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WA Specialist dont take Public patients?

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#1 MsFeralPerthFembo

Posted 04 February 2013 - 02:51 PM

Hi this is not baby related but not sure where else to ask.

DH has had a problem with his wrist for about a year. He went to the GP who referred him to physio. He went to physio for a few months no improvement. Went back to GP and got referral for ultrasound, still couldnt find what is wrong. GP asked if he had private health insurance and he said no and wrote him a referral to a wrist specialist.

DH called the specialist today and was told they only see patients who have PHI, no exceptions. So DH calls the GP and gets a new specialist name and when he called got same answer (only take private patients).

He calls the GP surgery again and tells them what happened and they basically said dont know "maybe we can refer you to a teaching hospital, will see what we can do" and they have no idea what that would involve or how long it would take.

We had no idea that specialists wont take public patients when deciding not to get PHI. And now it is a "pre-existing" condition we can't just go out and get PHI as we wouldnt be covered for it.

Does anyone know of a WA wrist specialist that will see people without PHI? We know it might be expensive but at this stage we just want to see someone and figure out what is wrong?! We are SOR but will travel.

#2 envs

Posted 04 February 2013 - 03:04 PM

Try going to a GP that bulk bills...they will have a list of specialists that treat public patients, but can be long...don't know any specialists myself. sorry

#3 kay11

Posted 04 February 2013 - 03:08 PM

Wow. I'd go the teaching hospital route. It might take a while, but we go through it for immunology and they've been good.

#4 Fossy

Posted 04 February 2013 - 03:10 PM

Seems odd they wouldn't see you if you're willing to pay. Did you advise them you're willing to pay all fees upfront?

Otherwise, look on your public hospitals website and see what doctors practice there, or ring and ask for a list? Im sure they'd be able to help you out. Good luck.

#5 MsFeralPerthFembo

Posted 04 February 2013 - 03:20 PM

Thanks for the replies. Yes we did say we are willing to pay upfront but they still said no.

I will try to find a list of public hospital specialists...

Kay, does a teaching hospital just mean where all the new doctors train at when they finish their degrees? Do you have any idea how long things take (eg months or a year?)

#6 SeaPrincess

Posted 04 February 2013 - 09:55 PM

You could also try calling PHI companies and find out what the waiting period would be for coverage.  It might not take as long as the waitlist (assuming you can even find one).  Or call one of the private surgeries and ask them if they know of a public specialist.

#7 au*lit

Posted 04 February 2013 - 10:03 PM

He probably needs to be referred to an outpatient clinic at a public hospital.

A teaching hospital is basically a big public hospital. In Perth they include Charlie's/QEII, Royal Perth, Joondalup and Fremantle (and Princess Margaret & King Eddies, but they won't help your DH).

#8 QueenElsa

Posted 04 February 2013 - 10:07 PM

You'll need to go back to your GP and he / she can send off the referral to the local public hospital.  The wait is likely to be long. Has your GP done an MRI? That may give you answers (I assume from your post that the cause is uncertain.). It will cost you but is worth it.

If you can, join private health insurance now as the waiting time may be shorter than the public hospital waiting list.  Sad but true, especially for orthopaedics.

I find it strange that the specialists won't even see you, so keep asking around and you may find someone.

#9 redglittershoes

Posted 04 February 2013 - 10:20 PM

PHI will cover pre existing conditions after a 12 month wait. You should also be able to get cover for a wrist on a low / medium level of cover. Others are right, that might be quicker than waiting on a public waiting list.

#10 IShallWearMidnight

Posted 04 February 2013 - 10:54 PM

id just get PHI as well. I have a hernia and its been a 5 month wait to ever SEE the specialist, let alone have the op (Im rural, and wasnt able to drive to perth and go private so Im stuck waiting down here)

#11 iwanttosleepin

Posted 04 February 2013 - 11:06 PM

I don't understand why they won't see you as a private patient?

I see my Dermatologist in Australia privately and I don't even get Medicare. I don't have private health insurance either.  (I do have travel insurance while in Australia).

The private health insurance won't cover an outpatient consultation anyway....so it's a bit odd.  What does it matter to them if they have a consultation and then from there you can make an assessment of where you want to go if treatment is warranted.

#12 Luvmy4

Posted 04 February 2013 - 11:59 PM

I have had the same issue.  In my experience no doctor would see me even with the offer of payment upfront.
We ended getting PHI & had to wait 12 months as it was a pre-existing condition. I'm sure the wait at a teaching hospital would have been just as long.

#13 MsFeralPerthFembo

Posted 05 February 2013 - 12:02 AM

QUOTE (iwanttosleepin @ 04/02/2013, 10:06 PM) <{POST_SNAPBACK}>
I don't understand why they won't see you as a private patient?

The private health insurance won't cover an outpatient consultation anyway....so it's a bit odd.  What does it matter to them if they have a consultation and then from there you can make an assessment of where you want to go if treatment is warranted.

That's what we don't understand! What does it matter to the doctor if the money comes from us personally or from a PHI fund?

When we got rid of our PHI years ago we started putting the money we saved into a separate account so we could afford to pay if something like this ever came up. We had no idea it would ever be an issue of not getting to SEE a specialist without PHI.

We've decided to take out PHI now in case something like this happens again in the future (and we will avoid the over 30 penalty as DH turns 30 this year). Sounds like the 12 month wait for pre-existing conditions may end up being less than the wait with public system anyway sad.gif

Edited by JBaby, 05 February 2013 - 12:04 AM.

#14 Guest_LeChatNinjah_*

Posted 05 February 2013 - 12:05 AM

It sucks, OP and I think it should be illegal.

I'm effing furious on your behalf right now.

#15 Rhoxie

Posted 05 February 2013 - 12:21 AM

All doctors need to operate somewhere .. those who operate out of private hospitals( need PHI)  and those out of public hospitals (the best of which are the 'teaching hospitals")

My DH had both hands operated last year through a referal from a bulk billing GP to Kaleeya Hospital in Fremantle. He had a 5 month wait for the first hand and a further 6 weeks after that for the second hand.

Could not fault the treatment and his carpal tunnel is gone original.gif  

Get your referal to a public hospital and you'll probably be in and done this year.

#16 iwanttosleepin

Posted 05 February 2013 - 03:19 AM

Rhoxie - you are assuming an operation is needed.
The OP only wants a consultation at this stage.  That isn't covered by PHI anyway.

#17 Luvmy4

Posted 05 February 2013 - 09:10 AM

QUOTE (iwanttosleepin @ 05/02/2013, 01:19 AM) <{POST_SNAPBACK}>
Rhoxie - you are assuming an operation is needed.
The OP only wants a consultation at this stage.  That isn't covered by PHI anyway.

For me they didn't care & their reasoning was "if you did need surgery how do we know you can afford it. The doctor wont waste his time on consults with people who may need to go elsewhere for surgery."  The attitude was the same everywhere I tried I even had people hanging up on me when I dared to question them about it.

The only option was go public teaching hospital or get PHI & wait. Which we did as we were finally in a position to afford it.

Edited by Luvmy4, 05 February 2013 - 09:11 AM.

#18 shelly1

Posted 05 February 2013 - 09:39 AM

I would atleast ask for an MRI. I had a problem with one of my wrists, Dr refered me to physio and it didnt help, xray didnt show anything, catscan didnt show anything and finally I went for an MRI which showed inter articular ganglion - nothing sinister but I did need surgery to remove it

#19 Soontobegran

Posted 05 February 2013 - 09:54 AM

That is very unfortunate OP. sad.gif
I have not met specialist who will not take on a patient without PHI as it really doesn't affect him at all? Medicare pays him not PHI.

The only thing I can think of is that he only works out of the private system and will not take on patients he can not treat through a private hospital knowing that for most people paying up front for private hospital stays and treatment without PHI is out of the question?

Mind you having PHI does not assure you of an earlier appointment with a specialist. Wait times are often months with popular specialists and popular hospitals.

You had a question about tertiary educating public hospitals and who provides the care. Very many of the same specialists that work privately also work in the public system. They are consultants and the registrars and residents work 'under' them. The consultant will usually be involved in decision making and surgery so you will never have major diagnosis and treatment decided by those still learning.

#20 Feral Madam Mim

Posted 05 February 2013 - 11:40 AM

If you have taken out PHI I would still also ask for a referral to a public hospital (I went through a public hospital for my ankle), that way if a spot comes up in the public system before your wait period is over you can still take it, if your wait periods ends first then you can just cancel the appointment with the public hospital and go private (hope that makes sense). I would also get whats tests you can done now while waiting, that way when your appointment comes up you can save time by handing over everything you have and then coming up with a game plan sooner. If he has already had an ultrasound I would also ask for an Xray and an MRI (I know freo hospital does MRIs and from memory it took me about 4 weeks to get in for it).

#21 MsFeralPerthFembo

Posted 05 February 2013 - 01:50 PM

Thanks everyone. DH has already asked them to refer him to the teaching hospital tho it didnt seem like they had done it before so we will check up on them and make sure it is done.

He is also going to try and find a bulk billing GP who might know a public specialist and also to request an MRI. Hopefully that might at least help with diagnosis so we can figure out if surgery will be required at all.

It's not so much the wait that is the problem, but more of the run around with being told we could see a specialist and then told we cant and the GP acting like we are such an inconvenience to them and not knowing what to do.

When DD was favouring one side as a newborn our CHN was able to say "we are referring you to x, it takes 4-6 weeks and they will send you a letter with an apt date which will be about 4-6 weeks after that". If the GP had handled it similarly and was able to give us some kind of indication of the process, even if it did take over a year, we wouldnt have minded.

#22 Princess Leila

Posted 05 February 2013 - 03:43 PM

There will be no Medicare rebate on an MRI if you are referred by a GP. The only way to get the rebate is if a specialist refers you. So you can expect to have to pay a few hundred dollars to cover this.

#23 MsFeralPerthFembo

Posted 05 February 2013 - 03:45 PM

QUOTE (~CTCT~ @ 05/02/2013, 02:43 PM) <{POST_SNAPBACK}>
There will be no Medicare rebate on an MRI if you are referred by a GP. The only way to get the rebate is if a specialist refers you. So you can expect to have to pay a few hundred dollars to cover this.

Thanks for the heads up. Without having any indication how long the wait will be to see a specialist in the public system it might be worth going ahead with it ourselves...

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