Public or private: how to choose where to see a specialist

Public clinics are free but often have longer waits. Private specialists cost more but you choose who and when. Here's how to weigh it up.

In Australia you can usually see a specialist in two ways: in a public hospital outpatient clinic, or privately in a specialist's rooms. Both need a referral from your GP. The right choice depends on your condition, your budget and how soon you need to be seen.

Public hospital outpatient clinics

• Free for people with Medicare.
• Your GP sends a referral to the clinic and gives it an urgency category. See What do Category 1, 2 and 3 referrals mean?.
• Waits for non-urgent conditions can be long, and they vary by hospital and specialty.
• You may not choose which specialist you see, and you might see a different doctor, such as a registrar, at each visit.
• If you need surgery, you join the public waiting list and the hospital chooses the surgeon.

Private specialists

• You choose the specialist and can often be seen sooner.
• You pay the specialist's fee. Medicare pays a rebate, and you pay the gap. See Bulk billing, rebates and gap fees explained.
• Private health insurance doesn't cover the consult itself, but hospital cover can help if you need surgery or an admission. See Does private health insurance cover specialist visits?.
• You see the same specialist each time, which some people value for ongoing conditions.

Questions to help you decide

• How urgent is this? If your GP thinks you need to be seen quickly, ask whether the public clinic can see you in time.
• Can I afford the gap fee, and possibly surgery costs later?
• Do I have hospital cover that includes this treatment?
• Does it matter to me which specialist I see?
• How far am I willing to travel?

Some people see a private specialist for the first appointment to get a diagnosis sooner, then go on the public waiting list for surgery. Others start in the public system and move to private if waits are too long. Talk to your GP about what makes sense for you.

Moving between systems

If you change from public to private, or the other way, you'll usually need a new referral addressed to the new clinic or specialist. Let both know so they can update your records and avoid double booking.

Spec Book shows private specialists' next available appointments and fees, so you and your GP can compare options before deciding.

Don't wait for an appointment if your symptoms get much worse. Call 000 or go to the nearest emergency department for severe symptoms.

General information only, not medical advice. Everyone's situation is different, so check with your GP or the provider. In an emergency call 000.