West Australians forking out more than $100 for dermatology appointments, according to new Cleanbill report

West Australians are forking out an eye-watering amount for dermatology appointments, prompting specialists to call for Medicare rebates to keep pace with clinic costs. New data from online healthcare directory Cleanbill, to be released on Sunday, revealed the average initial consult for WA dermatologists was $257.56 and a follow-up consult cost $171.88. Medicare gives back $84.15 back for an initial consult and $42.30 back for subsequent appointments, however, this means West Australians are still forking out about $173 in out-of-pocket costs for the first consult and $129 for a follow-up consult. In a further blow, private health insurance does not cover dermatology consultations meaning the entirety of the out-of-pocket cost has to be paid by the patient. For patients like Angela Scott, who has to see a dermatologist every six months due to her eczema, the costs quickly add up. The 56-year-old said she was about $90 out-of-pocket each visit as well as paying $31 a month for her current treatment of Dupixent, which controls her chronic eczema. “The cost factor of seeing a dermatologist on top of finding a cream that is suitable to suit your skin that is just totally unbelievable,” she said. “My cost of seeing a dermatologist has significantly dropped since starting on Dupixent but there are a lot of eczema sufferers that still have to see a dermatologist every couple of weeks to get that management under control.” Australian Medical Association WA dermatology representative Sarah Page said patients were losing out as Medicare rebates had not kept pace with how much it costs to run a practice. Medicare rebates only increased by 3.5 per cent in July this year — an extra $2.85 for initial dermatology consults and $1.40 more for follow-up consults. “The main issue is that there’s really been very little increase in Medicare funding of specialists in general but in dermatology the amount that patients get back hasn’t really kept track with how much it costs to run a practice as well,” Dr Page said. “If you have a more complex case and it’s a longer consult there’s also no change in the amount of money that a patient gets back from Medicare. You either get a new consult fee or a follow up consult fee. Dermatology Specialist Group Perth dermatologist Clare Tait held a similar sentiment, calling for Medicare rebates to be indexed in line with inflation rates. “The government’s indexation of Medicare rebates has not kept pace with the rising cost of medical practice at all over the last, really, 25 to 30 years,” she said. “The current Medicare reimbursement for specialist consultations also does not in any way adequately account for the escalating complexity and the longer consultations that are required for our patients so our patients are significantly disadvantaged by a lower rebate for the subsequent consultations. “One of our primary concerns is to ensure that patients have equitable access to care and there’s no doubt one of the barriers to equitable access is cost.” In good news, all of the WA clinics surveyed in the Cleanbill report were all available to take on new clients. However, Dr Tait said there was a significant shortage in dermatologists and trainees that needed to be addressed to keep clinics’ books open. “Across the country, we only have 650 dermatologists and we have 110 trainees and this shortage is due to insufficient public investment in dermatology services,” she said.