideally, is not the only factor that you think about.”

Zable Health founders Matthew Gregory, a tech entrepreneur, and Scott Gentle, a physiotherapist, gathered the information partly through the voluntary assistance of doctors and partly through calling practices directly making inquiries as to fees. Some doctors have been angered by the publication of their details in the database and complained the information is unverified.

The Federal government has spent at least $24m on a Medical Cost Finder website which was supposed to provide transparency for patients on doctors’ fees amid rapidly rising out of pocket costs for patients, but several years after its establishment only displays the fees for a handful of specialists.

Zable Health's digital referral plan has brought transparency to doctors' fees nationwide.

Mr Gregory said currently, the system of referrals to specialists is so opaque and fragmented that many patients end up not booking in to see a medical specialist even if they are referred. Research has indicated that happens in around 28 per cent of cases, with factors such as long wait times and lack of certainty as to fees playing a part in the trend.

“What’s been interesting to realise is that this information about fees and availability isn’t necessarily a secret, it’s just that there’s been no place that compiles it,” Mr Gregory said. “A lot of the data that we’ve gathered has actually been supplied directly from doctors, who have recognised that a system like this needs to exists and does support patient outcomes.

“We know that when patients are stressed out, when they’ve got anxiety around their condition, they may find the prospect of booking in to see a specialist overwhelming. And it actually prevents them from making calls. And some people then put the referral into the too hard basket.”

Sydney GP and former Australian Medical Association (NSW) president Michael Bonning said the referral website may be useful to GPs, but it was still important for patients to discuss with their GP the section of a specialist. “A lot of the way GPs refer is based around inherent knowledge,” Dr Bonning said. “Over time, as a GP who has experience, you get a good sense of which specialists are good and also who’s available and who’s nearby.”

Federal AMA president Steve Robson said the referral website was likely to be the tip of the iceberg in terms of health technology forcing transparency, but there could be unintended consequences or issues of accuracy.

“Anything that improves access and transparency for people seeking care is worthwhile,” Professor Robson said. “But one of the key unintended consequences of comparator websites is that they tend to be inflationary. Doctors look at what their colleagues are charging and, if the fees are higher, they tend to put their own fees up. This is just an immutable law of economics.”