Up to one in five Australians are not seeing specialists when referred by their doctor due to cost concerns.
New Medicare data shows the number of medical specialist appointments billed had fallen by 10 percent over the past six years, despite the population growing by more than seven percent.
Private Healthcare Australia CEO Rachel David said given it could take months, and sometimes years, to see a specialist doctor in the public system, it was extremely worrying many people were not seeing a private medical specialist when referred by their GP.
Dr David said in 2019, there were 5,640,731 initial specialist doctor consultations billed through Medicare, while in 2024, there were 10 percent fewer (5,092,786).
“During the same period, the Australian population grew by more than seven percent,” she said.
Dr David said surveys had shown a rising number of Australians were not seeing a specialist when they needed to due to cost.
“Data from the Australian Bureau of Statistics and Patients Australia show 10-20 percent of people referred to a specialist doctor are not attending because of cost or uncertainty about the cost.
“At the same time, data from Zable shows psychiatrists are charging up to $950 for a first appointment, obstetricians up to $650, and cardiologists up to $600.”
She said Medicare covered about a third of this fee, with health insurers not permitted to cover a specialist doctor’s fees when the consultation occurred outside of a hospital admission.
“If you don’t see a specialist doctor when you need to, it puts you at risk of worsening health and crises that result in emergency department visits and more expensive care in the hospital system further down the track.
“The barrier is clear. People can’t afford to see private medical specialists in the community. This is the first step to accessing a private hospital. This trend needs to be addressed if we want our private hospitals to thrive and take pressure off the public hospital system.”
Dr David said the Federal Government had committed to putting thousands of specialist doctors’ fees on the Medical Costs Finder website, which was a great start to assist GPs and consumers to shop around for a specialist charging in their price range.
“We need this to happen as soon as possible. In Australia, doctors can set their own fees. Research shows they charge based on competition in their area and the wealth of people living around them, so people living in areas with fewer doctors tend to face higher fees,” she said.
Dr David said there was no evidence people received better treatment from a doctor that charged more, and she urged consumers to discuss fees with their GP and specialist clinics before attending for a first appointment.
“If you need specialist medical care and you’re worried about the cost, talk to your GP about finding a specialist you can afford. There are still some specialist doctors who bulk bill or will help you with the cost, so you don’t have to delay medical treatment.”
