Dr John Batten
By John Batten
Launceston General Hospital orthopaedic surgeon and University
of Tasmania senior lecturer John Batten has been elected the president of the
Royal Australasian College of Surgeons.
In 2017, Australia's hospitals admitted about 748,000 patients, an
increase of almost three per cent in both emergency and elective admissions
from the previous year.
Finding out that you, or a loved family member, needs surgery can be
scary, overwhelming, and challenging physically, mentally and financially.
As the number of surgical procedures available grows, it's never been
more important for patients to feel empowered and in control of the choices
that will benefit their long-term health and wellbeing.
As president of the Australasian College of Surgeons (RACS), an
organisation that advocates for the highest surgical standards, I want
Australian patients to know that they can, and should, ask questions to give
them peace of mind about both their care and the costs they can expect.
I also want Australians to know that high fees do not necessarily
guarantee quality of treatment, care or outcomes.
While the vast majority of Australian surgeons aim to deliver
affordable, lifesaving, quality patient care, there are a small number within
the surgical industry who charge excessive, or sometimes even extortionate,
rates.
These rogue operators charging excessive fees are in breach of the RACS
Code of Conduct which seeks to ensure full disclosure and transparency in all
aspects of surgical financial consent.
No one in a health system such as ours should have to contact a financial
planner, re-mortgage their home, touch their superannuation or seek crowd
funding to access surgical treatment. Urgent, acute or cancer related surgery
can be timely and adequately dealt with in the public system and all surgeons
have a duty to advise their patients of this.
What factors affect
surgical fees?
Like all medical practitioners, surgeons do not have a standard set of
fees, and RACS does not set fees. Fees related to an operative procedure
account for many factors, including the difficulty and duration of the
procedure and the cost of providing care before, during and after the
operation, such as theatre costs, anaesthesia, pathology and dressings,
bandages and other hospital costs. The surgical procedure itself is only one
component of a number of different fees the patient receives.
There's also the evolution of technology in our sector and the impact it
has on patient outcomes to consider.
Just like every sector around us, from manufacturing to financial
services, the healthcare industry is benefitting from the development of
innovative technology to enhance the lives of Australian people.
We've all seen, or at least heard of, surgical robots which are used
most commonly to complement a surgeon's skills, increase accuracy and offer a
minimally invasive procedure to patients.
Take an appendectomy (the removal of the appendix) for example. There
are multiple ways that this operation can be undertaken; with or without
technology, or a combination of both. If we put that into the context of fees,
that's three different prices a surgeon might quote depending on how they
complete the procedure, and which method best suits the needs of the patient.
Interestingly, when we look at all day and overnight hospital procedures
(2014-15) about 95 per cent of patients face no gap payments, with the average
gap payment for the remaining 5 per cent at $130. So the tail end of high fees
comes from a very small percentage that needs to be looked at more closely.
At a systemic level, purchasing or contracting arrangements between
private health insurers and hospitals can impact upon out of pocket costs and
continue to remain opaque to patients and medical practitioners.
RACS encourages greater transparency of any conditions which may affect
clinical decision-making.
To varying degrees, all these influences can impact the cost of a
surgical procedure but should in no way influence the outcome of patient care.
Before agreeing to any procedure, patients should understand all
available treatment options and associated fees and should seek a second
opinion if they are concerned.
Be informed and
educated
We want every Australian to feel confident, educated and to understand
what to look out for when selecting a surgeon and agreeing to the fees for a
procedure.
First, ensure that your surgeon is a FRACS. These are surgeons who are
Fellows of the Royal Australasian College of Surgeons. They undergo rigorous
training and commit to ongoing learning and maintenance of knowledge and skills
demonstrated through various Continuing Professional Development (CPD)
programs.
This ensures Fellows not only maintain competency but also continuously
build on and improve their clinical knowledge and skills in order to provide
high-quality contemporary healthcare to the public.
You should also take the time to contemplate the procedure and ask
questions about care and fees, before agreeing to the surgery.
All patients should assess the financial implications of their surgery,
which is a hugely important aspect of informed financial consent.
While the duty of patient care rests on the shoulders of surgeons and
their dedicated teams, patients shouldn't be afraid to ask as many questions as
possible to ensure total confidence in their choice.
There are several considerations that patients should think about when
it comes to building a holistic view of their fees:
·
Ask for an estimated total cost of your procedure up front before you
agree to the surgery
·
Where there is concern about fees, seek a second opinion or raise your
concerns with your referring practitioner
·
If you have private health insurance, confirm what you are covered for
with your insurance company and ask if there will be any out-of-pocket costs.
In most cases even if you have private health insurance there will be some out
of pocket costs
·
Before you go into hospital as a private patient ask your surgeon about
the fees to be charged by all of the health professionals that might be
involved in your care, including anaesthesia, pathology services, medical
imaging, physiotherapists etc
·
If you continue to feel unsure of the proposed course of treatment or
fees to be charged, ask your referring doctor to recommend another surgeon
Support for fair fees
As an advocate for sustainable and affordable fees, RACS strongly
supports the full disclosure and transparency of fees as early as possible in
the patient-doctor relationship and champions the need for patients to
understand all treatment options available to them.
If you have any complaints or concerns about a surgeon you can raise
these directly with the surgeon or the hospital or you can contact the relevant
authority — the Australian Health Practitioner Regulation Authority.
We take a strong position on this issue, and also encourage all patients
who consider their fees unreasonable to contact the RACS Professional Standards
Department about any concerns on professional.standards@surgeons.org.
You can also read our frequently asked questions guide and other
information that will help you make an informed decision about your medical
care on the Royal Australasian College of
Surgeons website.
John Batten is president of the Royal Australasian College of Surgeons.
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