An Item Number is a code that identifies a particular medical service or procedure. For example, Total Knee Replacement is identified by the item number ‘49518’. Some operations involve more than one part, and therefore are associated with more than one item number. When provided with a quote for your operation, the item number(s) will be listed. This information is required by your health insurance provider to calculate the benefit you will receive for this service. The number(s) will also be required by the hospital and other providers of health care services to calculate fees associated with your care.

We are able to give you an estimate of fees for the initial, longer consultation, and for the subsequent visits when you make your appointment. All consultation fees should be paid on the day. We accept cash, cheque and credit cards (excluding American Express and Diners). If you desire, we are usually able to process the Medicare rebate on your behalf at the time of payment. A current referral from your GP or another doctor is required to claim the Medicare rebate.

We subscribe to the concept of Informed Financial Consent. If surgery is recommended, we will provide you with a quote. This will include an estimate of the surgeon’s fee, assistant’s fee (if applicable), and list any applicable rebates.

It will not cover any hospital, physician or anaesthetic fees; these will be billed to you separately and are your responsibility. It will not cover pathology, radiology or pharmaceutical fees

It will also not cover any physiotherapy or other therapist fees; these will be billed separately by the practitioner concerned, if not included within the hospital’s account. Most health funds have provision for these treatments.

For self-insured patients, we can help provide estimates of the likely out-of pocket expenses for the anaesthetic and hospital costs.

The Medicare Benefits Schedule (MBS) was created in 1985 with the creation of Medicare universal health care in Australia. It is a listing of how much the Federal government thinks any given medical service should cost. The Medicare rebate is then what the government is prepared to pay towards this service; currently this amount is 75% of the MBS schedule fee.

When the MBS was created in 1985, the schedule reflected the average cost of health procedures and was agreed on with the Australian Medical Association (AMA). The federal government has not increased the schedule in line with inflation to reflect the increasing costs of health care provision, leading to the development of a ‘gap’. The AMA has continued to provide a schedule of fees, indexed for inflation and other costs of healthcare provision since 1985.

A gap is the difference between what the doctor charges and the Medicare rebate. Your health insurer will pay some or all of the difference between the MBS rebate and the doctor’s account for hospital services. The insurer has the discretion to pay whatever amount they feel is reasonable and this may be up to the AMA schedule fee. There is wide variation between insurers as to the amount that they will rebate their policyholders; any sum over this is the responsibility of the patient.

In the United Kingdom, Republic of Ireland and Australia, consultant surgeons have traditionally been addressed as Mr, instead of Dr. This practise reflects the history of the development of the profession of surgery.
 
In Europe, from the middle ages the practise of pulling teeth, mending bones, blood-letting and minor surgical procedures was usually done by “barber surgeons”. These men had no higher education and looked after soldiers wounds after battle, but were also responsible for cutting hair, bathing and shaving others. The guild that encompassed these men was known as the Barbers Company in 1308. In 1540 the guild of surgeons and that of barbers merged to form the Company of Barbers and Surgeons. In the 18th century, the practise of medicine became professionalised to those who had obtained a university degree. It was the law that only those with a medical degree could use the term “Doctor”. In accordance with this, formally educated gentlemen surgeons who were also physicians formed the Royal College of Surgeons in 1800.
 
With the advent of voluntary hospitals, the prestige of surgeons increased such that the surgeons wished to be distinguished from physicians and reverted to the title of “Mister” – a form of reverse snobbery!
 
In Australia, either term is acceptable but in Victoria, South Australia, Tasmania and some parts of NSW surgeons are still mostly addressed as “Mister”. In other parts of NSW and in Queensland it is “Doctor”. Eventually the use of the title “Mister” may become an anachronism.