Why every Australian deserves the same access to specialist advice that doctors give their own families.
When my mum recently had a fall and fractured her knee, I didn’t take her to the local public hospital emergency department to wait for hours.
My sister, a GP, coordinated the whole thing. She called an orthopaedic colleague, got specialist advice within minutes, arranged for mum to be admitted directly to a private hospital, and she was in theatre within a few hours. From injury to surgery, the process was seamless.
I’m not telling you this to boast. I’m telling you because this is what happens when you have a doctor, a nurse, or any healthcare professional in the family. Most people know the feeling — something goes wrong and you instinctively call your cousin who’s a nurse, your uncle who’s a GP, or your neighbour who works at the hospital. You get advice. You get direction. You get looked after differently.
For healthcare professionals, this is second nature. When we or our families get sick, we tap into a network of trusted colleagues for rapid, expert advice. We know a better way exists.
So why can’t this level of care be provided to all Australians?
Every doctor has a little black book
Every clinician carries an invisible asset: a mental directory of specialists they can call for guidance. The orthopaedic surgeon you trained with. The dermatologist down the corridor. The paediatrician who always picks up the phone. Nurses, midwives, and allied health professionals carry their own versions of this network too.
When a doctor’s child has a worrying rash, they text a photo to a dermatologist friend. When their parent has an abnormal blood test, they ring a haematologist for a second opinion. The advice comes back, often within minutes.
This isn’t a parallel healthcare system. It’s what good medicine looks like when the barriers are removed. For most Australians, those barriers remain firmly in place.
The system most Australian families experience
For a family without medical connections, the journey is very different.
A GP identifies a concern, writes a referral, and sends it — often still by fax — to a hospital outpatient department. Then the waiting begins — months for an appointment; in some specialties, years.
During that wait, nothing happens. The child’s asthma goes unoptimised. The adult’s suspicious screening result sits in limbo. Anxious families present to emergency departments, not because they need emergency care, but because they have nowhere else to turn.
The Grattan Institute’s 2025 report, Special treatment: Improving Australians’ access to specialist care, laid bare the scale of the problem.
Across major Australian cities, more than 50 specialties have public outpatient wait times exceeding one year. In paediatrics, developmental clinic waits can stretch to four years. Wealthier communities receive up to a quarter more specialist services than disadvantaged ones. The system entrenches inequity.
Your GP: the chief medical officer of your family
Here’s what I believe: every Australian family deserves a chief medical (not marketing!) officer — and their GP is the natural person to fill that role. GPs are the backbone of our healthcare system. They know your history, your family, your context.
They manage the vast majority of health concerns and coordinate care across multiple providers. They should be the CMO of your family.
But we have built a system that undermines their ability to fulfil that role. When a GP needs specialist input, the options are often poor: refer and wait, spend hours chasing hospital switchboards, or hear months later that the referral has been declined or, if they are fortunate, placed on a waitlist that may stretch for years.
As a paediatric respiratory specialist, I can confidently say that one in three patients referred to me could be better managed in primary care, if their GP had timely access to specialist advice. Not a formal in-person consultation, just a conversation — the kind I have with colleagues when someone in my family is sick.
Democratising the doctor’s privilege
This is not a thought experiment. The model already exists. It’s called Advice & Guidance, and it enables any healthcare provider to seek structured specialist input through a secure digital channel — before, instead of, or alongside a traditional referral.
A specialist reviews the request within days and responds with targeted guidance. It is the formalisation of what doctors already do for their own families — except it’s documented, auditable, equitable, and available to everyone.
The evidence is compelling.
Related
In the UK, the NHS’s Advice & Guidance service handles over four million requests annually, preventing more than one million unnecessary outpatient appointments. In Queensland, Mater Health delivers the Queensland eConsultant service, a statewide program that gives GPs, nurse practitioners and other primary care providers access to timely specialist advice across more than 20 medical and surgical specialities, usually within 48 hours. More than two thirds of requests avoid the need for a traditional outpatient referral.
The Queensland government has backed this model through a state-based tariff for specialist A&G, recognising that timely clinician-to-clinician input can reduce unnecessary referrals, prevent duplicate investigations, and lower out of pocket costs for patients and carers.
The impact on real patients is immediate. A senior Queensland GP recently provided feedback to a specialist at the Mater after using the state-wide service:
“The patient was very impressed at the streamlined process of seeking advice and noted that this had saved her a lot of time and money in getting to a diagnosis. From my perspective as a GP, this was an excellent outcome, having inherited a patient and simply noticed a mildly raised serum calcium on bloods done for another reason. Without having to spend a lot of time on an issue which was not the patient’s priority, or spending a lot of time doing unremunerated research into what should happen next, we were able to detect and treat something which, if untreated, was likely to cause ongoing morbidity.”
The Grattan Institute’s 2025 report calls for a national secondary consultation scheme, estimating it could enable at least 140,500 consultations annually, avoid around 68,000 specialist referrals, and save patients about $4 million in out-of-pocket costs. Even these figures are likely to understate the opportunity.
International evidence and local experience suggest that, at scale, the benefits could be considerably greater.
And this isn’t just about GPs and non-GP specialists. It’s the optometrist asking the ophthalmologist for advice; the pharmacist asking the GP; the dentist asking the oral surgeon; the physiotherapist asking the orthopaedic surgeon; the psychologist asking the psychiatrist; the nurse practitioner in a rural clinic seeking guidance from a paediatrician 300kms away.
When you give any healthcare provider a direct, structured channel to the right expert, you streamline access to specialist advice and cut the unnecessary faff that clogs the system — the duplicate tests, the avoidable referrals, the months of waiting for an answer that could have been provided in days.
But the strongest evidence isn’t in the published literature. It is in the lived experience of every doctor who has ever picked up the phone to help a colleague manage a patient. We know this model works, because we use it every day. We just haven’t built the system to make it available to everyone.
Every family deserves a CMO
I think about the families I see in clinic — parents who have driven hours from regional towns, taken days off work, and waited months for an appointment that a single piece of timely advice could have prevented.
Then I think about my mum’s fractured knee. From injury to surgery in hours, not weeks. Not because she received better medicine, but because she had access to a better system.
That disparity is the issue.
Access to specialist care in Australia is not equal. Where you live, what you earn, and who you know still determine how quickly you are looked after. A child in regional New South Wales with severe asthma should not receive a lesser standard of care than a child whose parent happens to be a doctor. A pensioner with a suspicious screening result should not wait months for guidance that could be provided in days.
This is a question of (in)equity.
Every Australian family deserves a CMO. The model works. We know it works, because we live it every day. Now it’s time to make it available to everyone.
Associate Professor Vikram Palit is a paediatric respiratory physician, and CEO and founder of Consultmed.
