Public vs private practice — what's the difference?
How public and private medical practice differ in Australia — income, hours, training opportunities, on-call, security, and lifestyle.
A common career question for trainees and consultants is public, private, or both. Many Australian doctors do both — split appointments are normal. This page summarises the differences in plain English.
At a glance
| Dimension | Public | Private |
|---|---|---|
| Employer | State/territory health service | Practice owner, group practice, or self-employed |
| Income (consultant) | ~$350K–$450K full-time | Up to ~$800K (varies enormously by specialty and volume) |
| Income (trainee) | Award-based (varies by state) | N/A — most training sits in public |
| Job security | Permanent positions exist; staff specialists have employee protections | Self-employed risk; no employer safety net |
| Hours / on-call | Rostered; on-call mandated | Self-managed; can be heavier in private |
| Patient mix | High-acuity, full case mix, public/uninsured | Insured, often more elective, narrower mix |
| Teaching / supervision | Built-in for staff specialists | Optional; less structural |
| CPD support | Often included or partly funded | Self-funded |
| Leave | Standard award leave + study leave | You don't get paid when you're not seeing patients |
| Admin overhead | Low (employer handles) | High (billing, compliance, staff, premises) |
For income detail by sector, see How much do psychiatrists earn in Australia? — which generalises across specialties with adjustments.
Why most consultants do both
A typical post-fellowship pattern:
- 0.4–0.6 FTE in public — keeps you in high-acuity case mix, retains teaching and supervisory role, gives leave and CPD support, anchors income
- The remainder in private — adds income upside, more lifestyle control, ability to subspecialise
Pure full-time public is most common in academic and public-only-specialty roles (e.g. consultation-liaison psychiatry, acute physician, public health).
Pure full-time private is most common in procedure-heavy specialties with strong patient demand (some surgical specialties, dermatology, gastroenterology, ophthalmology).
What's harder to see from the outside
Public looks more secure than it sometimes is. Staff specialist contracts can be renegotiated; state health services restructure; locum and contract roles dominate in some specialties. Don't assume "public = job for life".
Private looks more lucrative than it often is. Setup costs (premises, EMR, staff, indemnity, marketing) can take 18–24 months to recoup. The first 2 years are typically lean. Specialty matters — some specialties have low private volume by design.
On-call costs are real in both. A high-volume on-call commitment can dominate your week regardless of your nominal hours.
Distribution Priority Area (DPA) rules can dictate private viability for IMG consultants — the location of your private rooms determines whether you can bill Medicare. See Visa types relevant to doctors.
Decisions that determine which mix is right
- What's your target income, and how much income variability can you tolerate?
- Do you want teaching / supervision / academic involvement?
- What's your on-call appetite?
- Where do you want to live? Some specialties only have private viability in metropolitan areas.
- Do you want to be a business owner, or do you want to focus on clinical work?
Where AdvanceMed can help
- 1-on-1 coaching on the public/private decision at each career stage
- Sector-aware CV / Resume rewrites — public hospital CVs read differently from private practice ones
- Interview prep for staff specialist appointments and visiting medical officer panels
Last updated 4 days ago
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