At MediBetter, we often talk about sustainability in healthcare, not just financial sustainability, but clinical sustainability too: the ability for doctors to deliver care that’s thoughtful, thorough, and truly patient-centred.
Last week, one of my long-term patients asked me a simple question:
“Are you switching to bulk billing like the Government said?”
It’s a fair question and one that many Australians are now asking their doctors, and it is putting many doctors on the spot to have a difficult conversation.
I explained that our clinic isn’t switching just yet, but we’re watching closely and listening to community feedback. Still, if we were to move to 100% bulk billing, it would mean a fundamental shift in how I deliver care.
The Trade-Off No One Talks About
Bulk billing might sound like a win for accessibility, and in many ways, it is. But there’s a trade-off that often goes unspoken.
Current economics dictate that for many (often metropolitan) clinics, the switch to private billing has been a painful but necessary requirement to ensure that overhead costs are met and that GP pay remains competitive enough to keep them from seeking alternative industries.
If our clinic transitioned entirely to bulk billing under my current model of care, the clinic I work with and I would be taking a substantial financial hit. Therefore, if my clinic were to switch to fully bulk billing, my care would have to change. I’d no longer be able to manage multiple issues in a single appointment; instead, each consultation would need to focus on just one problem, and appointments would be much shorter.
For more complex health concerns, that would mean multiple short visits across several days or weeks rather than one in-depth conversation.
When I explained this to my patient, they said:
“That’s why you’re our doctor, because you take the time to care when we need it.”
It was a powerful reminder of why many of us practice slow medicine - care that prioritises depth, understanding, and continuity over speed and volume.
Why “Slow Medicine” Still Matters
Not every clinic or patient fits neatly into a short-consultation, bulk-billing model. The average consult time across the country has lengthened to match the complexity of the disease burden of the population. The majority of consultations last just under twenty minutes, and GPs are navigating multiple presentations, often intertwined with mental health and social issues.
For most of my patients, the quality of the doctor-patient relationship I provide and the time I take to explore their health properly are worth paying for. I find that occasionally patients will attend a bulk billing clinic for a simple issue, but are willing to keep coming back and pay to see me for appropriate management of their complex care, because they know that quality care takes time.
I went into General Practice to be a holistic family doctor. The kind that takes the time to achieve those long-term health outcomes. The most common term I hear in patient feedback is 'thorough'. I wanted to be the doctor who stops that heart attack from ever happening through the power of communication and relationship building. It's hard to be that kind of doctor in 6 minutes.
That said, I understand cost-of-living pressures are real, and if our community tells us that free care is their priority, then we’ll adapt accordingly. But patients need to know what that change really means for their care experience.
A Systemic Challenge for General Practice
Having personally experienced fast medicine, I’ve always aimed to build a different kind of practice, one that takes time.
Unfortunately, as Government policies increasingly shape how healthcare is delivered, the model that values time and thoughtfulness may become harder to sustain. The current incentive program has deepened the divide in funding between fast and careful medicine.
Bulk billing has its place, but we shouldn’t mistake access for quality. The challenge ahead is finding a balance between the two, so patients can access affordable care without losing the human connection that makes medicine meaningful.
How MediBetter Supports Sustainable Practice Models
At MediBetter, we’re building tools to help clinicians find that balance, using smart MBS data and automation to make billing simpler, more transparent, and financially sustainable.
Our mission is to help doctors spend less time decoding the MBS and more time with their patients. Because while policy may push for faster, cheaper care, we believe technology should empower doctors to deliver better care. Care that values time, quality, and connection.
