To establish a third data point on what it genuinely costs to run a private ophthalmology practice. The study was run previously in 2008 and 2017, and a fresh data point now gives us a trend line. The data is central to our advocacy: it lets us push back on the narrative that specialists are overcharging, and it supports our case ahead of the Senate committee hearing on accessibility and affordability in October. As validated numbers are the only figures that carry weight with government, this data is our strongest evidence.

As many private practices as possible. The college has kindly shared the survey with all fellows, not just ASO members. Please also encourage other practice managers and doctors you know to take part. The more responses we collect, the stronger our position.

The deadline is 10 September. Returning it earlier is appreciated, as Anthony reviews every response individually and that takes time.

Allow roughly 40 minutes to an hour, ideally alongside your practice manager. It is quicker if you already keep your practice numbers in a spreadsheet. You will need actual figures (for example vehicle and conference costs) rather than rough guesses, so it helps to have your data on hand before you start.

Yes, it is confidential. Each response is assigned a practice ID, and that ID is all that appears in the collated dataset, so the data itself carries no personal details. Your name and preferred contact method are collected only so that Anthony can reach you if a figure needs clarifying. Responses are reviewed only by Anthony and are not shared.

Ideally 2025-26. If that is not workable, the previous financial year is acceptable. There is a drop-down in question 1 to indicate which year you have used. The key requirement is that your activity and your costs all relate to the same period, so the figures stay consistent.

Annual. All cost figures should be entered for the entire year.

Provide your best estimate. This is not an audit. If you know a figure for 2024-25 but not yet for 2025-26, estimate the current year from the previous one and what you expect has changed. As long as you have a reasonable basis and some evidence behind the figure (for example a signed lease with a known increase), an estimate is fine. Where a box does not fit your situation, write what you think it should be in the notes beside it and add your best estimate.

FTE is based on 10 sessions per week, where one session is half a day (about four hours). Full time is defined as 9 out of 10 sessions, on the basis that most people take around half a day off each week for other commitments. If you genuinely work all 10 sessions with no time off, that is roughly 111 percent. Sessions are captured separately from hours so we can reflect both the rostered days and any overtime worked within them. In a large practice, head count and FTE head count will differ: you might have 20 doctors who average four days a week, giving an FTE head count of about 16, while total hours worked could imply more again if people are doing overtime. For multi-doctor practices, it helps to list your calculation for each doctor.

More help calculating FTE

Ideally as two separate returns, one for the rural site and one for the non-rural site. If a single set of rooms serves both, that is a different situation. The survey is deliberately not locked down and allows comments, so note the arrangement in the survey and Anthony can work through the specifics with you directly.

Either works. You can do a single return on a percentage basis (for example 20 percent clinic, 80 percent day hospital), or complete one for each if that is easier. Anthony is likely to treat day surgery separately in the analysis regardless, as it has its own cost base and FTE. If you split them, he may need to confirm which costs are shared and how they are apportioned.

Only the hours worked at this practice. The procedures and costs recorded need to align with the hours, so include only the activity that took place within this practice.

Per injection. Even though overheads are calculated on a per-patient basis, the injection figures should be entered per injection, because that is how the government will assess them.

This distinction applies to staff, not to the doctors themselves. Clinical staff are those whose role requires a health-practitioner qualification and who form part of the patient journey. Non-clinical staff are those in roles such as front desk, administration or accounting who do not hold a health qualification. (For reference, the long-standing definition of a full-time doctor's work is 6 sessions of private consulting, 1 session of private operating and 2 sessions of VMO work. CPD done after hours is not counted here.)

The test is not whether the task is face to face, but whether it requires clinical expertise. If the work needs medical or health expertise, it counts as clinical, even a doctor writing up notes after hours. If it can be done by someone without a health-practitioner qualification, it is non-clinical. It comes down to the qualification the work requires.

Yes. Building and fit-out sit in question 3 (premises, including the depreciation allowance for building and fit-out). Equipment-related fit-out sits in question 5. Which one you use depends on whether you are describing the physical building or the equipment within it.

On a replacement-value basis, as an annual cost, rather than the written-down accounting value. Estimate what the fit-out would cost to do today and convert that to an annual figure. If that is too difficult, simply note the original cost and year beside the box (for example, fit out cost $100,000 in 2000) and Anthony can work it out. The same approach applies to all accounting items: we are after the underlying ongoing cost, not the historical purchase price. This is also why equipment is listed item by item, so that current values can be applied.

No. Those episodes are not separately funded, so they are not calculated. This is why the PPO relies on items 104, 105 and 109, injections, and a proxy for surgery. For general ophthalmology, that proxy is roughly the number of cataracts multiplied by about 1.25, since cataract surgery makes up the bulk of the work, and it turns out to be surprisingly accurate. If your software can produce an accurate count of individual patients seen in the year, that is also helpful, either in place of the proxy or as a check on it.

The Per Patient Overahead. Adapted for Australian practice from John Pinto's work in ophthalmic practice management, it tells you how much you need to charge, on any given patient occasion, to make one cent of profit. The self-assessed PPO in the final tab is compared against Anthony's own methodology, and the two should broadly align, with only minor differences around how equipment is treated.

Anthony will not share results with anyone unless directed to by the ASO. As in previous years, the ASO expects to release the average PPO and average overhead figures, unless there is an issue with the data. Individual responses remain confidential.

Contractors are indeed counted as staff costs (either clinical or admin where appropriate). They would not incur many of the other on-costs but that is incorporated into the total fee of the contract. Enter the contract cost under wage costs but please put a note to say what proportion of wages relate to contractors, next to the wages amount. This is just for completeness for validating the data.

Costs are generally best captured at the site level, since equipment and other investments are made there. Ideally, separate your costs site by site.

Where costs are shared across sites to keep them down (a sensible approach), simply pro-rata the shared costs across sites using whatever split best fits your organisation, as long as the totals add up across all sites. In practice, it's usually back-office functions like accounting that are shared, and pro-rata works well for those.

One complication: if sites are heavily entwined, with staff working across several of them, it's often better to combine them into a single "super site". This is uncommon, but it may better reflect how your business actually runs.

The logic is straightforward. We're building an economic model of what a replacement practice would cost to run. Put another way: if your business ceased trading, what would it cost to run an efficient practice performing the same type and volume of procedures, for the same patients, in the same locations? Or: what would it cost the government to service all the patients your practice currently looks after?

Many of these costs are built into the specifics of your business: the location, the building, the equipment, and the staff you've already trained. All of it took significant upfront and ongoing investment to build. Much of it is tied to where you operate, especially your staff, which is why each site carries its own cost structure even when set-ups look similar.

So treat each site as a separate practice, unless there's substantial overlap in staff and patients.