Medical Forum
Doctors a 'target' in discussions about healthcare costs
The AMA has said doctors have become handy targets in discussions about healthcare costs as it rejected proposals to strengthen rules around informed financial consent.
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Medical Forum
It also warned that the proposed changes to informed financial consent (IFC) rules could result in unnecessary disputes and increased compliance costs.
A Department of Health, Disability and Ageing consultation on IFC and fee transparency asked whether IFC should be legally enforceable in Australia and whether medical providers should be penalised for not providing it to their patients.
It formed part of a wider piece of work on addressing transparency around specialist fees, including plans to publish all fees on the Medical Cost Finder website.
In its submission the AMA rejected the proposals, saying that providing informed financial consent was already a clear part of professional responsibility and that as the course of medical treatment can be uncertain an overarching legislative framework should be approached with “significant caution”.
National President Dr Danielle McMullen said the vast majority of practitioners were doing the right thing and were committed to providing patients with information about the costs of care before it is delivered.
“There will be occasions where IFC is more difficult, as the course of medical treatment can be uncertain, such as in the case of complications or emergencies,” she said.
“Care also needs to be taken that any IFC reforms don’t create the misconception that a lot of doctors are dishonest because that is simply not the case. Doctors have become a handy target for some people in discussions about the cost of healthcare, but it is the patchwork and piecemeal nature of Medicare funding that drives the growing out-of-pocket costs.”
“The last thing anyone needs is the creation of a new regulatory regime that involves doctors and patients in unnecessary disputes and drives up compliance costs.”
Instead, the AMA would like to see a profession-led approach that focuses on education and professional guidelines.
Its position statement on IFC, published in 2024, states IFC is a sound ethical, professional and business practice that should apply to all registered health practitioners.
Discussing fees and likely out-of-pocket costs with patients is something that already takes place prior to treatment, according to the AMA. It emphasises that it is an important element of good medical practice that supports patient autonomy and shared decision-making.
“A profession-led model that focuses on good practice and supports patients and doctors alike is a much better approach,” Dr McMullen said.
“Many in our profession are already feeling disheartened and distressed, in part due to recent publicity around specialist fees that has painted an inaccurate picture of why out-of-pocket costs have grown.”
The AMA recommends that IFC be provided to patients in writing before a planned procedure or treatment is performed.
Specialties like general practice should advise patients verbally about likely costs or through publicly available information.
The Medical Cost Finder website provides information on IFC to patients and offers information about specialist fees.
It was launched in 2019, when the Liberal/National coalition was in power, in an effort to improve transparency around specialist fees for the general public.
Under new legislation the federal government plans to mandate publishing all specialist fees on the website. It also proposes to publish Medicare, hospital and insurer billing data that is already collected as part of its bid for transparency.