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HomemioptometryThe Irresistible Pull Towards Private Billing

The Irresistible Pull Towards Private Billing

Andrew McKinnon takes a seemingly simple question and uses it to spark a wider conversation about whether more practices need to introduce private billing.

I had an interesting question from a member recently: Is there a difference in terms of the requirements for examination standards and recordkeeping depending on whether you bulk bill or bill privately?

Of course, the mode of billing that you employ has no bearing at all on the standard of care that you must provide or on the content of your clinical records. The concepts are completely independent of each other.

However, the rationale behind the question was interesting. If I bulk bill, then am I likely to spend less time with the patient than if I bill privately (and more expensively)? If I bill more, will I spend more time with the patient, and therefore would my notes (and exam content) be greater?

Refer answer above. However, the implications of these questions are important for us all.

As Medicare cost pressures continue to mount (and they will), the impetus for optometrists to move to private billing will, in my view, become irresistible – and not too far down the track.

The reason for this is important for the profession. If we stick with our currently very high rates of bulk billing, eventually corners will start being cut, because it will be uneconomic to operate a truly full scope practice with the modest amount that Medicare offers as a rebate. Yes, sales can pick up some of the gap, but eventually that gap will become too wide.

Some of our colleagues have already moved to private billing and, from what I am hearing, there aren’t too many regrets. They will still bulk bill some patients, but in general, if you want top line service and care, you’re expected to pay for it.

It is a debate (and a change) that I think needs to start very, very soon.


We all know that a change is as good as a holiday. Well, from 2024, change is coming to Super Sunday.

With major renovations taking place at Luna Park, we have decided to move across the harbour to Jones Bay Wharf and the magnificent Doltone House function centre.

Sitting right on the water just at the edge of Darling Harbour, with light rail and ferries at the door, it is a great place from which to launch the next phase of this iconic conference.

So if you haven’t already done so, mark this date in your diaries – Sunday 19 May, 2024. See you at Doltone House!


Maybe it’s just coincidence, but since the start of the current run of inflation and price pressures, we have seen a marked upturn in the number of lapsed optometrists seeking to return to clinical practice. Some have been out for only a few years, but others haven’t practised for more than 20 years and, as you would expect, need quite a bit of support.

Note: If you haven’t practised for less than three years, then you have no problem; you can go straight back in. However, if it is more than three years, the fun begins!

If anyone is thinking of getting back into clinical practice, our message is this: It can be (and often is) a long and involved process. Regardless of how long you’ve been out of practice, coming back in requires a lot of thought, planning and, importantly, commitment. If you haven’t practised for a number of years, it could be a two to three-year journey to regain your registration. You need to be in the right head space before you start.


And finally, as we head towards the endof-year madness, a reminder not to underservice your patients (and, of course, don’t overservice either). Your patients come to you because they need your expertise. They are looking for solutions to their visual problems.

Take the time to find out what they really need and prescribe accordingly. If that means two pairs, contact lenses plus spectacles, whatever it is, don’t feel obliged to minimise your prescribing. Prescribe what you think is the best solution for your patient. They can always modify it if they don’t want to take all the options. But if you don’t offer the options, the patient will never know what might have been.

Andrew McKinnon is the Chief Executive Officer of Optometry NSW ACT