Accessibility and sustainability in private healthcare

This is a bit more of a personal reflection, and there’s no clear solution here, just something I’ve been thinking about.

One of the things I’ve struggled with since becoming self-employed is the ethical side of charging people for healthcare. It’s never fully sat right with me. I personally do believe that people should be able to access the right and best care possible independent of their income.

At the same time, I’ve also found it difficult being part of a system that can incentivise seeing more people, selling more services, and working more hours. I do think this contributes to issues like over-medicalisation and over-servicing. I’ve seen it happen, and it used to frustrate me a lot.

Over time, though, I’ve started to understand why it happens. Not necessarily agree with it, but understand it. The reality is that to do the job we care about, healthcare providers need to earn a sustainable income.

In private healthcare for allied health professionals, there isn’t a lot of external support from the government. Medicare provides 5 sessions per year, shared across allied health, and it doesn’t come close to covering the actual cost of running a clinic. NDIS fees and funding is getting slashed everywhere. DVA is looking to make some serious funding cuts in the next few years.

There are limited grants, and most of the recent Medicare funding changes have focused on general practice rather than allied health (seems to have been completely ignored).

So for most services, including ours, we rely on people paying directly. Early on, I tried to keep fees as low as possible to make things more accessible. But over time, that approach started to take a toll. I experienced financial stress and, for the first time, burnout, and it happened more than once.

As the clinic has grown, there’s also the responsibility of paying staff fairly and creating something sustainable for the long term. So my view on pricing has changed.

I still don’t like increasing fees. But I also don’t see a realistic alternative if we want to continue providing good care, support our team, and keep improving what we offer to the community.

It’s not a perfect system. But it’s the reality we’re working within.

We’re always trying to find the balance between making care accessible and making it sustainable.

Written by

Samuel Bulten

Exercise Physiologist | Masters in Medicine (Pain Management)

Director, Adapt Movement

Disclaimer

This information is for educational purposes only and is not a substitute for personal medical advice. These blogs are written by Sam Bulten and represent his opinions and insights and are based on his experience and interpretation of the research. As Sam is a human, these opinions and insights are not absolute truths.