Gap fees rise as doctors manage greater patient needs

General practitioners are increasingly treating patients with more complex health conditions, pushing some appointments beyond the standard Medicare-subsidised 20 minutes into longer and more costly visits. 

This means patients are paying more to see doctors. The longer your consultation, the more you pay out of your own pocket as doctors try to make up the cost of delivering the service – because, they say, the Medicare rebate is inadequate. 

A survey by the Royal Australian College of General Practitioners (RACGP) found the average consultation is now nearly 20 minutes – an 11% increase since 2022. 

Doctors say patients need longer appointments for conditions including mental health and ageing, but GPs remain stuck in a “six-minute medicine” model. 

GPs say patients are asking them to treat complex health conditions because they can’t afford to pay specialists’ fees. People aged 65-plus are more likely to present with complex and chronic health conditions and have the highest number of services per person across all medical services.  

On average, it now costs $82 for a short visit to the GP. That’s up from $78 a year earlier. 

Doctors say driving the price hike is the cost of delivering services and the day-to-day running of a clinic. 

These are some of the key findings from the RACGP 2025 Health of the Nation report. The RACGP says their findings demonstrate that GPs are more committed to patients and their health than ever.

The report’s release comes as GPs are lobbying the Federal Government to increase the financial incentives they get for long ­patient consultations.

“GPs are providing more complex care than ever, on the same per-patient government spending as a decade ago and supporting affordable and accessible healthcare that keeps patients out of expensive hospitals for longer,” RACGP president, Dr Michael Wright, said.

According to the report, which surveyed more than 2,400 GPs, 86% of them manage conditions they expect non-GP specialists would typically treat. This is most often due to cost and patients’ limited access to specialists.

Dr Wright said rates of chronic disease and mental health presentations are on the rise, the population is ageing, and 68% of GPs pinpointed the increasing complexity of patient presentations as the greatest challenge facing the profession.

“It (the survey) also highlighted a significant missed opportunity when it comes to preventive care; 84% of GPs want to provide more preventive care, but only one in three have the time to provide it to their patients,” he said.

Preventive medicine covers a range of services that can help to identify a problem that could lead to chronic illness or disease.

These include testing blood pressure and cholesterol, weight management, and screenings for cancer and diabetes but can also include drug and alcohol diversion, mental health assessments, and nutrition.

“The funding and time that would allow us to do that hasn’t followed through,” Dr Wright said.

“Better funding and support for multi-disciplinary care, supporting prevention, increasing support for longer consultations … I think they’re the important things.”

The Australian reported this had the support of the Australian Primary Health Care Nurses Association, which said there was a huge opportunity for nurses to do more.

The association’s president, Denise Lyons, said data shows only 29% of nurses working in general practice work to their full scope of practice.

“Better utilising the nursing workforce, particularly to support care co-ordination and preventative activities, can have a huge impact on the health of the community, and benefits for nurse’s job satisfaction and workforce retention,” she said.