Surgical Fees Estimate and Explanation
This letter is designed to explain my fee structure and why it differs from the Schedule Fee recommended by the Government. I have felt this necessary after recent large increases in indemnity premiums and the introduction of a substantial retrospective levy.
The Schedule Fee was introduced by the Federal Government as Medicare in 1973 and has increased annually by amounts usually less than one percent. The Australian Medical Association (AMA) has also set a scale of fees to be used as a guide for medical practitioners around Australia. This rises with the Consumer Price Index (CPI) annually but does not account for large rises in items such as indemnity insurance. My fees are based on the AMA fees allowing for the fact that my practice is in central Sydney. There has been a significant divergence between the two fees over the years, and this results in a gap between my fee and the fee which is reimbursed by the government or private health funds. The current situation has arisen because of many years of neglect of the system by various governments. If you would like to complain about the inequities of the current system I would suggest you write directly to the Prime Minister.
Not unexpectedly, the cost of running a medical practice rises by a lot more that one percent per year. A recent study of practice costs across Australia estimated that it costs around $230,000 (before insurance) to run a gynaecological practice. Unfortunately NSW is now one of the most litigious states in the world and my major cost is medical insurance. This has been rising alarmingly over the last few years. This year I have paid almost $70,000 in insurance. I believe the rises will continue and I do not believe the current indemnity situation is sustainable. The current arrangements for retirement insurance cover are particularly onerous and when I retire I may be in the position of not having any insurance cover for any claims.
There has recently been a campaign promoting the idea of “no gaps” for medical services. Australia now provides some of the cheapest medical care in the Western world. For the reasons listed above I will not be joining these schemes and I do not believe they are likely to work in the long term.
Unfortunately and due to the increasing administration costs of pursuing outstanding accounts, I ask that the gap payment be paid in advance and prior to the date of surgery. A swipe of your credit card will be requested to ensure that the gap is paid in full at completion of the surgery. An estimate of the total cost of surgery is always provided, but this may change when we actually get to theatre.
I have an assistant doctor to help me with most of the surgical procedures. The normal assistant fee is 20% of the surgeon’s fee. You will also receive a bill from the anaesthetist. My secretary can help you contact the anaesthetist who will be performing your anaesthetic if you wish. Anaesthetists charges are generally time based.
I also operate in a public teaching hospital where no surgical fee is paid and where you cannot choose your doctor. I am responsible for an operating list where junior doctors are trained in surgery but have no control over which doctor
Blood tests, xrays and pathology are an extra charge and will be invoiced seperately.
You should contact your health fund so that they can advise your level of cover in regard to accommodation and operating theatre fees. Patients who are not covered by a health fund must pay the accommodation and theatre fees on admission in full.
I hope this helps clarify the issue of fees and if you would ever like to discuss your account I would be happy to oblige.