What Doctors Need to Know
The Australian Salaried Medical Officers’ Federation (ASMOF) has launched a long-overdue push to reform the Staff Specialist Award in NSW, aiming to create a fairer, simpler, and more sustainable employment framework for doctors working in public hospitals. A key sticking point in these negotiations is the Right of Private Practice (RPP) arrangements.
RPP was originally introduced as an incentive — a mechanism to supplement public hospital salaries by allowing doctors to see private patients within the public system. But in practice, RPP has become a complicated, inconsistent, and often inequitable scheme.
Why RPP Is Problematic
- Unpredictable Income: Doctors relying on RPP face income instability due to variability in billing opportunities, especially in specialties or locations with fewer private patients.
- Administrative Burden: The complexity of RPP rules, reporting, and billing practices creates unnecessary stress and exposes doctors to compliance risks.
- Equity and Fairness: Doctors working under the same award can earn vastly different total incomes based solely on their access to private patients — not on workload, experience, or contribution.
Be Ready: RPP Might Not Change
Despite ASMOF’s efforts, it’s possible that RPP arrangements will not be meaningfully restructured in this round of award reform. NSW Health has a long history of resisting change to RPP, given its entanglement with hospital revenue streams and entrenched bureaucratic processes.
What This Means for You
If RPP remains in its current form, doctors will need to become even more proactive in understanding and managing their RPP entitlements and billing practices. That includes:
- Staying informed on what qualifies as legitimate billing under your RPP model.
- Ensuring proper documentation and coding to avoid rejected claims or clawbacks.
- Using available support — including hospital finance teams, specialist billing consultants, or medico-legal advisors — to ensure your billing aligns with both hospital policy and Medicare rules.
Doctors should not have to choose between focusing on patient care and ensuring financial viability. But in a system where RPP rules are unlikely to change soon, vigilance and efficiency in billing are critical to protecting your income.
The Bottom Line
Award reform is essential. But until structural changes are made to replace or standardise RPP across NSW, doctors must be realistic: prepare for the current system to persist. Now is the time to tighten up your billing practices, seek expert advice if needed, and ensure you’re making the most of your legitimate entitlements.
