Choosing a surgeon
The nature of the doctor-patient relationship today is that the referring doctor can make recommendations about surgeons, but the final decision for which surgeon to use rests with the patient (in the private system). If you aren’t familiar with the names of any surgeons, you may not feel as though you have much choice in the matter – this information will help you in making your choice. Remember that if you are unsure or unhappy, you are welcome to get a second opinion.
Public or private?
Australia has two hospital systems – the public (funded to a certain level by the Government) and the private (which relies on payments from patients and their insurance companies). The public system is free, but the two major disadvantages are (1) the patient is allocated to a surgeon, who may or may not be an expert in the problem he or she is treating; (2) unless the condition is life-threatening, the patient must go on to a waiting list, and is treated when the hospital is ready, rather than when the patient wants treatment. The private system is available to anyone, but you must pay for all services. Insurance can be used to cover part of hospital fees in the private system, but anyone can still use the system if uninsured and pay by cash or credit card. If you are injured at work or in a motor vehicle accident, an insurance scheme is usually available to cover your treatment in the private hospital system. You can visit a surgeon in the public system at the outpatient clinic of a public hospital (again, you will not get to choose the surgeon, and may wait a long time for an appointment) or you can visit surgeons at their private consulting rooms.
Recommendation: If you are insured, or able to afford the payments, it is best to use the private system, as you will generally receive superior treatment.
Which surgeon should I choose?
The following are general principles that I use when recommending surgeons for treatment of sports and related injuries in Sydney:
 | Most surgeons in Sydney will subspecialise in a particular area. It is best to have a surgeon operating on you who is dealing with similar problems very often, rather than one who treats them only occasionally. |
| Because the majority of my patients play sport, I recommend surgeons who are experienced at treating athletes and sports injuries. As an NRL team doctor, I am aware of the surgeons that are generally used by the various NRL teams throughout Sydney, for example. Surgeons who are used to treating athletes will help you return to the maximum activity level possible. |
| I do not receive any payments from surgeons in return for referring them patients, so I will advise you without any financial consequence to myself. Every person (including myself) who has an opinion of the skill of various surgeons has certain factors that will bias their opinion. For example, as I work in the inner city, I tend to know more about surgeons in this area. |
If I have a referral written to one surgeon, can I use it for another surgeon?
My referrals are ‘transferable’ in that I believe that the patient has the ultimate choice of surgeon. If you want to see two different surgeons, though, you will need two different signed referrals.
Is it worth the trouble of trying to compare the price of different surgeons?
It is a very difficult exercise to compare the prices of different surgeons, as there are many components to the bills you will receive (surgeon’s fee, anaesthetist’s fee, assistant’s fee, hospital theatre fees, hospital bed fees, and miscellaneous charges, such as X-ray, braces, pathology tests etc.). Different procedures have different fees and the exact procedure you will undergo may not be known until the surgeon is actually in the process of performing the operation. You are welcome to try to obtain information on operation fees, but the complications of the health system may quickly make you decide it isn’t worth the worry. If you are trying to compare the prices of one surgeon with another, you need a reference such as a Medicare item number for the operation you are likely to have, so that you can ask the surgical fees for that item number. Almost all surgeons will have fees that are higher than the Medicare schedule fee, as these fees have not kept pace with inflation, whereas expenses in medical practices have risen much faster than inflation in recent years. Remember that surgeons who have very busy practices are charging fair market prices, in the sense that there are lots of people who are willing to pay these prices. One factor that you may be assured of is that surgeons almost always set their fees and stick to them. It is reassuring to know, if you are frustrated by the size and complexity of the bills, that other patients having the same operation are being charged the same prices in the same manner. Some health insurance companies are now offering ‘no gaps’ products – however, many of the best surgeons are not available using these products, as they are restricted in the prices that they can charge.
Lists of surgeons can be supplied to patients in Sydney attending appointments who need a referral.
Some reputable surgery clinics in Sydney have their own Websites: