My experience has been mixed. But I find the public hospital (albeit longer wait times) have more access to knowledge and equipment than a private hospital.
Curious to hear peoples experience of going to a public hospital or paying to go to a private hospital when it comes to an emergency. Especially given the perception of paying means better care…
I don't understand why this has 5 downvotes, isn't this sound advice? Using the advice of an expert in the industry?
As someone in the industry, in an emergency I have not heard of anyone advising anything but public. Private is good for only a few things and generally not emergencies. Private can be useful for non-urgent/elective matters but a public hospital can transfer you there anyway if that's the case - e.g. if you have a broken limb needing surgery and it isn't life threatening then private may treat you quicker.
It very much depends on the emergency and the capabilities of the hospital (both public or private).
@t123: no, if you're in it for a real emergency (i.e. you're gonna die within a few hours if nothing is done) then public all the way, even almost all of the private will send you to the public eventually in those case. Otherwise, you'll be in for a long wait in public hospital, even possible in case your arm snap broken into 2 pieces.
I waited in public emergency for appendicitis for over 2-3 hours in real agony (i.e. struggle to line in the queue) but will still trust them when it comes to emergency.
if the option is available, and you can afford it, private.
i've heard too many horror stories about the public system, and the hospital for my city has an especially bad reputation, i'd take my chances on the way to the capital city.
public may be free, but the standard of care often matches the price you pay.
Having worked in both I'm interested to know what you have found makes private better?
Ive found that the same doctors will generally work across both hospitals (work in public for benefits/prestige, whilst also working in private for better money) , however nursing ratios and skillsets are better in public as are allied health funding.
Also, its important to have an actual emergency trained doctor in the "emergency department" (which most private hospitals I have come across do not)
everyone i know who has been to both has been left waiting for hours to see anyone at the public ones, and when they finally do get to see someone, the standard of care is lacking.
i don't want to say too much, but if you are ever in Tas, don't get sick or in an accident outside of hobart, there are some real horror stories with the hospitals in other areas of the state, especially one of the northern ones, not the LGH, though that has its own problems, better pay attracts better workers, who knew?
Thats generally how triage models work though.
Time doesn't mean carelessness, it often means less severe (unless theres a real crisis).
If you were going to wait 6 hours in public ED (low severity triage category), you'll probably be 30 mins in private because private can handle you.
If you were going to wait 15 mins in public ED (i.e. high severity triage category) you would probably be transferred out of the private ED to get looked after by the "better workers" as you like to refer to them as.
@tensionday: LGH has (had?) a particularly bad reputation among junior doctors for understaffing. Hospitals in general also strongly discourse their doctors logging their overtime worked under the implication it will hurt their career prospects in popular rotations, so understaffing is also a cost cutting measure at the expense of everyone
You're seriously complaining about triage wait times? If you really had something critical, you'd be pushed to the front in either system. Public hospitals actually have criticalists. Private ones, even ones with EDs, do not. Do some reading and find out where level 3 cases go: they get transferred into public wards because without the facilities and expertise, privates won't touch them.
I have private health insurance and have used it to skip the public queue and see specialists. But if I, or anyone I know, was actually at death's door, I'd go public every time. In fact, the ambos wouldn't even give you a choice, regardless of how fancy your policy is.
Same doctors, sure. You’ll get the registrar who works for the same doctor in the public.
Nothing wrong with the registrar, just someone more junior. I’m not sure if that’s the same to me.
Fair point.
At the end of the day thought the consultant is still responsible for the care of the patient. If it is the same consultant, they should care just as much for their public patients as they do for those in private as they are liable either way.
Every week I have patients transferred to me in public who when they get sick in private require more intense care, often at the consultant's request (still remains their patient when transferring public).
@tensionday: funny its usually the opposite, consultant sees people in private and when they are really sick they come over to public where they have all the goodies
Agreed. Definitely a huge improvement in nursing ratios in public which can only be good. Privates are a bit shocking in that regard and I have been in almost every major private hospital in Brissy to know I would very happily go to a public
man you'd be lucky to get trained anybody anywhere these days
i rather public, even as a student i thought private are too cost driven (may as well work in accounting or rehab)
privates are just resorts for old people
a lot of things can change the "experience" too, such as how urban/rural, how far from a large city, how junior, training support, ward culture itself can vary from ward to ward making a huge difference
As someone with connections to people who work in Private, it's all the same BS
that has not been the experience of myself or anyone i know who has had the benefit of experiencing both
It's all the same behind the scenes though. Maybe outward appearances are different but it's all the same in the end.
@Zondor: it's not all the same though.. it's the difference between getting a correct diagnosis or being sent home and told to "come back later if it gets worse", it's the difference between waiting 6 + hours or less than 1.
@[Deactivated]: well, in private you tend to be more on the side of overinvestigation - because of $. which can be just as harmful. you are really just paying for the convenience and shorter wait. also keep in mind a lot of private EDs aren't set up for anything subspecialised. if you need a level 3 ICU or subspeciality attention at short notice you are better off in public than to take your chances with a ward locum J(unior)MO covering for consultants working elsewhere
@May4th: "well, in private you tend to be more on the side of overinvestigation - because of $. which can be just as harmful."
Not really, in a private hospital the patient actually gets billed out of pocket for pathology tests, whereas it's all "free" in public, so some doctors understand this and don't order otherwise unessassary tests (in Australia, it's illegal to obtain kickbacks so there are no monetary interest for a doctor to over-order tests. "Because of $" makes no sense in Australia). Furthermore, quite often in the public it's the junior doctors on the ward that orders the standard daily battery of tests. As it's "free" to both the doctor and the patient, quite often they just shotgun their tests and order everything as A> they don't want to miss something, B> they don't want to miss something their senior doctors want.
"overinvestigation… which can be just as harmful."
I'm sure you can find an example where the above is true, though that is the rarity rather than the norm. The context of your phrase suggests it's the norm. I challenge you to give an example of a test that was "unessassary/overinvestigated" as a norm in the private that causes harm.
@Deridas: for one, CTs are much more readily available and ordered in private land. if you think it's a rarity to see harms of overinvestigation you probably haven't seen enough of medicine. you seem to think i'm making a value judgement on public vs private like the OP. i'm not, i'm just pointing out what experiences you are likely to have in each. we all know that the main and sometimes only reason public EDs practice rational investigations is because every test comes out of their departmental budget
@May4th: "we all know that the main and sometimes only reason public EDs practice rational investigations is because every test comes out of their departmental budget"
In modern Australian medicine that is largely untrue. Investigations are always ordered by doctors, or policies made in conjunction with doctors. We're not in the US where investigations and treatment is dictated by health insurers/corporations. As doctors, we don't actually care about departmental budgets, we just investigate and treat the patient in front of us.
CTs are more readily available in private, perhaps that's true, but that does not lead to more "unessassary" investigations. Do you have any evidence to back your claims? As mentioned prior, the same doctors work at public and private, and it's the doctors that determine whether an investigation is done. If an investigation is not nessasary, and itay cause significant harm, why would a doctor order it? Is it because it's avaliable?
TLDR:
1> All investigations are ordered by doctors in Australia, not hospitals/departments/budgets
2> Doctors in Australia do not get kickbacks or any monetary benefits from investigations
—> are you sure you're not confusing Australia with US style medicine?
"if you think it's a rarity to see harms of overinvestigation you probably haven't seen enough of medicine."
You can't make blanket statements like this. You should quote evidence and examples to back your claims. You have taken a true statement "some investigations may cause harm", and blanketly apply it to investigations that doctors do more unessassarily in the private without considering the benefits vs risks ratio. You are, indeed, claiming that 1> the doctors in the private are somehow clinically inferior that they would make unessassary investigations compared with their public counterparts, and 2> presuming this is true, these investigations are causing harm
If you're claiming 1> and 2> is true, that's a big call.
@Deridas: I'm not claiming anything. It's what's happening from first hand experience working in one of the busiest EDs in the country. No so much necessarily negligence, but the barest necessary tests are ordered due to funding considerations
public may be free, but the standard of care often matches the price you pay.
Like the thousands of dollars in tax paid each year? Pretty sure that's worthwhile.
How about go public but admitted as private patient?
No different. Care and the staff is the same. Essentially instead of the Govt paying for your care, the insurance pays for it.
Will it have shorter wait time?
No.
That is not how it works. Being treated in public as private patient means that you manage to get your admission based on the public criteria, be it an emergency treatment or elective on waiting list. Once you are admitted you have a choice to use your insurance to pay for the cost of your treatment.
Zero difference. The only benefit for using the private hospital system is if you want a specific doctor and are time limited.
Otherwise public wins hands down
As someone who has spent in years in both public and private hospitals. Public all the way.
When I had a family member have a heart attack - so glad they ended up in the public system. The private wouldn't have had the tools apparently…
That’s what my family members in Health say too
Why?
Totally agree. Why put your life in the hands of a private organisation, designed specifically to make money off your health?
Besides, if it’s a true emergency, most private hospitals will simply shove you straight to public as they’re not equiped for much more than planned procedures
If i'm bleedin out, whichever is closest!
You won't be seen at a private hospital, unless you acknowledge their charges with the triage nurse.
how about with major surgery, like hip reconstruction/replacement ? public is fine ? NSW
Is fine, just don't mind the wait.
Public for an emergency every time. Private if you want to get a nose job.
yup public for emergency. once the emergency is over, if you have the option, get moved to a private during recovery for the better meals and ambience.
private is for not ending up in emergency in the first place. I had gall bladder surgery start of 2020. GP diagnosed, radiology confirmed and I had been scheduled for an appointment with a surgeon. all in the public system with inherent wait. before my appointment with surgeon I ended up in emergency department and had emergency surgery the next morning. If I was private initially I might not have ended up in emergency.
I dont like private because if you have to stay overnight/few days, they stick you in a room on your own, and I hate being on my own. I dont mind having someone else around to chat with the while away the long boring hours.
From personal experience after spending months in hospital after my accident I'd rather be in a room on my own… anyday.
I agree. If I'm sick and resting then the last thing I need is a "chatty types" sicko right next to me.
Going to a private hospital doesn't necessary means you will get a private room. Sometimes, you still need to share with others.
Yeah but odds are way better.
@WhyAmICommenting: It depends more on what kind of insurance cover you have, and if it allows for you to have a private room or not. Of course there's a chance you'll be given an upgrade to a private room, but I don't know what are the odds of that.
When you get Golden Staph 3 times it does :(
Same, I can't deal with snoring
Its increasingly the same for public hospitals. The doctors say they don't like wards, they want every patient to have their own facilities like toilets, so there is no chance of cross-infection. So when new hospitals are built they are built with a room for each patient. Whether they are private or public. That was a major contributor to the huge cost of Adelaide's new public hospital.
im the opposite. me and my gadgets are good enough :)
This is a hot take. I've really disliked the patients around me when in hospital.
Very few private hospitals have actual emergency capabilities. Their "emergency" departments are almost like preadmission clinics which is grossly understaffed and under resourced for the highest triage categories
Plus treatment in their emergency is not covered by PHI. Personal experience I attended due to post OP complications. I left after three hour wait in private emergency. Ended up seeing a GP who sorted it out. He was kind enough to fit me in and also did not charge anything out of pocket.
Can you give me an example of a private hospital you would want to go to in an emergency? I am curious.
Mater in Brisbane
They are a special one as they are both Public and Private. They have a fantastic room food service too
SAN & Norwest in Sydney
I checked out Norwest. Looks the goods so I will assume the others are as well.
Peninsula Private Hospital
The vast majority of private hospitals do not have an emergency department.
The vast majority of public hospitals have an emergency department.
You can use your private health insurance when you are admitted to an emergency department to ensure that you pay an excess for the treatment.
You can use be admitted as a public patient to an emergency department to ensure that you pay NO excess for the treatment.
Which private hospital has an emergency department that is a real emergency department and not one that just treats you enough to pass you on to a public hospital?
If you've got time to choose, it's not an emergency :)
Exactly.
If you're taken by ambulance, can you tell them which hospital you want? Or is this only with uber ambulances?
When I was barely conscious in the back of an ambulance, they asked me if I wanted to go public or private.
Uber abluancs??
Ambulance Black
I've been to public emergency 4 times and 3 of the 4 were flawless experiences. One time I waited 6-8 hours and was sent home and later almost died (leading to the 4th experience) but I can't blame them as I have a rather unique condition.
I'd only pick private for something non-urgent as you're likely to get in and out much faster.
Curious what condition
Extremely rare Auto Immune disorder.
Asherson's syndrome
Depends on my problem and the wait times. I check the dashboards and if Adelaide is all Code White then I'll go private. Cost is $470 out of pocket.
Experience? You can have just as much time sitting waiting for a ward bed in private as public. Private tends to be over the top on scans and bloods compared to public. As a result, you have to anticipate further out of pocket expenses.
Only LMH is white at the moment, safe to have an emergency:-
https://www.sahealth.sa.gov.au/wps/wcm/connect/public+conten…
What's code white
Code white is when the hospital is at 125% of capacity. When that happens they start trying to divert patients to hospitals which aren't in white. When they are all white though….like now (apart from two smaller hospitals)….then don't plan to have an emergency!
If you look at the dashboard linked above you can see on the right hand chart the last 24 hours for each hospital and the green/amber/red/white bands. So right now FMC hospital is in white status as it has 55 patients being treated and another 23 waiting to be seen. Capacity is 59, though this is a rubbery figure as it depends on staffing as well and the mix of patients. If you aren't high priority then you are going to wait 117 minutes on average right now.
If someone is bleeding out/about to die, public all the way.
Public any day of the week.
If anything they're better prepared.
And you've already paid for it in your taxes.
for an emergency, public every time. More resources
for an genuine emergency, just take me to the closest one
Nice to have the option for both if you can afford it. Corruption within the public health system is rife, all those things the state health publishes about policies and service guarantees is just wasted ink. When the shit hits the fan you'll need to hire a lawyer to get them to actually live up to any of it.
I'm not sure about now, but I remember being told a while ago that if things got really ugly at private hospital, they would ship a patient to a public hospital because there's more equipment and knowledge readily available.
Yes, a friend had to be transferred to a public hospital after she experienced complications whilst giving birth at a private hospital.
I'm assuming that as a private practice, liability is going to be one of the biggest considerations. So I wonder, at what point do they go "we need to get this patient out of here". Especially with medical conditions that can suddenly take a turn for the worst. Or if something happens and they can't move the patient. Bit scary to think about…..
Very scary…… best not to think about it!
Now, what's for lunch today?
if shit goes sideways at a public hospital they'll ship you to a better public hospital too.
I was lucky, my local hospital is Monash in clayton. one of the best teaching hospitals in the country. when my gall bladder surgery went unexpectedly bad the student surgeon was able to get help from the more senior guy in the room.
the guy in the bed across from me had not been so lucky. his same surgery was started at a hospital in Gippsland and had also gone unexpectedly badly. he had then been moved to Monash clayton after complications from the initial surgery. when I met him he had already been two weeks at the monash and was still there when i left a week later.
Wow ncie one Monash clayton
But they didn't brace my nose after septo/rhinoplasty smdh🥴
Dont think most private hospital got proper emergency care or equipments.
Even with pregnancy, if shit hit the fan, sometimes they send you to public.
Private good with elective surgery.
If you have an emergency just go public. If you go private and they cant handle you they dump you in public and you still get charged.
Note some hospital staff will try and con you for your insurance details with sob stories about not putting a burden on the public health care system. They then leave you with a gap payment and excessive charges on the private insurance.
That's what I couldn't understand at all. Why not charges on the private insurance but without gap? Then more people will be willing to use their private cover on public hospital.
I've had nothing but good experiences in public hospitals despite longer wait times. No wait time in genuine emergencies either (mum was having a heart attack). I don't feel the additional service/shorter wait I got in private was worth having to fork out the extra $.
I find private docs have no dedication and mostly after the bottom line $. If one ask a bit more info their charges increases. There is also wait times in private but shorter. Making appointment with private takes around 6 weeks cos they spread themselves thin with practices in many locations and hospitals too.
If life threatening always public. Also I do not believe you get the choice of private if you call the ambulance, it's always public.
Private if you probably if you have ongoing conditions or foresee bit of non life threatening surgeries or know that you have to visit hospitals a lot
Private Emergency Dept isn’t covered by private health insurance, so pretty unlikely. I’d do private for a planned admission eg surgery. If the public emergency was crazy busy I might consider it for something like a simple fracture, but even even then I’d be reluctant as then all the follow up is private too.
Depends on age and health status. If you're young and just have the odd emergency- public. If you're older or have conditions which require not wanting to wait years for adequate treatment -private.
True emergency - always public
If you can afford it and have Doctor acquaintances/friends that can guide you, private sector all the way…