In this episode of PodMD, NAB’s Head of Behavioural and Industry Economics, and author of the NAB Health insights report, Dean Pearson, will be discussing 2024/25 NAB Health Insights Report (Part 1) – Health Practitioners Through the Eyes of Patient.
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*As always, all in this PodMD podcast is intended for health professionals and the comments are of a general nature. Information given is not intended as specific medical advice pertaining to any given patient. If you have a clinical issue with one of your patients please seek appropriate advice from a colleague with expertise in the area.
Today I’d like to welcome back to the PodMD studio Dean Pearson.
Australia’s health system is widely regarded as among the best in the world, supported by a range of highly qualified practitioners who provide safe, reliable, and quality healthcare for all Australians.
But do their patients agree and what do health consumers really value from these practitioners?
To find out NAB has again reached out to a large representative sample of Australians across the country who shared their experiences with the health system, exploring issues such as wait times, access, affordability, and overall satisfaction with health professionals and the system.
Here to discuss this research is Dean Pearson NAB’s Head of Behavioural and Industry Economics and author of the NAB Health insights report.Question 1
THello Dean, thanks for joining us. Firstly, why did NAB do this research and what differentiates it from other work already available to health professionals.Dean: Thanks for having me back on the podcast.
Healthcare is unlike most other sectors of the economy, with a unique connection to our shared national values around equity and citizenship.
At the same time, public perceptions and experiences with healthcare services are so important in identifying how well a country’s health system is meeting the needs of its population.
Patient expectations can also help frame future demand for health services, funding and payment models.
This is our 13th year compiling this report – and it’s a little different from previous years and I think this is what truly differentiates it from other research available.
Health practitioners told us they wanted to hear more from their patients, with more feedback in their own words, so they could better respond to the specific opportunities and concerns raised.
We’ve listened, and this year have included patient comments across a range of areas most important to them.
Often when you ask survey respondents to go beyond just ‘ticking a box’ and provide written feedback, it can be difficult to get much of a response.
In a sign of just how important health practitioners are in their patients’ daily lives, they were more than happy to share their views.
Most importantly, even those patients who were highly satisfied, believe more can be done.
Post COVID a new breed of patient has emerged, one who is not only seeking a more pro-active approach to managing their own health and wellness but are showing less loyalty to practitioners when they perceive they are not meeting their needs.
And, sometimes the most aggrieved patient can also be the most insightful, particularly given the rising incidence of switching.
Our hope is that these insights are a great help for health practitioners as they plan for the next 12 months and beyond.Question 2
Let’s start with a very simple but important question: are patients satisfied with healthcare in Australia? I’d also like your views on whether satisfaction levels matter if patients are receiving good health care?Dean: Let me the answer the second part of your question first.
Why should it matter whether patients are satisfied?
The simple answer is that it can lead to patient loyalty, better clinical outcomes, and patient compliance.
In practical terms, it sees patients as “consumers” of health services, which then requires practitioners to address issues beyond medical care.
So how satisfied are Australians with the health system overall?
They remain “moderately satisfied”, with perceptions broadly unchanged over the past year but there continues to be important differences by gender, age, and location
On average, satisfaction was unchanged at 6.5 pts out of a possible 10 pts.
By comparison, in countries such as Singapore scores are typically 8 pts or higher.
Of course, Singapore has a population of just under six million people aided by a centralized administration, predictable financing, and strong public health and health care delivery systems.
This gives the government a great deal of control over how care is ultimately delivered.
Moreover, the average satisfaction score masks the large number of Australians – over 1 in 3 (36%) – that report being “very” satisfied (i.e. scoring 8 pts or higher).
And, by comparison just 1 in 10 (11%) report being very unhappy (i.e. less than 3 pts).
Satisfaction remains highest in capital cities and lowest in rural areas.
Around 7 million people – or 28% of the Australian population – live in rural and remote areas. These Australians clearly face unique challenges and often have poorer health outcomes than people living in metropolitan areas.
People living in rural and remote areas have higher rates of hospitalisations, deaths, injury and also have poorer access to, and use of, primary health care services, than people living in Major cities.
Men were slightly more satisfied but women a little less so than last year.
Last year we noted that in a nod to Australia’s universal health coverage, income was also not an important determining factor, with satisfaction levels spread narrowly between the higher and lower income group.
Of concern, the gulf in satisfaction by income has widened, with satisfaction edging down among those in the lower income group but unchanged for higher incomes earners.
The survey also revealed a noticeable decline in satisfaction among Australians who identified as LGBTQI+.Question 3
Thanks Dean. Did you make a distinction between overall satisfaction Australia wide and those who require ongoing treatment or medication for a medical condition who are often closer to the system and as a result their satisfaction is particularly important?Dean: Yes, we did.
Over three quarters of Australians have at least one long-term health condition.
Nearly half reported having at least one chronic condition.
Mental and behavioural conditions, back problems and arthritis are the most common chronic conditions.
Chronic conditions account for 37% of all hospitalisations, 61% of total disease burden and 87% of deaths in Australia.
Importantly, our research suggests Australians with a health condition are considerably more satisfied, scoring a much higher 7.5 pts in 2024 (up slightly on last year), with over 6 in 10 (62%) very satisfied (scoring 8+ pts).
Key predictors of patient satisfaction are typically sociodemographic factors including age, distance to the care, number of visits and waiting times as well as factors such as improving values and attitudes, cleanliness, waiting time, safety and effective care and availability of medicines.
Again, satisfaction remains highest (and improved) among Australians living in capital cities and lowest for those in rural areas – though it has also improved.
Men remain more satisfied with their care than women, despite an improvement in satisfaction among women.
Younger health consumers requiring ongoing care typically have higher expectations about the care they receive, with patient satisfaction typically falling with age.
While around 8 in 10 patients over the age of 65 reported high satisfaction with their care, only 3 in 10 scored highly in the 18-24 group.
Income also remains a key differentiator though satisfaction with care improved in both lower and higher income groups in 2024.
NDIS participants were more satisfied with their care in 2024, but again LGBTQI+ patients much less so.Question 4
So overall that’s quite encouraging. But, did the survey find any changes in visitation to health practitioners over the past year?Dean: Yes it did.
Over the past year, GPs, pharmacies, and dentists were again the most commonly visited health practitioners.
Visitation was highest overall for GPs with just over 7 in 10 (71%) Australians visiting a doctor in the past 12 months – however, this was down slightly on last year (73%) and well down on 2022 when almost 8 in 10 (78%) Australians had visited a GP.
Some patients may be delaying or avoiding GP appointments as the cost-of-living bites, with evidence of fewer standard consultations taking place in many parts of the country this year compared with before the pandemic.
Patients may also be stockpiling a longer list of medical issues before making an appointment.
A similar trend was observed for pharmacies, with the number visiting remaining at around 6 in 10 (61%) in the past 12 months, down from 7 in 10 (70%) in the 2022 survey.
We also noted a small decline in the number that visited an optometrist or specialist doctor.
Similar numbers of Australians – around 1 in 2 (or 51%) – have visited a dentist (up from 47% in the 2022 survey) as the tail end of backlogs of people who postponed their appointments during the pandemic looks to have eased.
Of concern, growing number of Australians (almost 1 in 10 or 8%) signalled they had not visited any health practitioner (vs. 5% in 2022) over the past year.
In particular, many Australians continue to fall well short of Australian Dental Association recommendations.
Of concern, around 3 in 10 had not visited a dentist for 3 or more years.
While around 6 in 10 Australians in capital cities had visited a dentist in the past year, this compares to just 4 in 10 in rural areas.
Australians over 65 were most vigilant with around 2 in 3 having visited a dentist in the past year.
Noticeably more people on higher incomes visited more often.
Having private health cover was also important, with almost 2 in 3 with cover visiting a dentist in the past 12 months, compared to only 4 in 10 without.
More older Australians typically visited all health practitioners over the last 12 months than did younger people, except when it came to public hospitals and psychologists and psychiatrists (18-24 group).
By income, key differences were the much larger number in the higher income group that visited a dentist (55% vs. 40%), and in the lower income group public hospitals (33% vs. 18%).
By region, we noted a somewhat higher number in capital cities that visited a GP (75%) and Dentist (53%) in 2023, and a much higher number in rural areas a public hospital (35%).
Rural area visitation to a dentist (41%) and to a public hospital in capital cities (18%) was somewhat lower in 2023.
Of concern, a large number of Australians also told us they should have visited a health professional more often.
In fact, 1 in 2 health consumers believe they should have visited a practitioner more in the past year, potentially risking more serious health consequences by delaying treatment.
The most common practitioners missed were dentists (21%) and GPs (17%).
Around 1 in 10 did not see a specialist doctor, psychologist and psychiatrist, pharmacy, optometrist or chiropractor, osteopath or physiotherapist, despite believing they needed to.
Interestingly, topping the list of practitioners least likely to have been missed were vets (only 2% of Australians report missing a needed visit – people really do love their pets!).
Over 1 in 2 (53%) Australians who had not visited a dentist in the past year cited cost as the reason, up from 49% in 2023 and 43% in 2002.
Just over 1 in 4 (27%) said they had no reason to visit, down from 37% in 2002 and 31%.
With more people not visiting dentists because of cost and fewer believing they did not have a need to visit one, cost of living pressures may be forcing more Australians to defer visiting dentists at a time when more are experiencing dental health issues.
Cost was key across the country, particularly in rural areas (where 67% of those who had not visited in the past year said it was due to cost).
Not surprisingly, a much lower number of Australians with private health cover had not visited due to cost (43%).Question 5
Is cost the reason why a growing number of Australians have not visited a health professional?Dean: No it’s more complex than that.
When asked why they had not visited, cost did feature prominently across most practitioner groups but reasons differed considerably by type of practitioner.
Interestingly, affordability was the most common reason for not having visited a chiropractor, osteopath or physiotherapist (54%), ahead of dentists (51%) or psychologists and psychiatrists (49%).
Around 4 in 10 also cited affordability as the main barrier to visiting optometrists (39%) and specialist doctors (38%), and 1 in 3 private hospitals (33%).
Only 1 in 10 however said affordability was the reason for not using a public hospital (11%), 2 in 10 for not visiting a pharmacy (21%) or GP (21%) and for vets, affordability was only given as a reason for not visiting by 3 in 10 (29%) health consumers.
Interestingly, a much higher 46% of Australians said they had not visited a pharmacy and 44% a public hospital because they were ‘self-managing’, with 1 in 3 also choosing to self-manage rather than see a vet or psychologists and psychiatrists (30%).
Getting an available appointment was a reason for noticeably more people (28%) when trying to see a specialist.
Around 1 in 4 did not know who to see in relation to vets, with lack of time cited as a reason by somewhat more people for not visiting an optometrist (28%) and public hospital (24%).Question 6
With affordability a key constraint, did you look at perceptions of cost and whether patients believe they have changed over the past year?Dean: Yes, it is perhaps not surprising that patients believe all providers have become more expensive.
They were in strongest agreement that vets – identified by around 3 in 4 Australians (77%) of patients – had experienced price increase over the past year, with only 3% of consumers believing it was cheaper.
Around 2 in 3 said it was more expensive to see a dentist (62%) and chiropractor, osteopath and physiotherapist (62%), and 6 in 10 a pharmacy (61%) or psychologist and psychiatrist (60%).
Using a private hospital or specialist doctor was more expensive according to 57% of all Australians, while 56% said the cost of other health providers increased.
Around 1 in 2 (50%) said GP services were more expensive and 4 in 10 (40%) optometrists. Only 1 in 4 (24%) believe using a public hospital was more expensive.
Cost perceptions did however vary across regions.
Noticeably more people said it was more expensive in capital cities for dentists (66%), chiropractors, osteopaths and physiotherapists (63%), psychologists and psychiatrists (63%), and specialist doctors (60%), but more in regional cities said other health providers were more expensive (65%) and in rural areas public hospitals (31%).
More people in regional cities (85%) and rural areas also said vet costs were higher than in capital cities (72%).
We also noted a significantly lower number in rural areas who said private hospitals (31%) and other health providers (29%) were more expensive.
Out‐of‐pocket costs for patients have clearly risen.
This has no doubt contributed to some patients forgoing or deferring healthcare.
Waiting times have also increased for many services, while access has been reduced for some drugs or technologies.
Health insurance premiums and co-payments are also rising.
Gaps in universal healthcare system coverage are particularly noticeable in services such as dental and some allied healthcare.Question 7
In this environment, the importance of bulk billing to Australians when visiting a doctor is no doubt increasingly important. Did your report look at the incidence of bulk billing?Dean: Yes we did.
And you’re right, it’s growing in importance in the minds of patients.
But only 6 in 10 (60%) Australians report being bulk billed the last time they visited a GP or doctor, down from 63% in 2023 and 71% in 2022.
Numbers were down across most monitored groups.
By region, bulk billing was highest in rural areas (unchanged 64%) but fell slightly in both regional and capital cities (to 60%).
By age, it was highest by a significant margin among the over 65 group who were also one of only few groups to report higher rates of bulk billing in 2024 (76% vs. 73% in 2023).
Bulk billing rates declined across all other age groups and were lowest and fell noticeably among younger patients – only 1 in 2 of those between the ages of 18-34 were bulk billed.
Interestingly, Australians on lower incomes were the only other group to report higher rates of bulk billing in 2024 (81% vs. 75% in 2023), and significantly above the higher income group (51%).
NDIS participants and people who identified as LGBTQI+ also reported much lower rates of bulk billing in 2024.
While fewer people report being bulk billed, the importance of bulk billing to Australians has grown.
When asked how important bulk billing was when selecting a doctor, on average Australians scored a very high 8.2 pts out of 10.
It also scored very high in most key groups and increased with few exceptions.
Almost 7 in 10 (68%) health consumers overall believe bulk billing is extremely important when selecting a doctor (scored 8+ pts).
By region, it jumped sharply to 71% (59% in 2023) and was rated as extremely important for more women (72%) than men (64%).
It ranged more widely across age groups, with around 3 in 4 (74%) 45-54 and over 65 years olds scoring the importance of bulk billing extremely important, falling to just over 1 in 2 (54%) in the 18-24 group.
We also noted a sizeable increase in the 25-34 age group who scored very high (69% vs. 57%), with 35-44 year olds, the only group to report a fall (63% vs. 72%).
In the lower income group, the number who said it was extremely important was noticeably higher at 76% (67% in 2023), but also rose in the higher income group (64% vs. 61%).
We also counted sharply higher numbers of NDIS participants (73% vs. 63%) and among those in the LGBTQI+ community (74% vs. 63%) who scored the importance of bulk billing very high.Question 8
It’s no surprise that cost is important to all patients. But of course, cost does not necessarily equate with value. Do Australians make a distinction between these 2 concepts?Dean: Yes, very much so.
In the eyes of patients “value” remains high for many practitioner groups.
Australians on average scored the value of care, advice or treatment highest for pharmacies (8.1 pts) and optometrists (8.0 pts).
Chiropractors, osteopaths and physiotherapists and public hospitals were next (7.6 pts), followed by private hospitals (7.5 pts).
Australians also scored value relatively high for GPs, specialist doctors, dentists and vets (7.3 pts), and lowest for psychologists and psychiatrists (7.1 pts).
Around 7 in 10 also believe optometrists and pharmacies offered “excellent” value (scored 8+ pts), and around 6 in 10 for public hospitals, specialist doctors, private hospitals and chiropractors, osteopaths and physiotherapists.
Around 1 in 2 said dentists, vets and psychologists and psychiatrists offered excellent value.Question 9
So, what is “value” in the eyes of patients and what more can practitioners do to demonstrate it?Dean: Not surprisingly, many spoke of cost wanting prices that better reflect the actual time spent and fees that cover the Medicare gap.
But others wanted longer appointments and feeling less rushed, practitioners being on time, taking more time to “really listen” rather than a quick “10 min consultation before moving on to the next patient”, more “straight forward answers and solutions”, more “long term solutions”, a more “wholistic approach to health and welfare”, more home visits, practitioners making “too many assumptions” about them, more attention paid to being COVID safe including better air filtration and mandatory masking and making the practice it feel more “welcoming”.
Another theme was not having to obtain and pay for an annual referral from a GP to see the specialist for those with ongoing, chronic conditions, being more specific as to why follow up appointments were needed and waiting times of up to 2 weeks “just to get a telehealth”.Question 10
One of the key reasons Australians are satisfied with their personal “health care” is ease of access, has there been any change this year?Dean: Australians continue to believe it is “very” easy to see or use a range of practitioners, particularly pharmacies (scoring 8.7 out of a possible 10 pts vs. 8.8 in 2023), optometrists (8.3 pts vs. 8.5 pts) and vets (8.1 pts vs. 8.2 pts) – though all scored marginally worse than in the 2023 survey.
The survey also suggests it is still quite easy to see a chiropractor, osteopath and physiotherapist (7.9 pts vs. 8.2 pts in 2023), a dentist (7.5 pts vs. 7.7 pts) and private hospital (7.5 pts vs. 7.7 pts). That said, the ease of seeing practitioners in these areas has fallen consistently over the past two years.
It’s also still quite easy to see a GP (unchanged at 7.3 pts).
It was somewhat easier to access a public hospital in 2024 (6.8 pts vs. 6.4 pts), but a little harder to see a specialist (6.5 pts vs. 6.8 pts).
Psychologists and psychiatrists were rated hardest to see (6.4 pts vs. 6.3 pts).
Australians living in regional cities found it somewhat more difficult to use a public hospital, and in rural areas a dentist, GP, psychologist and psychiatrist.
Noticeably more men said it was harder to see a vet, and women to access care from a private or public hospital, a specialist doctor and psychologist and psychiatrist.
By age, the ease of seeing healthcare practitioners was rated more difficult among age groups under 35 and easiest among the over 65s.
With psychologists and psychiatrists rated hardest to see, it is concerning that many Australians continue to struggle with their mental health, with 16% reporting they had been diagnosed with mental health illness or disorder over the past 12 months, though encouragingly this was down slightly from 18% in 2023.
But, at the same time, the number who felt they needed professional help for their emotions, stress, or mental health over the past year climbed to almost 4 in 10 (39% vs. 36% in 2023).
And, fewer of these Australians report getting the help they believe they needed with just under 1 in 2 (47%) accessing mental health care (vs. 51% in 2023).
This aligns with a growing number who have reached out but were waiting to see someone – rising to almost 1 in 5 (19% vs. 15% in 2023). An unchanged 1 in 3 have not sought any help.
However, it appears those in greatest need are increasingly being prioritised with 6 in 10 (58%) people who received care waiting less than a month (24% less than 2 weeks and 34% 2 weeks to less than a month), up from 1 in 2 (51%) who waited less than a month in 2023.
Fewer also endured longer wait times of over a month (1 in 3 in 2024 compared to over 4 in 10 or 42% in 2023). That said, while 6 in 10 in capital cities waited less than a month, fewer than 1 in 2 (46%) did so in rural areas. Around 6 in 10 in the higher income group also reported wait times to access care of less than a month, compared to 47% in the lower income group where more than twice as many people endured wait times of more than 6 months (22% lower income; 10% higher income).Question 11
What did patients believe a health practitioner could do to make it easier to see them?Dean: Many spoke of wanting better access to GPs who bulk billed, more generous operating hours particularly on weekends, practitioners remaining “true to their appointment times and for example, “booking appointments for 4pm and not seeing someone until 5.30 to 6pm”, employing more and investing more in staff, working “less sporadically” and “in the same place”, introducing better booking systems and “more follow up phone calls and reminders”.
A number spoke of being unable to find doctors who were taking on new patients and the need for more Government action to reduce waiting lists in the public system, with one patient believing they were “at their worst in his 78 years”, while others urged practitioners to close their books to better service existing patients. Some spoke of having to wait over a year to see a specialist and how this was weighing on them, while others mentioned having to book “three weeks advance” for an appointment.
Finally, many felt there was a need for more trained doctors while also acknowledging “how busy and overworked” their local GPs appeared.Question 12
We know that feeling listened to is so important to patients.
There are numerous surveys exploring how soon some practitioners interrupt their patients during an appointment (I’m not sure I believe it but apparently the median is 11 seconds) and some argue they don’t even give patients a chance to first explain the reason for the visit.
So, do patients believe health practitioners really listen to them?Dean: Our research suggests they mostly do, though some practitioners perhaps more than others.
Optometrists came out on top scoring 8.1 pts out of a possible 10, followed by pharmacies and vets (8.0 pts). All other practitioners also scored quite high – from 7.7 pts for dentists to 7.2 pts for public hospitals.
The share of Australians scoring practitioners very high (8+ pts), ranged from 2 in 3 for pharmacies, optometrists, vets and chiropractors, osteopaths and physiotherapists to 1 in 2 for psychologists and psychiatrists and public hospitals.
It was also pleasing to find very few scored their experiences low (less than 3 pts) – from 1% for optometrists and private hospitals to 8% for public hospitals.
We did note some differences across key groups.
Australians over 65 typically scored higher for all practitioners, particularly chiropractors, osteopaths and physiotherapists, specialist doctors, GPs and public hospitals.
By income, the biggest differences related to specialist doctors (with those on lower incomes feeling much more listened to than those on higher incomes – 8.1 pts lower income; 7.2 pts higher income).
Australians who identified as LGBTQI+ rated listening lower for GPs (6.8 pts), psychologists and psychiatrists (6.8 pts) and public hospitals (6.5 pts) lower.
Once again when invited to share what practitioners could do to make them feel more listened to there was no shortage of feedback.
Many spoke of taking more interest in them “as an individual”, understanding that “they themselves live with their condition”, not being “put in box because of their medication”, being more “supportive of alternative views” and less “patronising and condescending”, asking more questions about “their thoughts on what is happening”, being more talkative and building rapport, more eye contact and “getting off the computer”, more continuity of doctors to avoid feeling like “no one fully understands their full situation”, involving patients more in their diagnosis and treatment, more appointments after work hours and weekends, making new patients feel “just as valued as existing ones” and getting to know the family medical history, not continuing to work on the previous patients documents during their consultation, giving them the “full time paid for”, less judgment, not being late for the appointment time “they themselves set”, more surveys “with prizes to honestly give their valuable comments”, and being able to discuss multiple concerns rather than limiting their attention to one per appointment.
Others mentioned practitioners having a narrow focus on physical rather than mental health. Another theme revolved around affirmation of how patients feel about their illness and recognition of their anxieties and nervousness and “seeming like they don’t reallyQuestion 13
In addition to feeling listened to, patients also value highly feeling cared for as a person, (things such as being sensitive to their needs, respected, friendly). Are there any key insights here for our listeners?Dean: Yes, overall, practitioners scored well though once again it did vary across practitioner groups.
Chiropractors, osteopaths and physiotherapists led the way (8.2 pts out of 10), just ahead of optometrists and vets (8.0 pts).
Other practitioners also scored quite highly – from 7.9 pts for pharmacies to 7.2 pts for public hospitals.
Many Australians also scored practitioner care very high (scored 8+ pts), though this ranged somewhat more from around 3 in 4 for chiropractors, osteopaths and physiotherapists to just over 1 in 2 for public hospitals.
Very few Australians overall scored the extent they felt cared for low (less than 3 pts) for all practitioner groups – from just 1% for private hospitals, optometrists, and pharmacies, to 8% for specialist doctors and public hospitals.
Australians aged over 65 scored chiropractors, osteopaths and physiotherapists, specialist doctors, GPs and public hospitals higher than did those in all other age groups.
Income was not an important determinant with both lower and higher incomes groups scoring about the same for all practitioners except specialist doctors (somewhat higher in the lower income group).
Interestingly, a much lower number of people in rural areas scored high for chiropractors, osteopaths and physiotherapists, vets, specialist doctors, psychologists and psychiatrists, and public hospitals.
Far fewer NDIS participants scored chiropractors, osteopaths and physiotherapists high (54%) compared to the national average, but vets much higher (83%).
Among people who identified as LGBTQI+ we also noted a much lower number who scored high for GPs (44%) and public hospitals (43%).
When asked to share what more could done, many spoke of wanting more empathy and not to diminish their concerns, of trying to make them feel as comfortable as possible when explaining their problems, being more careful during examinations and treatments to “not hurt them”, spending more time and not trying to “shuffle them out the door asap”, making the practice a “warmer and quieter place”, remembering them and checking files before the appointment, treating patients as individuals “rather than just another patient that’s on your list of tasks for the day”, more suitable information guides for those who are legally blind, following up by “giving them a call”, believing the patients “lived experience”, to “actually them me to follow up if they have a test done”, being “less judgmental of their bodies” and not treating patients like a “disembodied carcass” (their words), offering more after treatment check-ups to encourage good choices, more advice on the best ways to achieve “their own health goals”, while also advising “the best medical choices to get there”.
Some even felt they were being “gaslighted”.Question 14
Another key theme that often comes through strongly is the importance of using language that patients can easily understand. What did you find?Dean: Overall practitioners also scored very well in this area but did range somewhat across practitioner groups.
Chiropractors, osteopaths and physiotherapists scored highest (8.4 pts out of 10), just ahead of vets, optometrists, pharmacists (8.2 pts) and dentists (8.0 pts).
All other practitioners scored quite high and in a narrow range – from 7.9 pts for specialist doctors to 7.5 pts for public hospitals.
The average score masked a large number of people who scored very high (8+ pts) – ranging from over 3 in 4 for chiropractors, osteopaths and physiotherapists, and vets to around 6 in 10 for public hospitals, psychologists and psychiatrists, and private hospitals.
Very few scored low (less than 3 pts) for all practitioners – from none at all for optometrists (at 0%) to 7% for psychologists and psychiatrists.
When asked to share how practitioners could help their patients better understand them, a number of health consumers mentioned “slowing down when talking”, especially for those “who have a thick accent”, less jargon, asking if they have any questions and ensure the patient understands what they have been told, offering more printed information with more “flyers to take home” and providing “reference materials that I can follow up on themselves”, being “more personable and less aloof and distant”, understanding that “people have different comfort and boundaries”, better explaining their role as a practitioner including “what they’re able to treat and what not”, recording what they say so patients could relisten later at home or writing down what they say and any specific terminology, discussing “in plain English”, not “making them feel they have all the answers before they have heard their symptoms fully”, not “just looking at pathology results but listening and evaluating symptoms being described”, taking things “step by step”, and explaining how patients could get more help if needed and where to get it. While some wanted things explained to them in more “normal terms”, others spoke of not assuming they were not capable of understanding more complex topics.
Finally, some suggested having the ability to email any question after appointments if they thought of them.Question 15
What about the overall practice environment?Dean: Most practitioners scored very well.
Chiropractors, osteopaths and physiotherapists scored highest (8.3 pts out of 10), ahead of optometrists (7.9 pts), dentists (7.9 pts), vets (7.9 pts), private hospitals (7.8 pts), pharmacies (7.8 pts) specialist doctors (7.8 pts), GPs (7.6 pts) and psychologists and psychiatrists (7.5 pts).
Public hospitals scored lowest (6.9 pts).
The majority or patients also scored the overall environment ‘high’ (i.e. 8+ pts), particularly for chiropractors, osteopaths and physiotherapists (8 in 10 patents).
Around 7 in 10 scored the overall environment for specialist doctors, private hospitals, dentists, and optometrists high, and around 6 in 10 for pharmacies, vets, GPs and psychologists and psychiatrists.
Less than 1 in 2 (46%) however scored the overall environment at public hospitals high.
Few Australians scored overall environment low (less than 3 pts) across all practitioners with the exception of public hospitals – from none at all for optometrists to 9% for public hospitals.
The over 65s scored all practitioners highest, especially optometrists (8.4 pts), pharmacies (8.2 pts), specialist doctors (8.5 pts), GPs (8.1 pts) and public hospitals (8.0 pts).
Suggestions to improve the practitioner environment include more cleanliness, having “fewer sick patients in the waiting room” and more private waiting rooms to protect other patients, more COVID safety including mandatory masking by staff and patients, full sanitising stations and proper air purification in the public areas and every consult room.
Others spoke of making the practice “feel less like a retail space” or “a factory turning out patients”, more cleanliness, a dedicated waiting area at pharmacies while patients wait for prescriptions and service, “warmer and friendlier receptionists” and greeting people when they arrive, “more hues of colour” to help alleviate stress, being “less clinical and a bit more homely”, provide a cleaner smelling environment through scented candles or oils, providing tea and coffee making facilities, dedicated areas for people with sick children.
Some wanted better quality televisions and lamented the loss of magazines while others wanted TVs removed “because of noise”, providing easier access to washrooms, less clutter, a more laid back dress code, better temperatures, improving the acoustics “so it’s not so loud”, more windows and plants, and seating arrangements that provide more comfort and space between people rather than feeling like “cattle in a pen” (again not my words).
Some however felt that any additional improvements would however come with a catch because “if it costs, they will charge”.Question 16
So, who do patients believe are most important to them in terms of their own or family’s health (both physical and mental)?Dean: It’s a really interesting list.
GPs came out on top, with over 9 in 10 (92%) Australians rating them as the most important.
Coming in second were psychologists and psychiatrists (identified by around 3 in 4 or 73% of Australians).
Many Australians continue to struggle with their mental health, with 16% reporting they had been diagnosed with mental health illness or disorder over the past 12 months, though encouragingly this was down slightly from 18% in 2023.
Around 3 in 10 (30%) have been diagnosed at some point in their lives.
At the same time however, the number who felt they needed professional help for their emotions, stress, or mental health over the past year climbed to almost 4 in 10 (39% vs. 36% in 2023).
And, fewer of these Australians report getting the help they believe they needed with just under 1 in 2 (47%) accessing care (vs. 51% in 2023). This aligns with a growing number who have reached out but were waiting to see someone – rising to almost 1 in 5 (19% vs. 15% in 2023).
An unchanged 1 in 3 have not sought any help.
Encouragingly however, it appears those in greatest need are increasingly being prioritised with 6 in 10 (58%) people who received care waiting less than a month (24% less than 2 weeks and 34% 2 weeks to less than a month), up from 1 in 2 (51%) who waited less than a month in 2023.
Fewer also endured longer wait times of over a month (1 in 3 in 2024 compared to over 4 in 10 or 42% in 2023).
That said, while 6 in 10 in capital cities waited less than a month, fewer than 1 in 2 (46%) did so in rural areas.
Around 6 in 10 in the higher income group also reported wait times to access care of less than a month, compared to 47% in the lower income group where more than twice as many people endured wait times of more than 6 months (22% lower income; 10% higher income).
Importantly, those who receive help remain quite satisfied, on average scoring a solid 7.2 pts out of 10 in 2024 (though down slightly from 7.3 pts 2023 and 7.5 pts in 2022) and over 1 in 2 (52%) were “very” satisfied (scoring 8+ pts).
Satisfaction was somewhat higher in capital and regional cities than in rural areas where it also scored somewhat lower than in 2023 (6.5 pts vs. 7.1 pts).
Men and women were equally satisfied with the care they received. However, it ranged widely across age groups from 7.7 pts among 25-34 years old to 6.7 pts for 18-24 yr olds.
NDIS participants also scored lower, while those who identified as LGBTQI+ scored their satisfaction higher.
A much higher number identified psychologists and psychiatrists in their top 5 in capital cities (77%), and chiropractors, osteopaths and physiotherapists in regional cities (79%).
Noticeably more women valued dentists (71%) and vets (37%), but men private hospitals (39%).
By age, higher numbers in the 18-24 group said specialist doctors (100%) and pharmacies, among the 35-40 age group optometrists (60%), the 45-54 group private hospitals and over 65 psychologists and psychiatrists (100%).
Noticeably more people in the higher income group valued dentists (62%), chiropractors, osteopaths and physiotherapists (59%) and vets (28%), and among those in the lower income group, pharmacies (71%) and optometrists (73%).
Significantly more NDIS participants put psychologists and psychiatrists (100%) in their top 5, and in the LGBTQI+ group, GPs (100%), pharmacies (75%), and public hospitals (75%).Question 17
You mentioned earlier that Australians were only moderately satisfied with the healthcare system as a whole.
In the eyes of patients, is there a difference between healthcare (one word to describe the system) and health care (two words which refers to a health provider’s actions).Dean: Yes, there definitely is.
Satisfaction with the latter in terms of quality of care, advice or treatment received from health practitioners over the past 12 months remains very high, although it has moderated somewhat for some practitioners.
This year, vets scored highest, bumping optometrists from top place.
Again this highlights a key difference between cost and value, with the highest number of Australians in agreement that vets have become more expensive.
Vets were also one of only two groups to report higher satisfaction compared to last year (8.3 pts vs. 8.0 pts).
Public hospitals were the only other area to record higher satisfaction (7.5 pts vs. 7.0 pts in 2023), but satisfaction with public hospitals remained among the lowest overall.
Satisfaction was unchanged for pharmacies (8.2 pts), dentists (8.1 pts), GPs (7.8 pts) and psychologists and psychiatrists (7.4 pts) who also ranked lowest overall.
But Australians who visited optometrists (8.2 pts vs. 8.4 pts in 2023), chiropractors, osteopaths and physiotherapists (8.1 pts vs. 8.3 pts), private hospitals (8.0 pts vs. 8.2 pts) and specialist doctors (7.8 pts vs. 8.2 pts) were less satisfied with the care, advice or treatment they received compared to last year.
Satisfaction was lower in regional cities for private hospitals and in rural areas for psychologists and psychiatrists.
Women were much more satisfied than men with the care received from vets and psychologists and psychiatrists, and men with specialist doctors and public hospitals.
People over 65 were more satisfied with optometrists, chiropractors osteopaths and physiotherapists, specialist doctors, GPs and public hospitals.
Satisfaction scored much lower among for 18-24 year olds for vets, chiropractors, osteopaths and physiotherapists, specialist doctors and public hospitals.
Well above average levels of satisfaction was noted for Australians who identified as LGBTQI+ for chiropractors, osteopaths and physiotherapists, but well below average levels of satisfaction for GPs and public hospitals.Question 18
In previous years you have explored the topic of switching.
This is becoming of increasing importance to practitioners so I’m sure our listeners would be interested in any developments in this space.Dean: I agree this is a key issue.
Healthcare is becoming less transactional and more experiential, with patient retention increasingly tied to experience.
As a result, patients are growing more comfortable switching providers when their current one isn’t meeting their needs, although is more common for some health practitioners than others.
This year, only 2 in 3 Australians overall indicated they had not switched their practitioner, compared to 7 in 10 in 2023. This was led by large rises in the number who switched GP (19% vs. 14% in 2023) or dentist (13% vs. 8%).
We noted smaller increases for specialist doctors (7% vs. 5%), optometrists (6% vs. 4%), psychologists and psychiatrists (5% vs. 3%), chiropractors, osteopaths and physiotherapists (3% vs. 2%) and vets (3% vs. 2%).
By region, more people in regional and capitals had switched dentists, while somewhat more women switched GPs than men (23% vs. 15%).
Switching is far more common among younger people, especially Gen Z and millennials.
Other outliers by age included much higher numbers of 25-34 year olds who switched GP (32%), specialist doctors (12%) and 18-24 year olds psychologists and psychiatrists (12%).
More 18-24 and 25-34 year olds also switched dentists.
Far more people over 45 did not switch any health professionals than under 45.
For many healthcare organizations’ their future growth will depend on how well they understand what it takes to keep younger people loyal.
A well average numbers of NDIS participants switched specialist doctors, dentists and psychologists and psychiatrists, and in the LGBTQI+ group GPs, dentists and psychologists and psychiatrists (22%), with far fewer in both groups also indicating they did not switch any practitioners.Question 19
Patients clearly want more from providers than just good care.
What are the most important considerations when searching for a new doctor or other health professional?Dean: According to almost 6 in 10 patients (58%), convenience was key, while around 1 in 2 looked for health providers that offered bulk billing (53%) or were easy to make an appointment with (47%).
Though in the past, healthcare consumers routinely ranked the patient-provider relationship as their top healthcare priority, convenience seems to have surpassed it in recent years.
Consumers increasingly want convenience, whether that’s from their mechanic, retailer or health provider.
Around 1 in 4 said cost/out of pocket expenses (39%) and convenient hours was most important (38%), while 3 in 10 (29%) valued qualifications (29%).
Recommendations from family or friends was key for 1 in 4 (26%) people and recommendations from other health professionals for 1 in 5 (21%).
Only 1 in 10 were influenced by patient (12%) or positive online reviews (11%), and less than 1 in 10 (8%) by access to telemedicine or virtual visits.
While younger consumers are more likely to lean toward convenience, older patients, especially those with chronic care conditions that require routine management, typically will give relationships a higher priority. Suffice it to say the two values are not mutually exclusive.
The desire for convenience is likely contributing to the growth of non-traditional care models.
That said, as people continue to return to their “normal” pre-COVID lives, we have also seen a significant fall in the number of consumers that had a telehealth or telemedicine appointment with a GP in the past year – down to 31% from 41% last year – while the number that had a telehealth appointment with a specialist doctor nearly halved to just 5% (8% in 2022). It was basically unchanged for psychologists and psychiatrists (4% vs. 5%).
Most consumers (over 7 in 10) continue to rate a traditional face-to-face consultation with a GP better than a virtual one.
The importance of bulk billing is also not surprising. When we again asked Australians if they were bulk billed the last time they visited their doctor or GP, the number that said they were fell noticeably to 63% from 71% last year.Question 20
You started the podcast by noting that sometimes the most aggrieved patient can also be the most insightful,
Can you share what really dissatisfied patients actually want?Dean: Of course, and I think it is quite telling.
The top concern for around 7 in 10 of very dissatisfied patients was simply ‘listen to me’.
Around 1 in 2 also wanted better value for money, for practitioners to spend more time with them, shorter waiting lists and more friendliness and respect.
Around 4 in 10 wanted more help to understand the nature and causes of their health issue, to be told what they needed to do prevent and minimise symptoms or prevent further problems or recurrence of their health issue.
Helping them understand what their prescribed medications do was also highlighted by 1 in 3 very dissatisfied patients, while 3 in 10 pointed to extended availability, being involved in decisions made and a more welcoming environment. Almost 1 in 5 said use less complex language.Concluding Question
It sounds like a very comprehensive report. So how would you sum all this up Dean?Dean: Well I would begin with the really good news – patients are largely satisfied with the healthcare system overall, and this is particularly the case for those of us with an ongoing medical condition.
Patient satisfaction for most individual practitioners remains very high too, although it has moderated somewhat over the past year for all practitioners and satisfaction is higher among those in capital cities compared to those in regional areas.
But there has been a drop in visitations across several key areas, including doctors and pharmacies.
Cost may be a factor here, with Australians reporting a deterioration in affordability for most providers compared with last year.
Access to care, too, may play a role in the fall in visitations.
While access is still generally good, it has worsened in a number of cases over the year, in particular for public hospitals and psychologists and psychiatrists.
Most importantly, overall value still scores highly despite the fact that switching is on the rise.
Your patients clearly continue to hold you in high regard as practitioners.
But they’re also getting more demanding.
Often when you ask survey respondents to go beyond just ‘ticking a box’ and provide written feedback, it can be very difficult to get much of a response.
In a sign of your importance in your patients’ lives, they were more than happy to share their views, both negative and positive.
Jeff Bezos famously once said:
“When the customer anecdotes and the data disagree, the anecdotes are usually right.”
This doesn’t mean it’s wise to rely solely on anecdotes and intuition, but it’s a reminder to be humble and re-examine the data for what may have been previously downplayed or even overlooked.
I hope your listeners enjoy reading through the report and it becomes a useful reference document for their practices.Thankyou Dean and I hope you all enjoy reading this report.
Having a deeper understanding of patient attitudes to their health and the system as a whole can only help health professionals to be better equipped to understand, engage and most importantly, retain them.
