Paid an arm and a leg to see a specialist? Fee transparency could help

The  Medical Costs Finder (MCF) website was launched by the Morrison Government in 2022. MCF is an online tool to help patients compare and understand the costs of common medical specialist services across Australia. The aim was to reduce surprise, out-of-pocket costs for people who are referred by their GP to see a cardiologist, dermatologist, psychiatrist or other health specialist.  

Participation was voluntary. At the end of 2025, just 88 of the around 6,300 eligible specialists (1.4%) have chosen to display their fees. What do they have to hide? 

In a bid to increase transparency, last week the Albanese Government introduced legislation that would make participation in the MCF mandatory. This follows research by the Grattan Institute showing that close to a million people skip or delay seeing a specialist each year due to the cost. Most of these people are from disadvantaged communities. 

What makes specialists so special? 

Adjusted for inflation, specialist fees have grown by a whopping 78% since 2010. That’s about 4% on top of the consumer price index. For context, the 4.4% increase to private health insurance premium becomes 0.6% when inflation is taken into account. Even after subtracting the amount covered by Medicare, specialists fees grew by 73%. By comparison, the out-of-pocket costs for other medical services that Australians rely on, including trips to the GP, have risen only as much as inflation. 

The reaction from specialists to this Bill has bordered on hostile. Rather than welcoming it as a way of improving the patient experience, some specialists have called it part of a “blame game” that “may discourage bright young people from pursuing careers in medicine.” 

Specialists try to claim that their high fees simply reflect the increasing costs of running a medical practice. Yet most sectors face the same pressures – rising rents, wages and energy costs – without comparable fee growth.  

If costs specific to medical practice are rising (which, incidentally, is a reason cited by insurers for rising premiums) shouldn’t these be reflected in non-specialist fees? While the latest medical equipment can be expensive, research suggests that it doesn’t guarantee a better outcome. 

Perhaps the health benefits generated by specialist interventions justify the costs? Unfortunately, routine, publicly available provider-level outcomes data are limited. We do know, however, that low-value care interventions are common in the private sector. 

Specialists are simply charging what the market will bear. If their patient numbers were dropping, they would lower their fees. This is how markets work. Increasing Medicare rebates would likely just result a commensurate rise in fees. 

‘Eminence-based’ medicine 

Professor Brendan Murphy — a kidney specialist who served as Australia’s Chief Medical Officer from 2016 to 2023 (during the pandemic) — argues that specialists have developed a “sense of entitlement”. He also says that they exhibit cartel-like behaviour. Indeed, several of the top specialties including ophthalmology, dermatology and obstetrics appear to have limited the number of trainees over the past decade. Limiting supply is a good way to raise prices.  

Murphy has called specialist fees the “challenge of our time”, and points out that medical specialists – especially ‘procedural’ ones like surgeons, ophthalmologists and cardiologists — are among Australia’s highest earning occupations. 

It takes hard work and sacrifices to become a doctor. But can the same not be said for university professors, specialist tradesmen, pilots, homelessness workers, and single mothers working three casual jobs?

The real reason for the reaction

This Bill will improve fee transparency, making it easier for patients to ‘shop around’ and compare prices for the specialist procedures they might need.  

Specialist fees can vary considerably, even in the same postcode. Patients armed with the full information may ask why Dr A charges twice as much for a procedure as Dr B down the road. Are their outcomes twice as good? Is the bedside manner exceptional? 

Specialists want to avoid scrutiny because international research shows there is little correlation between prices and outcomes – tragically illustrated by a recent Australian example. 

Fee disclosure is just the first step

Compelling specialists to list their fees on the MCF website should help to improve the patient experience. It will promote transparency and competition, and perhaps even improve value for money. 

But more must be done.  

The logical next step would be to introduce routine collection of clinical outcomes – including outcomes reported by patients themselves. This should help people make more informed choices. It will also enable specialists to justify their fees. Outcomes data can be statistically adjusted to ensure providers who take on more complex cases are not disadvantaged. 

The Grattan Institute proposes reducing unnecessary specialist referrals. This makes sense given Australia’s over-reliance on acute services.  

Specialists may also wish to reflect on why they chose their profession, and whether the oath they took as doctors aligns with billing practices that exclude patients in most need of their care. They’re always welcome to work in the public sector where they can help reduce the time these patients must wait for specialist care.