Written by Joshua Malin
Specialists make up an essential part of the Australian healthcare system, so we’ve gone through specialist referral statistics to get a picture of how the system stacks up. Here are some of the key takeaways:
There were 36.6 million specialist appointments across 8.6 million Australians in 2020-21.
Obstetrics and gynaecology were the most utilised specialisations.
In 2021-22, more than 1 in 5 people between 15-24 saw a mental health professional.
Older Australians were more likely to have visited a specialist in 2021-22.
To see a specialist in Australia, you will typically require a ‘referral’ from your primary health care practitioner (e.g. your GP) or another allied health professional (e.g. a nurse, dentist or physiotherapist). A referral is simply a request from one doctor to another asking them to diagnose or treat you for a condition they specialise in.
Your referral will include details on your condition, a summary of relevant background information and medical history and anything else your specialist needs to know.
In 2020-21, there were around 36.6 million MBS-subsidised visits to a specialist with a referral.1 These specialist appointments were provided to 8.6 million people across Australia, meaning 34% of all Australians visited a specialist in 2020-21.
Of these 36.6 million specialist appointments, 77% were in a non-hospital setting (e.g. private consulting rooms and outpatient clinics), while 23% were in a hospital setting (e.g. specialist surgeons, obstetric care and in-hospital psychiatry.
Below is a summary of the most utilised specialists in 2020-21. This only includes non-hospital visits that were subsidised by Medicare. There were a total of 28.2 million out-of-hospital appointments, with an average of 3.4 visits per patient.1
| Medical specialty | Specialist patients (millions) |
| Obstetrics and gynaecology | 2.6 |
| Ophthalmologists | 2.2 |
| Psychiatry | 2.2 |
| Cardiology | 2.2 |
| General surgery | 1.7 |
| Dermatology | 1.6 |
| Orthopaedic surgery | 1.4 |
| Paediatric medicine | 1.3 |
| Medical oncology | 1.2 |
| Gastroenterology and hepatology | 1.1 |
| Source: AIHW – Referred Medical Specialist Attendances1 | |
Technically, you may be able to see a gynaecologist without a referral in Australia. However, this means you won’t receive a Medicare rebate for your visit. Medicare typically pays 80% of the Medicare Benefits Schedule (MBS) fee for out-of-hospital specialist appointments when you have a referral.
The best way to get a referral to see any specialist in Australia is to discuss your health concerns with your GP. While you may be able get a referral from other healthcare professionals in some circumstances, your primary care physician is most qualified to coordinate your healthcare across multiple specialists.
You’ll require a referral to be covered by Medicare for ophthalmologist appointments in Australia. However, optometrist appointments work a little differently; Medicare will cover you for one visit to the optometrist every year if you’re over 65 and every three years if you’re under 65.
You can get a referral to see an ophthalmologist from your GP or an optometrist. Typically, you would visit an ophthalmologist for more serious eye conditions that require surgery, like cataracts, glaucoma or cancer. For less critical eye conditions like long or short-sightedness, an optometrist is more suitable.
If you need to buy new glasses, this could be covered by a private health insurance policy that offers optical cover.
Like all conditions, you’ll need a referral if you want Medicare to pay towards specialist appointments to treat cancer. When you’re diagnosed with cancer, you’ll typically be referred to a specialist depending on the type of cancer you have.
A common way of treating cancer is referred to as multidisciplinary care, which involves multiple doctors who specialise in different aspects of your treatment. For example, this could include a cancer care coordinator, a radiation oncologist, a surgeon and other allied health professionals like physiotherapists or dietitians.
In the table below, you can see the average fees for a range of common specialist services or procedures. These fees are only applicable to a private setting where doctors can choose their own fees. In a public hospital, specialists can only charge up to the MBS fee, which is paid in full by Medicare.
| Medical specialty | Procedure/service | Typical specialists’ fees |
| Obstetrics and gynaecology | Caesarean section (no complications) | $3,500 |
| Ophthalmologists | Cataracts surgery | $2,000 |
| Psychiatry | Initial appointment | $440 |
| Cardiology | Pacemaker surgery | $2,600 |
| Dermatology | Removal of skin lesion | $1,600 |
| Orthopaedic surgery | Knee replacement | $4,800 |
| Paediatric medicine | Initial appointment | $390 |
| Medical oncology | Initial appointment | $280 |
| Gastroenterology and hepatology | Colonoscopy | $1,200 |
| Source: Department of Health and Aged Care – Medical cost finder2 | ||
Below you can see the proportion of people who saw a specialist in 2021-22 by age group.
| Age group | Saw a medical specialist(%) |
| 15-24 | 28% |
| 25-34 | 29.6% |
| 35-44 | 32.3% |
| 45-54 | 38.5% |
| 55-64 | 45.2% |
| 65-74 | 52.7% |
| 75-84 | 61.9% |
| 85 and over | 57.4% |
| Source: ABS – Patient Experiences3 | |
Below is the proportion of people who saw a mental health professional by age group in 2021-22.
| Age group | Saw a mental health professional (%) |
| 15-24 | 21.1% |
| 25-34 | 20.5% |
| 35-44 | 17.6% |
| 45-54 | 19.1% |
| 55-64 | 13.9% |
| 65 and over | 9.1% |
| Source: ABS – Patient Experiences3 | |
1 Australian Institute of Health and Welfare – Referred medical specialist attendances. Updated July 2022.
2 Australian Department of Health and Aged Care – Medical Cost Finder. Accessed June 2023.
3 Australian Bureau of Statistics – Patient Experiences. Released November 2022.
