21 June 2022

Patients baulk at paying a gap

Medicare Political

At the same time, a survey found bulk billing and affordability ranked low as a reason for patient satisfaction with their GP.


Patients can be a fickle lot: a large survey has found that one in two patients would abandon their regular GP if the practice started charging a gap.

The very same report found that affordability is one of the last things on a satisfied or dissatisfied patient’s mind.

The seemingly paradoxical data comes from this year’s edition of the Australian Healthcare Index, which measured the attitudes and views of around 11,500 people around the country toward healthcare.

The survey, which was conducted in April this year by booking vendor Healthengine and the Australian Patients Association, also took in attitudes about pharmacist prescribing in light of the proposed trial in north Queensland.

Just over half the respondents said they would be comfortable with pharmacists diagnosing and prescribing for select conditions and a quarter said they would not.

Opinions on billing were mixed.

Repondents were asked: “If your GP changed from bulk bill to introduce an out of pocket cost for a standard consult, how would this affect you?” and had to choose from among eight options: “I would find a new bulk bill GP as I don’t want to pay out of pocket costs”, “I would stay with my GP regardless of any out of pocket costs”, then “I would stay with my GP if the out of pocket cost was less than $20/$30/$40/$50”, “I would stay with my GP if the out of pocket cost was over $50” and “Other”.

Almost half said they would move to a bulk-billing practice. (The survey did not ask how far these patients would be prepared to go to find one.)

Around one in six respondents said they would stay with their GP regardless of the cost.

Of the respondents who put a number on it, 17% said they would stay with their regular GP if out-of-pocket costs were $20 or less, 5% if the out of pocket was $30 or less, 2% if it was $50 or less and 3% if it was over $50. The final 7% were unsure (“other”).

Still, general practice managed to hook an overall Net Promoter Score of 35, which essentially means that a majority of people would actively recommend their current GP to friends or family.

The most common reason for someone to recommend their GP was because of good quality of care, followed by good medical advice and convenient ways to book communication from staff.

Bulk billing as a reason to recommend a clinic came in fifth, and affordability came in ninth. 

Just 18% of respondents would not recommend their current GP, and about a third of people were passive.

For people who wouldn’t recommend their GP, the most common reason was poor quality of care, followed by poor medical advice and lack of communication from staff.

More people cited long waiting room times, poor booking availability and unhelpful staff as reasons not to recommend a practice than the clinic not offering bulk billing or being too expensive.

Dentists got around the same score as GPs in terms of patient satisfaction levels, while private health insurers managed to receive a rating of -11, meaning they had more detractors than supporters.

The leading reason for dissatisfaction with insurers was poor value for money and unaffordability.

The report also flags the growing backlog of patients seeking help for their mental health.

Before the pandemic, only 1% of psychologists were not taking new clients; this has now increased to about 33%.

A quarter of the respondents said that their mental health had declined in the six months leading up to the survey, with 40% of those people identifying covid as the reason behind their decline.

Of the 26% of people who had sought mental health support over the previous six months, most had managed to access care within two months.

For the 18% of people who were still waiting to get care at the time, 28% had been waiting two months or less and 72% had been waiting longer than two months.

Australian Healthcare Index 2022, online 21 June

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Donald Rose
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Donald Rose
1 month 21 days ago
When there is a shortage of lettuces or a shortage of gas what do their producers do? Gouge. And seriously gouge. Quadrupling the price before breakfast in some instances. Around Australia there is a shortage of GPs. So its gouge time my friends. If we want to survive in this fast paced world its time to grow up and operate like every other small business operator. All those patients looking for a bulk billing GP should keep an eye out for 50c lettuces and petrol under $1 during their hunt. Graduates would be lining up for general practice if they… Read more »
Marc Heyning
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Marc Heyning
1 month 21 days ago

Reads to me that although patients are reluctant to pay a gap, they value good care and service more.
Confirms what we find in our own practice, we charge a significant gap (could be bigger to be truely honest) but we continually strive to make sure the care and service patients receive is as good as our locality allows.

Some patients may leave in the short term but they tend to come back when they have experienced the ‘FDB’ equivalent. And those that did not, most of these we were happy didn’t (but don’t quote me on that).

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