Hi Georgina I think your point about letting the market decide is a good one. We cannot advocate how much someone can or will pay for a service. The amount you pay a GP is capped by the sheer number of them available, and good knowledge about what constitutes a Œproper¹ fee level. They key, as you say, is to educate the public and GP¹s about what they get from various services and what constitutes quality - in a way like the accountants have recently done. That was a great campaign about using a chartered accountant and I understand that it was very successful. I¹d like to see an advertising campaign about clinical psychologists, maybe something along the lines of your mental health is too important to trust just anyone. I would add, however, that in rural and outer suburb communities the market doesn¹t get to decide. It comes down to who will work there for what income. It¹s still a question of whether people will pay. But it seems to me that the market economy is founded on choice, and without it things don¹t work so well. All the best Tony On 4/09/10 11:33 AM, "georgina swinburne" <georginaswinburne@hotmail.com> wrote: > Hi Marie, > > I don't believe that there is a "specialist fee" or a "specialist rate", only > a "specialist rebate". The APS has a "recommended fee", but as far as I am > aware, it does not differentiate between specialties, and we are free to > charge whatever we want. Moreover, the APS has recommended that all > psychologists charge $212 (or there abouts). I think we are getting into > dangerous waters if we confuse "specialist fee" with the "specialist rebate". > > I would not be surprised if there are clinical psychologists charging > considerabley more than the APS recommended fees. It's reall y up to the > consumer to find a service and cost that fits for them. I think having > automony to set fees is important and that any psychologist can charge what > ever they choose. > > What we can do, with the support of ACPA, is educate GP's about the difference > in qualifications & rebates and inform our local GP's about our indiviudal > fees, so that they, as the gatekeepers, can assist consumers of mental health > to make informed decisions. > > Georgina. > > Dr Georgina Swinburne > B.Sc., B.Arts(Hons), Grad.Dip.Clin.F.Th., D.Psych.(Clinical Child & Adolescent > Specialisation), M.A.P.S. > Principal Clinical Psychologist > > Melbourne Children's Psychology Clinic (MCPC) > Located at: Brunswick Family Dental Surgery > 44 DeCarle Street, Brunswick 3056 > www.melbournecpc.com.au <http://www.melbournecpc.com.au> > Phone: 9517-6272 (9517-MCPC) > Mobile: 0466 631 151 > > > > > > > > From: hardman.marie@bigpond.com > To: tony@sydneyclinicalpsychology.com.au; office@list.acpa.org.au > Date: Sat, 4 Sep 2010 07:13:21 +0800 > Subject: Re: [ACPA] Fw: Generalist Fees > > Re: [ACPA] Fw: Generalist Fees > Hi Tony, > > I couldn't agree more Tony in regards to the costs of running a private > practice and the overheads etc. My point was that generalist psychs are > charging $200 per hour in one practice that I know of, and there are probably > more practices who do this. > > A particular patient was referred to this practice and when she inquired > about the fees, was told that the consult would cost $200.00. There was no > consideration to bulk billing or even reducing the cost for this patient. She > was told that she could 'pay off' the balance after rebate from Medicare. The > estimated cost for 4 sessions was $800.00, and the rebate was only $313.60 > from Medicare, leaving a balance of $486.40 for her to 'pay off'. > > When I inquired about the cost and checked qualifications with the Board, not > one of the psychs was a Specialist psych. I guess what Im saying is that I > believe it is unethical for lesser qualified psychs to be able to charge the > Specialist rate, even given the cost of running a practice. You obviously take > the financial status of the patient into consideration with your fees. > However, not everyone does this and it goes against the grain that 4 x 2 > psychs are able to charge out at Specialist rates. > > Of course, if a patient 'shops' around, they will find Specialist psychs like > yourself who will reduce the fees for patients who cannot afford $200 per hour > (and I have seen patients and just bulk billed as you do). As you point out, > this then gives the patient an opening to see a Specialist psych at a reduced > cost because the rebate is greater for the Specialist psych (and most of the > Clinical Psychologists I know in private practice will reduce fees for > patients who cannot afford the Specialist fees). > > In this particular case, and Im sure there are others, as above, the patient > could not afford to pay the consult cost of $200. I did manage to find a > Specialist psych who did reduce fees such as you do. But I personally was > amazed that this particular practice which consisted of only 4 x 2 psychs were > charging $200 for a consult. Whilst we may like to think that money is not the > motivation for seeing patients, obviously in some practices this appears to be > the case. If fees were 'capped' for the 4 x 2 psychs, the opportunity to > overcharge for a consult would not be an option. > > Warm regards, > Marie > > > > > > From: Tony Merritt <mailto:tony@sydneyclinicalpsychology.com.au> > Sent: Saturday, September 04, 2010 6:26 AM > To: hardman.marie@bigpond.com ; ACPA <mailto:office@list.acpa.org.au> > Subject: Re: [ACPA] Fw: Generalist Fees > > Dear Marie > > The difference in fee structure for generalists/specialists is particularly > apparent but also important for low earning clients, those on disability > pensions etc. In Sydney¹s inner west where my practice is located the rent and > overheads are such that I could not run a practice by bulk billing clients at > $80 an hour. You only have to look at the hourly rate for a public service > clin psych to see how this is not a viable figure. In my practice we bulk bill > /ATAPS about 25% of the clients at $117/$110 an hour and it really is not > profitable to do so, but I do it because of my values and beliefs. My point is > that the differential rate actually improves the chances, at least in metro > areas, that the disadvantaged get to see the more highly qualified clinical > psychs rather than generalists, because it is only the clin psych bulk billing > rate that is even vaguely viable. Cheers Tony > > > On 3/09/10 10:45 PM, "hardman.marie@bigpond.com > <http://hardman.marie@bigpond.com> " <hardman.marie@bigpond.com > <http://hardman.marie@bigpond.com> > wrote: > >> Hi everyone, >> >> >> I am forwarding Ray's email for everyone to see how much effort he has >> already expended in regards to fees charged by 4 + 2 psychologists, and the >> need to 'cap' the fee. I'm not certain of how fees are structured for >> medical practitioners, but I have the impression that there is a 'cap' for >> whatever service is provided. In the event that the patient is referred to a >> 'Specialist', then the patient will expect the consultation to cost more. >> For example, the Specialist's recommended fee maybe $250.00 for the initial >> consult, but the GP cannot charge $250.00 for a consult because they are not >> 'Specialists'. I believe it is generally accepted that a 'Specialist' will >> charge more for a consult than a GP. >> >> Warm regards from Perth, >> >> Marie >> >> >> >> From: ray rudd <mailto:ray.rudd@yahoo.com.au> >> Sent: Friday, September 03, 2010 12:58 PM >> To: hardman.marie@bigpond.com <http://hardman.marie@bigpond.com> >> Subject: Re: [ACPA] Generalist Fees >> >> >> Dear Marie >> >> Yes, the overall situation with Better Access permitting 4+2 is >> unacceptable, and will of course require further sustained lobbying from >> our profession. Together with my colleague, Prof Henry Jackson, we have >> submitted to government on this issue since our appearance at the Senate >> Enquiry on Mental Health in 2005, prior to program inception, and again for >> the second enquiry in 2008 (see Senate web site for record of submissions). >> We have also written to the Minister DoHA, other Members, and others with a >> substantive MH interest. Henry was also in the Australian, when he and >> three other senior clin psych academics resigned from APS on this issue. >> Some senior psychiatrists have also criticised the program publicly, e.g., >> Prof Mendoza resigned; Ian Hickie in the Australian. Federal govt is not >> listening at this point. >> >> After 5 years in which I have spent dozens of hours on this, I have been >> ongoing disappointed by my clin psych colleagues for their lack of >> action/lobbying Canberra on the issue. Sad. Continuing effort is still >> required, and it needs to come from as many clin psychs as possible because >> the more different voices the better. Can be done individually or through >> ACPA. Both is best. Judy has copies, I believe, of both UniMelb and UNSW >> submissions to the federal govt taskforce working on a plan for the >> national MH workforce. Those submissions say it all, including the need >> for salaried clin psychs in CMHC's as the main model, and a cap on fees if >> a fee for service model is to continue. I fully concur: as Henry says in >> his submission, Better Access was meant to provide better access for >> clients, not better access for psychologists to make money. >> >> I encourage you and committed colleagues to continue making criticisms >> formally in writing to the Mental Health Division (or ?Branch) of DoHA. To >> that end, the academic submissions by UniMelb and UNSW to which I referred >> are very helpful. >> >> If you wish, this email may be distributed to other ACPA members. >> >> regards >> Ray >> >> --- On Fri, 3/9/10, hardman.marie@bigpond.com >> <http://hardman.marie@bigpond.com> <hardman.marie@bigpond.com >> <http://hardman.marie@bigpond.com> > wrote: >> >> >>> >>> From: hardman.marie@bigpond.com <http://hardman.marie@bigpond.com> >>> <hardman.marie@bigpond.com <http://hardman.marie@bigpond.com> > >>> Subject: [ACPA] Generalist Fees >>> To: "ACPA members" <office@list.acpa.org.au >>> <http://office@list.acpa.org.au> > >>> Received: Friday, 3 September, 2010, 4:28 AM >>> >>> Hi All, >>> I'm not sure I've got the correct email, but I just thought I'd put >>> something out there that I was reflecting upon in relation to the Medicare >>> rebates for 'Specialist' and 'Generalist' fees; whilst the rebate maybe >>> less for 'Generalist psychologists', there is nothing preventing lesser >>> qualified psychologists charging consultations at the 'Specialist' rate. >>> For example, a 4x2 'psychologist' charging $200.00 per hour. I know of >>> 'psychologists' in at least one practice where the fee is $200.00 per hour >>> and not one of the psychologists is a 'Specialist'. Even less incentive to >>> complete Masters/Doctoral degree if the aim is private practice...Kind >>> regards to all, Marie >>> >>> >>> -----Inline Attachment Follows----- >>> >>> ________________________________________You are receiving this message as >>> you are a member of ACPA. If you wish to unsubscribe from this list or >>> change your options (eg, switch to or from digest mode, change your >>> password, etc.), visit your subscription page at: >>> >>> http://list.acpa.org.au/mailman/options/office_list.acpa.org.au/office%40acp >>> a.org.au >>> <http://list.acpa.org.au/mailman/options/office_list.acpa.org.au/office@acpa >>> .org.au> >>> >>> >> >> >> >> >> ________________________________________You are receiving this message as >> you are a member of ACPA. If you wish to unsubscribe from this list or >> change your options (eg, switch to or from digest mode, change your >> password, etc.), visit your subscription page at: >> >> http://list.acpa.org.au/mailman/options/office_list.acpa.org.au/office%40acpa >> .org.au >> <http://list.acpa.org.au/mailman/options/office_list.acpa.org.au/office@acpa. >> org.au> >> >> > > ________________________________________You are receiving this message as you > are a member of ACPA. If you wish to unsubscribe from this list or change your > options (eg, switch to or from digest mode, change your password, etc.), visit > your subscription page at: > http://list.acpa.org.au/mailman/options/office_list.acpa.org.au/office%40acpa. > org.au