Our Profession, Our Responsibility

It is worth being transparent about RANZCO’s role when it comes to fees charged by ophthalmologists. Like all specialist medical colleges, RANZCO trains and assesses doctors to become ophthalmologists, sets the standards for clinical competence, and seeks to uphold the professional values that define our craft. We do not set or regulate the fees ophthalmologists charge. That is not our function. But the absence of a fee-setting role does not diminish our moral responsibility to shape the culture of our profession. We lead through the values we instil, the standards we set, and the expectations we hold our members to. That is an influence we take seriously.

At its heart, the professionalism framework on ethical billing and fee transparency affirms values that ophthalmologists and eye care professionals already hold. Patient welfare comes first. Clinical decisions are made on clinical grounds, never financial ones. Patients deserve to understand what their care will cost before they agree to it, in plain language, upfront, with no hidden fees. Informed financial consent is as important as clinical informed consent; one cannot be complete without the other. And for patients facing financial hardship, or from First Nations, culturally and linguistically diverse, or rural and regional communities, compassionate billing is not an optional gesture but a professional expectation. These are not aspirational ideals. They are the everyday reality of how the overwhelming majority of ophthalmologists practise.

RANZCO wholeheartedly welcomes the Council of Presidents of Medical Colleges (CPMC) national Medical Specialist Professionalism Framework: Ethical Billing and Fee Transparency,1 launched at Parliament House in March 2026. The CPMC represents all 16 of Australia’s specialist medical colleges, and the fact that every college has united behind a single framework sends a clear and important message: the profession is listening, and it is acting. The framework does not introduce new rules. Rather, it gives clear and consistent expression to the principles that ophthalmologists, and all specialists, have long embraced. It reminds us of what patients should rightly expect from their care.

It is equally important to acknowledge that high out-of-pocket costs are not simply a product of individual specialist behaviour. The CPMC has been clear on this point, and I share that view. When public ophthalmology outpatient services are underfunded or overwhelmed, patients are directed toward private care, often without the time or information to compare options meaningfully. When Medicare rebates no longer reflect the true cost of modern specialist consultations, the shortfall is borne by patients. When ophthalmology services are thin or absent in regional and rural communities, the access problem is fundamentally one of supply, not pricing. Governments, both state and federal, have a genuine responsibility to address these structural gaps through investment in public hospital outpatient capacity, expanding numbers of specialist training positions, collaboratively developing services in areas of need, and a Medicare system that reflects the realities of contemporary care.