Adding to growing speculation some surgical patients are being fleeced, Medibank Private has found huge variations in the surgeon’s fees its clients are charged for common urology surgeries, including endoscopic and radical prostate removal.
The data on urology procedures, as well as that for ear nose and throat surgeries, was today released in the second round of the Surgical Variance Report series, a joint project between Medibank and the Royal Australasian College of Surgeons.
The project was designed to provide greater transparency on differences in patient experiences, including the median length of patient stays, rates of readmission and the surgical fees they are charged.
Out of a group of 175 surgeons, 27 per cent charged Medibank patients no out of pocket expenses for hundreds of endoscopic prostate procedures in 2014 but at least one charged an average of nearly $4000, the data shows.
There were also dramatic price differences found between states. ACT patients faced an average out of pocket expense of $2802 for the surgery, while those in South Australia were only charged about $183.
Patients in NSW paid an average $1620 out of pocket compared to $1138 in Victoria.
The differences in surgical fees for radical prostatectomy, the removal of the prostate, which can involve robotic technology, were even greater between states.
While 20 per cent of a group of 84 surgeons who performed at least five of the procedures in 2014 charged their patients nothing out of pocket for the surgery, some patients were slugged $10,810, with a median price of $2585.
NSW surgeons charged the most for this procedure, $6508, followed by the ACT where the average fee was $6181. In Victoria it was just under $5000. By comparison the average out of pocket expense for the same procedure in Tasmania was $1608.
The authors noted that some of the variation in radical prostatectomy charges could be due to the additional costs of robot assisted surgery, which was typically paid for by the patient.
Urological Society of Australia and New Zealand President Mark Frydenberg recently said he expected members to “uphold the highest ethical standards when charging for their services,” and that while out-of-pocket expenses were justifiable due to Medicare rebate freezes, “unreasonably high” fees may breach the surgeons code of conduct.
The report for ear nose and throat surgery also revealed variations in fees. For sinus surgery ($0 to $642), myringotomy procedures ($0 to $1369) and tonsils and adenoid surgery ($0 to $426).
Medibank Chief Medical Officer Dr Linda Swan said she hoped surgeons would use the data to compare themselves to colleagues. “The intent is to look holistically at all of the data that we have and enable physicians and surgeons to reflect on their practice,” she said.
Further reports in the series will examine variations relating to vascular and orthopaedic surgery.