Informed financial consent: why it matters for surgery and minor procedures

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. The procedure goes smoothly, but the patient later receives a pathology invoice they weren’t expecting. They call your rooms upset about ‘hidden costs’. Although you are not responsible for other providers’ fees, patients often assume everything is included unless told otherwise.

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 doctors seeing patients in their rooms, IFC typically begins when making an appointment. This is an opportunity for practice staff to explain consultation fees, any changes to billing, estimated rebates and potential additional costs such as procedures or testing. If your practice uses an online booking system, you will need to ensure the costs are made clear. This can be a pop-up or click-through page in the system or a message to refer people to your website for information about fees. Repeated reinforcement - especially following policy changes - ensures patients are not caught off guard.

For surgeons and other proceduralists, the complexity of the procedure usually dictates the level of detail required. Where multiple stages and/or input from other healthcare providers, including allied health or hospital involvement, is likely, written IFC is strongly recommended. This should explain your fees, outline anticipated out‑of‑pocket expenses from other providers and direct the patient to where exact figures can be confirmed. While you are not responsible for quoting hospital, pathology or radiology fees, patients rely on your guidance to know they may occur and where to obtain further information. Estimates, ranges and explanations of variables help manage expectations and reduce the risk of misunderstandings.

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.