Grattan Institute Report Finds Psychiatrists and Paediatricians Among Specialists Charging Extreme Fees

A new research report published by the policy thinktank the Grattan Institute reveals that extreme specialist fees have become increasingly common across Australia, forcing more than 2.2 million patients to pay exorbitant costs to see a doctor last year. According to the findings, professionals such as psychiatrists and paediatricians are among the most likely to routinely charge patients amounts that far exceed standard benchmarks.

The report, titled Out of control – how to rein in runaway specialist fees, defines an extreme fee as any charge sitting at least triple the official Medicare schedule fee, which serves as the benchmark price established by the government. Researchers noted that an additional 250,000 patients faced these high costs annually, highlighting a growing financial burden for individuals seeking medical care.

The Impact of Extreme Specialist Fees on Patients

The findings indicate that specialists cannot justify these charges by pointing to inadequate government rebates or the costs of running a business. Between 2012 and 2025, Medicare rebates fell in real terms by $9 per service, while specialists increased patient fees by an average of $37 over the same period, recouping the lost subsidy more than four times over. In 2025 alone, average specialist fees rose by 4% on top of inflation.

Some medical practitioners charge significantly more than their peers. The report highlights that the most expensive 5% of psychiatrists charge a median out-of-pocket fee of $669 for an initial consultation. For high-cost paediatricians, the median fee sits at $362, while high-cost cardiologists charge $265.11. These amounts reflect charges that are 104%, 212%, and 203% higher than their respective peers.

Proposed Policy Solutions and Government Response

To address the issue, the Grattan Institute report recommends that the government penalize any specialist whose annual fees average more than three times the Medicare schedule fee by forcing them to repay all rebates claimed that year, while allowing patients to keep their individual rebates. This regulation would impact roughly 6% of specialists nationwide, representing about 2,000 doctors, alongside more than 60% of private dermatologists and a quarter of obstetrician-gynaecologists.

Additional recommendations include federal and state governments investing $500 million annually to expand public hospital outpatient clinics, rolling out advice lines for general practitioners to seek prompt specialist guidance, and imposing binding training quotas on medical colleges.

Lead author and health economist Peter Breadon stated that the medical market has failed to self-regulate due to a lack of competition and long public hospital waitlists. Federal Health Minister Mark Butler responded to the Guardian by stating that “all options are on the table to rein in climbing specialist fees,” as the government continues working with a newly established specialist affordability working group.

Source: Psychiatrists and paediatricians among specialists most likely to charge ‘extreme’ fees, thinktank finds (source-feed timestamp 2026-11-08T09:00:35+00:00). AI-assisted report based on the cited linked article and its RSS feed; details were not independently verified.