Informed financial consent: why it matters for anaesthetists

Clear, proactive and timely conversations about costs help build patient trust from the start. Informed financial consent supports good medical practice, strengthens relationships and reduces medico‑legal risk. When your patients know what to expect - in advance of their treatment – it can contribute to confidence in the care you provide, and you are better protected.

Most doctors understand that informed financial consent (IFC) is more than just a necessary administrative step. It plays a deeper role with transparency at the core. IFC is an important foundation of ethical, patient‑centred care. It involves providing clear, timely information about the expected costs of healthcare - including fees, rebates and likely out‑of‑pocket expenses – and complements other consent processes, allowing patients to make fully informed decisions about their treatment.

This responsibility is embedded in Good Medical Practice: A Code of Conduct for doctors in Australia and is reinforced in guidance from the AMA and a number of specialist colleges. Australian courts have also confirmed that doctors have an obligation to provide transparent and meaningful information about costs before treatment occurs.

Beyond compliance, IFC is also a powerful tool for strengthening trust, managing expectations and reducing the risk of complaints or claims. When patients experience unexpected costs, it is often the catalyst for dissatisfaction - particularly if something else has not gone as expected.

Providing comprehensive and comprehensible IFC signals to patients that you value transparency, acknowledge their circumstances and see them as partners in their own care. For many patients, discussing costs openly helps reduce anxiety and may further frame your practice as trustworthy and professional.

For doctors, IFC is equally important. Clear conversations about costs can:

• build trust at an early stage in the doctor–patient relationship
• reduce the likelihood of disputes or complaints
• support patient‑centred care
• fulfil legal, ethical and professional obligations
• strengthen long‑term rapport and continuity of care.

Across every specialty, the principle remains the same: patients should not be surprised by the costs of their care. While what to charge is ultimately a practitioner’s choice, it is their responsibility to ensure patients understand what to expect. Although it may not always be possible to avoid unexpected costs during a course of treatment, patients should be informed of the likely fees upfront and be made aware that, in some circumstances, complications or unforeseen findings may require additional tests, treatments or care from other specialists.

Financial consent issues most often occur due to assumption, oversight or gaps in communication between different parts of the care pathway.

Consider this example. While covering a colleague’s list, you anaesthetise a patient who has been undergoing staged reconstructive surgery. Days later, the patient disputes your invoice, believing they had already been given ‘the costs’ by the surgeon’s rooms. Without clear, proactive communication, your fee feels unexpected - even if it is entirely appropriate.

In this scenario, the tension arises not from the fee itself, but from the surprise.

The most effective IFC processes are simple, consistent and tailored to the complexity of the care being provided. While the information can be delivered to patients in different ways depending on the situation, and the specifics will differ between specialties, the goals remain constant: establish expectations early, reinforce them as needed and provide patients with clear options.

For anaesthetists, proactive communication is key. Many find it helpful to provide a brochure or digital information sheet outlining their role, billing structure and expected out‑of‑pocket costs. Ideally, this is provided when the patient sees the surgeon, or at least mentioned, and then you and/or your practice staff can then send this information directly to the patient.

While a ward‑based or peri‑operative discussion can be appropriate in certain circumstances, it should complement rather than replace earlier communication. Information often includes MBS item numbers, hospital charges, private health coverage, possible cost variations and clearly labelled estimates.

If you are in a situation described above, taking over a colleague’s list, generally the best approach is to charge the same fee as the patient was informed of in the original IFC discussion. If you choose to charge a different amount which is higher, it should only be after full and timely disclosure to the patient.

The earlier the better. IFC ideally takes place before the appointment or procedure, and can be reinforced:

• at the time of booking
• on arrival at the practice
• during clinical consent conversations
• when discussing treatment options and cost implications

Because clinical and financial consent processes are often delivered by different members of the team, consistency is essential. A shared understanding within your practice reduces the likelihood of mixed messages or assumptions.

The format should match the complexity of care. For example:

• verbal IFC may be appropriate for simple, fixed‑fee consultations.
• printed or emailed information works well for standardised procedures.
• formal written quotes are important for complex or higher‑cost interventions, especially where multiple providers or variable fees may apply.

In all of these scenarios you can also reinforce the information on your website or brochures or notices in your waiting room. Regardless of format, the objective is the same: to give your patient enough information to decide how they want to proceed and then document the information you gave them.

Informed financial consent is about more than just billing. It is part of your professional identity - how you build trust, communicate clearly, and support safe and respectful care. When patients understand the costs associated with their treatment, it reduces anxiety, minimises misunderstandings and strengthens the doctor–patient relationship.

By approaching IFC as an integral part of your practice, you not only meet your legal and ethical obligations, you create a more positive and predictable experience for your patients - and reduce your medico‑legal risk in the process.