Media release

Should more Australian doctors be salaried rather than paid by fee-for-service?

Salaried doctors have no conflict of interest in the doctor-patient relationship, which engenders a patient’s trust, and reduces anxiety for the practitioner, Dr Brian Peat, an obstetrician from the Women’s and Children’s Hospital, Adelaide, argues in the latest edition of the Medical Journal of Australia.

Dr Peat wrote that more doctors should be on salaries, saying that it would be simple to change the current balance of numbers between salaried doctors and fee-for-service doctors, and that salaried doctors have the advantage of lower administration costs.

“They are in a better position to consider all aspects of the patient’s health, and to appropriately delegate tasks knowing they will not be out of pocket,” Dr Peat said.

Dr Peat said that often lifestyle-related chronic illnesses don’t fit into the short-consultation model for fee-for-service doctors, but salaried doctors can work around this issue.

“In a practice where patients with chronic illnesses are treated, a doctor may be required to take on the role of team leader, which is a difficult role to provide an item of service for. However, it is one well suited to a salary package.”

But in an opposing view, Dr Douglas Travis, a urologist from Western Health, Melbourne, and a Past President of AMA Victoria, argues that the majority of doctors should continue to be paid by fee-for-service.

“From the perspective of doctors, patients and funders, fee-for-service is the best method of remuneration because it provides the best transparency, accountability and incentive for everyone,” Dr Travis said.

“As a patient, you pay for what you get, and, as a doctor, you get paid for what you do.

Dr Travis said that there are a lot of misconceptions about fee-for-service payments, including that it encourages overservicing, results in people being unable to afford medical care, encourages doctors to try to provide more services in a given period, causes doctors to work excessive hours and offers no incentives to maintain continuing medical education.

However, Dr Travis said the fee-for-service model was not appropriate in research and teaching settings.

The Medical Journal of Australia is a publication of the Australian Medical Association.


The statements or opinions that are expressed in the MJA  reflect the views of the authors and do not represent the official policy of the AMA unless that is so stated.

 

CONTACT:             Dr Brian Peat                                0422 005 136

                           Dr Douglas Travis                           0437 253 731

Media Contacts

Federal 

 02 6270 5478
 0427 209 753
 media@ama.com.au

Follow the AMA

 @ama_media
 @amapresident
‌ @AustralianMedicalAssociation

Related topics