Doctor consultations

What is a doctor consultation?

  • A doctor consultation is a broad term meaning a meeting between a patient and a health practitioner to discuss the patient’s health. It can take place in various settings, such as a GP clinic, emergency department or hospital ward. It can also have many purposes such as providing advice, education, treating a condition, managing medications or general support. Any individual with concerns about any aspect of their health should seek medical assistance via a doctor’s consultation.
  • The healthcare system is divided into three core levels
    • Primary
      • Primary healthcare is initial step in receiving non-urgent medical assistance. It includes the services an individual can have in the community, most often referring to GP clinics. A patient can present for many different reasons, such as a new symptom, an acute injury, lifestyle advice, medication review or a referral letter.
    • Secondary
      • Secondary healthcare refers to consultation with a specialist doctor, rather than a general practitioner. In order to obtain an appointment with a specialist, the patient must be referred by their GP. Examples of specialists include cardiologists, gastroenterologists and psychiatrics but the amount of specialities are vast and continue to grow. Most specialists have long waiting lists and are more expensive than a standard GP appointment.
    • Tertiary
      • Tertiary healthcare is the hospital level of medical care. Hospitalisation is required when a patient is severely unwell, and not able to be treated in the community or requires a specific procedure.

GP consultations

How long is a GP appointment?

  • A standard single GP consultation is 10-15 minutes. However, the initial consultation is usually an extended appointment which will most often be a double appointment lasting at least 30 minutes.
  • It is recommended that patients with many concerns or many comorbidities needing to be addressed should also book in for a double appointment.
  • A single GP appointment is usually adequate for a single, minor issue such as requiring a repeat prescription. However, most patients will generally require either a longer appointment or several single appointments to have their needs adequately addressed. This is especially the case for mental ill-health.

How much does a GP appointment cost?

  • The financial cost of a GP appointment varies depending on the individual general practice clinic, length of appointment and type of service provided.
  • Medicare is Australia’s national healthcare system which is funded entirely by the federal government. Any individual living in Australia with a Medicare number is able to have free medical treatment in a public hospital as a public patient. Medicare also covers either part or all of the costs of a GP appointment, specialist appointment, and several allied health appointments such as physiotherapy, dietetics and occupational therapy.
  • As stated above, each individual general practice differs in their costs of an appointment and this is determined by each clinic at their discretion. The majority of GP clinics will follow the Australian Medical Association’s list of suggested fees for their service.
  • However, a standard 15-minute GP appointment will typically cost at least $50 AUS.
  • You are not required to pay the entire $50 fee as Medicare partially pays for the appointment. The Medicare rebate for a standard appointment is $36.30 AUS. This means that the federal government contributes $36.30 of the appointment cost which you can retrieve as a Medicare claim. You are only required to pay the out-of-pocket cost of $13.70. The more expensive the GP clinic fees for appointment, the higher the Medicare rebate and out-of-pocket costs will be. The longer the appointment, the higher both the Medicare rebate and out-of-pocket cost will be.

How do I get a Medicare card?

  • All the information for enrolling into Medicare can be completed online using the following link:
  • The link provides you with the information about whether you are eligible for Medicare, the requirements to enrol, and how to enrol.
  • The link also provides information about:
    • Enrolling a newborn baby
    • Enrolling if you’re Aboriginal or Torres Strait Islander
    • Enrolling if you are a traveller visiting Australia from another country
    • Enrolling for your own Medicare card, if you like, once you are 15 years old (prior to this age you will be on your parent’s Medicare card)

How do I claim a Medicare rebate?

  • Bring your Medicare card or Medicare number with you to the appointment to be able to make the claim at the GP clinic when you pay for the appointment. This is the easiest way to make your claim.
  • The other ways of retrieving your claim are:
    • Online – through your Medicare online account via the myGov website
    • Smartphone – through the Express Plus Medicare mobile app
    • Mail – through completing the Medicare claim form
    • Visiting a service centre
  • For detailed information about Medicare rebate claiming:

What is bulk-billing?

  • Bulk-billing means that the doctor has decided to make full cost of the appointment equal to the amount of the Medicare rebate. Therefore, you there are no “out-of-pocket” costs and you are not required to pay anything. Most general practice clinics will use a combination of bulk-billing appointments and appointments with an out-of-pocket cost. In this setting, each doctor at the clinic will make their own decision about how to bill each patient of theirs. Doctors may choose to bulk-bill certain patients who they know are financially struggling or living with chronic diseases and therefore requiring many regular appointments. Some general practice clinics are known as “bulk-billing” clinics and bulk-bill all patients based on the philosophy that healthcare should not come at a price for anyone.
  • If you are concerned about your health, do not let financial cost stop you from getting the help you deserve. If you need your appointment to be bulk-billed, call the GP clinic directly to ask if they bulk-bill or use the search engine using the link below to find a bulk-billing GP clinic in your local area.

Am I eligible for bulk-billing?

  • If you are visiting a GP clinic that does a mix of bulk-billing and out-of-pocket appointments, you may be eligible for bulk-billing if you have a health care card or are under 16 years of age
  • There are various types of health care cards listed below:
    • Commonwealth Seniors Health Card
    • Ex-Carer Allowance (Child) Health Care Card
    • Foster Child Health Care Card
    • Low Income Health Care Card
    • Pensioner Concession Card
  • Bring your concession or health care card with you to the appointment, along with your Medicare card, to be able to make the claim directly

Things to do:

Before the appointment

  • Think about what your aims and goals of the appointment are
    • Are you wanting a diagnosis for your condition?
    • Are you wanting to discuss medication?
      • Are you experiencing side effects from medication?
      • Are you wanting to change medications?
      • Are you wanting to start or stop a certain medication?
      • Do you need a repeat prescription?
    • Are you seeking a second opinion from a new doctor?
    • Are you seeking clarification in terms of your treatment and management?
    • Are you concerned about someone else (i.e. a health change – either physical deterioration, change in mood or change in behaviour – you have noticed in a loved one?)
    • Are you wanting a referral to a specialist?
  • Write down a list of all your concerns in as much detail as possible
    • Take this to the appointment, as many people can become flustered in the appointment and forget important details. A thorough history from the patient allows the GP to help you most effectively.
    • It is your experience of the symptom, illness or injury that is the most important information for the doctor to accurately diagnose and subsequently treat and manage your concern.
  • Write down any current or previous medical conditions, illnesses or injuries
  • Familiarise yourself with your family’s medical history
  • Make a list of your current medications, if any, and their doses
  • Bring your Medicare card
  • Bring any relevant medical results – imaging scans, blood tests etc.

Helpful template for patients to use to write out their concerns prior to the appointment:

*This template is most useful for a condition such as pain, but can be adapted for any type of health concern (note: mental health issues are more complex)

Main complaint:

  • Where is the site of your pain?
    • Is there a specific location of your pain? Can you pin-point the pain? Or does the pain feel more generalised and a whole-body or whole-area sort of experience? Does the pain move from one site to another?
  • What does your pain feel like?
    • Can you describe the type of pain you are experiencing?
    • Possible options: dull, sharp, ache, tearing, stabbing, ripping, throbbing, pulsating, crampy
  • How bad is your pain?
    • Can you rate your pain on a scale on 0-10, where zero is no pain and 10 is the worst pain you have ever experienced?
  • When did the pain first start?
    • How long have you been experiencing this pain?
    • Did the pain come on suddenly or gradually?
    • Is the pain constant or does it come and go throughout the day?
    • Does the pain come in episodes? If yes, describe an standard episode of pain such as the onset, length of episode, and offset
    • Is the pain worse at night or at particular time of the day?
    • Has the pain ever gone away?
  • Can you think of anything that might have caused this pain?
    • Have you been travelling lately?
    • Have you changed your diet?
    • Have you recently experience trauma or stress of any kind?
    • Have you had a recent acute illness or infection?
    • Have you been in contact with any sick people?
    • Have you recently started or changed any medications?
    • Is the pain associated with meals? Menstrual cycle (women)? Sexual activity? Bowel movements? Bladder movements? Certain time of day? Certain activities? Certain postures?
    • Have you recently had any medical procedures or admissions to hospital?
    • Have you recently gotten a tattoo or piercing?
    • Have you recently had unprotected sexual intercourse?
      • Note: these questions can sometimes be very sensitive but it is important for the doctor to have all the relevant information and the doctor is not going to be judgemental of any life choices
  • Does anything make the pain better?
  • Does anything make the pain worse?
  • Are you experiencing any other symptoms alongside the pain?
    • Associated symptoms indicate a certain body system may be involved, but there are also systemic features associated with pain that are more general and can be seen with many conditions. Below is a list of symptoms that can be associated with certain body systems for patients to consider:
    • General: fever, malaise, lethargy, muscle pains and aches, sweating, night sweats, weight loss
    • Cardiovascular: chest pain, shortness of breath, racing heartbeat, sleeping on more pillows than normal, swollen ankles, weight gain
    • Respiratory: cough, shortness of breath, sore throat, runny nose
    • Gastrointestinal: nausea, vomiting, diarrhoea, constipation, weight loss, pain when passing stool, pain with/after meals, change in bowel motions from normal, yellow discolouration of eyes and/or skin
    • Urological: pain when passing urine, passing urine more frequently, passing smaller/larger volumes of urine compared to urine, waking up in the night to pass urine, changes in menstrual cycle (females)
    • Neurological: headaches, neck stiffness, double vision, dizziness, confusion, unable to tolerate bright lights and/or loud noises
    • Autoimmune: joint pain, joint stiffness, rashes, malaise

Past medical history

  • Do you have any past or current medical conditions that you know of?
  • Screening tests
    • All sexes
      • When was your last faecal occult blood test (FOBT)?
      •  What is your HbA1c?
        • HbA1c is the most accurate indicator of blood glucose levels. It is a simple blood test that should be ordered at an annual GP check-up or work-cover check-up. It is ordered more regularly in patients who have been identified by their doctor as at-risk for developing diabetes (Hba1c > 5 per cent) and who have been diagnosed with diabetes (Hba1c > 7.0 per cent).
    •  Females
      • When was your last breast screen?
        • Breastscreen Australia is the national breast cancer screening program in Australia. It is available to all women aged between 40 and 74. It is available to women younger than 40 who have risk factors for breast cancer, such as a family member who has had breast cancer. The breast screen consists of a special imaging tool called a mammogram which is similar to a CT scan.
        • For more information:
      • When was your last cervical screening test?
        • The routine cervical screening test used in Australia detects human papillomavirus (HPV) infection in women aged between 25 and 74 years old, which is the cause of cervical cancer. This test has now replaced pap smear tests due to enabling earlier detection and therefore saving more lives. The test is available for all women in the above age group, or with risk factors, every five years.
        • For more information:
    •  Males
      • Have you had your PSA checked?
        • PSA stands for prostate-specific antigen. The amount in the body is measured with a simple blood test that allows for early detection of prostate cancer in males, with high PSA being associated with prostate cancer. However, it is not a screening test like breast, cervical and colon cancer because there is no age at which all men require their PSA level to be checked. Further, high PSA levels can be diagnostic for many other conditions other than prostate cancer. A doctor will order PSA levels on an individual basis depending on the patient’s risk factors, rather than based on a national consensus on screening for all patients once of a certain age.
        • For more information:

Family history

  • How is the health of your family?
  • If your parents are still alive, are they well? Do they have any medical conditions?
  • If you parents have passed away, how did they pass away?
  • Do you know of any medical conditions that run in the family?
    • Heart disease
    • Diabetes
    • Kidney disease
    • Cancer

Social history

  • Do you drink alcohol?
    • If yes, how often? How many drinks per night/ per week? Do you ever binge drink? Do you drink different types of alcoholic beverages?
  • Do you smoke cigarettes?
    • If yes, how many per day/ per week? How long have you smoked for? Have you ever tried to quit?
    • If no, have you smoked in the past? When did you quit? Have you ever started smoking again?
  • Do you use illicit drugs (e.g. marijuana, cocaine, methamphetamine)?
    • If yes, what types of drugs do you use? How long have you been using for? How often do you use these drugs?
    • *It is important to stress to the patient that every doctor consultation is completely confidential and the patient will get the most out of the doctor visit by being as open as possible
  • What do you do for a living? Are you still working? Are you retired?
    • This is important for the doctor to know to assess for any possible occupational exposures (i.e. a patient with a long-standing cough who works with toxic chemicals may have lung disease associated with this exposure). It can also help to assess whether the patient is active or sedentary most of the day (i.e. a patient who works as a labourer is much more active than an office worker, and sedentary lifestyle is a risk factor for many conditions such as diabetes and heart disease).
    • It is also important to assess whether the patient requires social work involvement due to being unemployed, or psychological support due to not coping under work stress.
  • Where are you currently living? Who do you live with? Is this a supportive environment for you? Do you feel safe?
    • These are very important questions to assess whether the patient requires referral to social work or psychological services.
  • What is your diet like? Are you physically active?
    • These questions are important as they help to assess the presence of risk factors for very common disease seen in the community such as heart disease, kidney disease and diabetes.

During the appointment

  • Be completely honest and open with your GP.
    • As a generalisation, doctors have chosen medicine because they are empathetic people who have dedicated their lives to helping others. They will not pass any judgment on any of your lifestyle choices or behaviours, but it is important they know everything you tell them is true to be able to help you most effectively.
  • Ask as many questions as you like.
    • If the GP says something you do not understand, always ask for clarification.

After the appointment

  • The subsequent steps after a GP consultation is very dependent on the specific circumstance and can range widely. The most important thing is that, after the consultation, you feel you have understood the GP’s advice and are comfortable with the outcome of the appointment.
  • Most often, the GP will advise a follow-up consultation either to discuss results from a test they ordered you to have done, to re-assess your condition, and to make decisions for your subsequent healthcare.
  • For more information:

FAQs

How do I choose the right GP for me?

  • It is impossible to know whether a doctor will be right for you before you have had your first appointment. If you have not seen a GP before, simply make an appointment at your nearest/ local general practice clinic. Following the first appointment, you can reflect on whether you would like the doctor you saw to become your regular doctor for medical conditions.
  • Consider:
    • Did you establish a good rapport with the doctor?
    • Did you feel comfortable speaking to the doctor about your concerns?
    • Was the doctor empathetic about your condition?
    • Do you feel as though the appointment was a success?
    • Did you come away from the appointment feeling as though your aims were met?
    • Do you feel as though the appointment was overall a success?
  • Australia has exceptionally high standards for all doctors. All patients can be assured that their doctor will always act with beneficence and non-maleficence.
  • Nonetheless, it is important that you feel you can trust and open up to your doctor, and personal preference is an acceptable reason to want to see a different doctor in the future.
  • If you do not feel an adequate rapport with your GP, you have the right to see a different doctor, either in the same clinic or a different clinic altogether. This is a personal decision that you can discuss with family and close friends for further advice.

How often should I see my GP?

  • It is recommended for everyone to see their GP at least once a year, even if the person has no particular health concerns. As always, prevention is better than cure, and a general health check-up can allow a GP to assess a patient for risk factors or indicators of a health condition before it fully manifests.

What should I expect in a standard health check-up?

  • The GP will generally ask questions related to your current health, any current or previous health conditions, current or past medications, past hospitalisations and surgeries, a history of your family’s health, as well as questions related to your lifestyle, such as your diet, alcohol, smoking and physical activity.
  • A GP will also conduct a general physical examination to assess the skin for any moles, lumps or rashes and to check heart rate, blood pressure and weight are all within the healthy range. If you are concerned about something in particular, such as a new or discoloured mole, bring this to the GP’s attention.
  • A GP will commonly order a set of blood tests to assess further for any risk factors of signs of disease. A blood test requires you to go to a pathology centre to have the test done, and the results will be sent directly to your GP for review. A follow-up appointment will be made so that the GP can go through the test results with you. Common aspects of a blood tests include a full blood count, cholesterol levels, and triglyceride levels, kidney-related function parameters, and Hba1c levels (diagnostic measure for diabetes).
  • The GP may also order various screening tests. Australia has various cancer screening programs which are generally recommended for patients based on age, gender, medical and family history. These include screening for bowel cancer, cervical cancer and breast cancer.
  • Annual GP check-ups becoming more important with age, as the risk of common diseases, such as cardiovascular disease, type II diabetes mellitis, and cancer increases.
  • For more information:

What questions should I ask my GP?

If you are searching for a diagnosis:

  • Remember, a good doctor should be asking you most of the questions because the patient’s own account of the health problem they are experiencing is the most important aspect of making a diagnosis. However, ask as many questions as you have during the consultation to ensure you feel like your goals of the appointment have been met by the end.

If your doctor requests a test, treatment or procedure:

  • Although all doctors ought to be acting in the patient’s best interests, there may be times when you disagree with your doctor or do not want to follow their advice for various reasons (religious beliefs, cultural stigma, financial costs etc.). This is why it is so critical to have a good rapport with their doctor so they can fully understand your situation.
  • Most doctor visits will result in the doctor requesting a:
    • Test (e.g. blood test, imaging scans)
    • Treatment (e.g. new medication, changing the dose of current medication, topical therapies, lifestyle modifications)
    • Procedure (e.g. echocardiogram, colonoscopy, surgery)
  • For any test, treatment or procedure, there are always going to be benefits and risks.

Choosing Widely Australia has identified five key questions for a patient to consider to ensure the appropriate and necessary amount of care is provided:

  1. Do I really need this test/treatment/procedure?
    • Due to the continuing and rapid advancement in healthcare, it sometimes happens that patients can be over-diagnosed and over-treated. Not all medical interventions are necessary for every patient. You have the right to ask your doctor why they think a medical intervention (such as a specific procedure) is in your best interests and what value it will add to your overall health.
  1. What are the risks associated with it?
    • Essentially all medical tests, treatments and procedures have risks associated with them. It is important that the doctor discloses all these risks to you so that you are aware and can make a fully informed decision about whether you would like to go through with it. You can be confident that your doctor will only be advising a certain test, treatment or procedure with the belief that the benefits outweigh the risks for you, but you still have a right to know all the risks to then make an informed decision about it yourself.
  1. Are they simpler, safer options?
    • In some circumstances, there may be less invasive or disruptive ways to treat and manage your health condition. For example, a patient with risk factor for developing heart disease may benefit from lifestyle modifications such as eating healthier, increasing physical activity and stopping smoking. Depending on the severity of the condition, these steps may be adequate rather than immediately starting medication or ordering heart-related tests such as an ECG or echocardiogram.
  1. What happens if I do not have the test/treatment/procedure?
    • Ask your doctor the risks associated with not having the test/ treatment/ procedure they are requesting. Will your condition worsen?
  1. What are the costs?
    • Think about both financial and emotional costs associated with the test/ treatment/ procedure. Additionally, consider the time and organisation required. Is it worth it for you?

Choosing Widely Australia has created a search engine available for both medical practitioners and patients for recommendations for all tests, treatments and procedures that healthcare providers can request for patients. The list has been developed by Australia’s peak health professional colleges, societies and associations, and is based on the most recent and accurate evidence. It is not to be used as a decision-making factor, as each patient must be treated as an individual, with their health care tailored specifically for them. However, the search engine provides a helpful addition to the doctor and patient decision-making process.

What are my rights?

  • Bring someone with you
    • For some patients, presenting to a GP can be a very courageous thing to do. People may avoid going to the doctor because they are scared of the outcome (“what if I have cancer?”), anxious about being judged due to certain lifestyle choices (drinking excessive alcohol, smoking, being overweight), or being embarrassed about their problem (skin rash in pubic region, erectile dysfunction, bowel issues). If you are feeling uncertain about attending a GP, you can always bring someone with you to the appointment. This can be a family member, close friend or any type of chaperone.
  • Request a doctor of the same biological sex as you
    • Due to certain cultural or religious beliefs, a patient may be required to see a doctor of the same biological sex.
    • Similarly, if your concern is sensitive, you can ask for doctor of the same gender. A female patient concerned about a new lump on her breast can request to see a female doctor. Likewise, a male with a painful scrotum can ask to see a male doctor.
  • Confidentiality
    • Confidentiality is a professional value held by all Australian doctors. Patients rely on their doctors to protect their confidentiality. In the vast majority of circumstances, a patient can be assured that anything they discuss with their doctor will be kept private between themselves and the doctor. This is a legal obligation on the part of the doctor. However, there are some important exceptions to this general protocol for medical confidentiality outlined below.
      • Risk of harm to yourself or harm to others
      • Notifiable diseases e.g. COVID-19, HIV, cholera, smallpox,
      • Notification of births and deaths
      • Notification to the coroner of a death in certain circumstances
      • Involvement of patient in serious crime e.g. rape, murder, child abuse
      • Medical conditions affecting fitness to drive e.g. epilepsy, stroke
    • For more information:
    • For specific information on informed consent, see informed consent document
  • Seek a second opinion
    • You have the right to seek a second opinion from another doctor for any reason. You may feel uncertain about your current doctor’s diagnosis or treatment. In this case, having a second opinion may give you reassurance or provide you with other options. You may also simply be seeking a better rapport with a new doctor.
    • You can ask your current doctor for a referral, ask the receptionist at your general practice clinic to see a different doctor for future appointments, or make an appointment with a doctor from an entirely different practice. If you decide to go to a new clinic, your new doctor will have access to all your previous health information though My Health Records, unless you have opted out of this platform. For more information about My Health Records, see the My Health Records document.

The Australian Charter of Healthcare Rights

  • The Australian Charter of Healthcare Rights was developed in 2008 by the Australian Commission on Safety and Quality in Healthcare and outlines the rights of any person in Australia who is receiving health care. The charter was reviewed by the Commission in 2018 and launched the second, and latest, edition of the charter in 2019.
  • There are seven main pillars of the charter: access, safety, respect, partnership, information, privacy and give feedback

What is English is not my first language?

  • If English is not your first language, your doctor can use the Australian Government Translating and Interpreting Service (TIS) to ensure proper communication between you and your doctor. This service is funded through Medicare and does not cost you or your doctor anything to use.
  • The service has access to over 2300 interpreters for over 140 different languages and dialects. It is available 24 hours a day, seven days per week. The service is primarily delivered over the phone, but a face-to-face interpreter can be arranged when necessary.
  • If you do not think your English is at a high enough standard, request for an interpreter when you book your doctor’s appointment. A pre-booked phone interpreter is helpful when the appointment is planned or for rarer languages. Immediate phone interpreting is available within a few minutes, but it is better not to use valuable appointment time waiting even this short time.
  • You may choose to choose a family member or friend as an interpreter. However, it is advised a medical interpreter be used through the TIS because they are trained professionals, whereas a family member or friend may accidentally leave our crucial information or not know how to translate important medical terms.

 

Can I see a doctor by myself if I am under 18 years old?

  • It is very important that young people feel they are able to see a doctor on their own. Young people in Australia are at an age where they are experimenting and may want medical advice regarding mental health, sexual health and alcohol and/or drug use. If you are under 18 years of age, you are still able to book and go to a medical appointment without a parent or guardian.
  • There is no black-and-white answer about whether a person under 18 years old can accept or refuse medical treatment. The concept of mature minor doctrine is a rule of law used by doctors to decide whether a person under 18 years old is mature enough to give make their own decisions about their health and healthcare. It is the doctor’s responsibility to make an objective assessment of the young patient to then make this important decision. If the doctor deems you to be not mature enough to make your own medical decisions, your parents or guardian will make the decision.
  • In general, a young patient can be confident that their doctor will not breach confidentiality, with the same exceptions applying to them as for patients over 18 years old (see above about confidentiality).