Some surgeons working in private hospitals are charging 15 times what their peers charge for the same procedure, and many have wildly different complication rates, new data shows.
In a sign some Australians are getting ripped off by surgeons charging exorbitant prices, Medibank has found great variation in fees charged by doctors for eight common operations including hernia repairs, colonoscopies (bowel investigations) and gastroscopies (investigation of the oesophagus, stomach and duodenum).
The review of thousands of procedures performed on Medibank members in 2014 showed surgeons performing gastric sleeve operations for weight loss charged average private fees ranging from $231 in South Australia to $3593 in Queensland. The average fee in NSW was $3160 and in Victoria it was $1874.
Private fees charged for gall bladder removals (over and above what the insurer and Medicare covered) also ranged from $369 in Tasmania to $1166 in NSW. In Victoria, the average fee was $387.
The Surgical Variance Report for General Surgery, prepared with the Royal Australasian College of Surgeons, also showed complication rates varied from 0 per 1000 bowel resection procedures for some surgeons to 571 per 1000 bowel resections for others.
Surgeons who did the lowest number of procedures tended to have higher complication rates.
President of the college, Professor David Watters, agreed the range was worrying, but he said the data did not take into account risk factors among patients or the surgeon's record with other patients who had different health insurance. However, Professor Watters said surgeons should be wondering how they perform against their peers and should contact Medibank to access their individual data when it becomes available soon.
"These reports will provide surgeons with information that may help them gain a better understanding of, and learn from, variations, for the benefit of the service they provide to their patients and the community," he said.
Professor Watters also encouraged patients to question surgeons about how many times they had done an operation and what their rate of complications was. He said patients should also ask about fees and if they seem high, they should contact their GP to shop around. The advice comes after the college warned surgeons who charge unreasonable fees could face sanctions if their patients complain to the college.
The report also comes as a range of private health insurers are revealing more about how much specialist doctors charge their members in an effort to drive prices down. The average fees in the Medibank report are those charged privately to patients after Medicare and Medibank have made their contribution to the cost of the patient's treatment.
The data also coincides with Medibank striking controversial performance-based contracts with private hospitals which say the insurer will not pay for "hospital acquired complications" such as bed sores or falls where there is good evidence they are preventable.
Medibank said future reports will look at variation among other common urology procedures, ear, nose and throat surgery, vascular surgery, and orthopaedic operations such as hip and knee replacements.
Medibank's Chief Medical Officer Dr Linda Swan said: "Information sharing is key to improving the delivery of healthcare, and ultimately to improving patient outcomes."
