Breaking a Leg: UK and Australia Compared

What do you get if you take one professional dog walker, two dogs, a dog park and put them all together on one hot spring evening?

Let me be more specific.

The professional dog walker is none other than the director of Dog Walks Pty Ltd and also partner in the local pet care business, At Home Pet Care with Karen. (In other words, Mrs Bobinoz.)

One of the dogs is called Hippy and the other dog is called Indie, this is what Hippy looked like when she was a very young puppy…

Hippy

But she is a lot bigger now and so is Indie.

Hippy and IndieThrow them all into the dog park, which looks like this during the Doggies Christmas Party held each December at our local dog park…

dog parkAnd what do you get?

Yes, that’s right, there was a big clue in the title of this post, the answer is a broken leg.

What happened?

This is precisely how it happened; the two dogs were running around together having fun in the fully fenced and self-contained off leash dog park area when Mrs Bobinoz noticed them hurtling towards her. She tried to sidestep them at the same time as they swerved to avoid her.

One of the dogs managed to ‘head-butt’ my wife firmly on the knee flooring her completely. The dogs head, of course, was completely fine. Karen though, well, she couldn’t walk.

Injured dog walking? The woman who runs a business in charge of Dog Walking in Australian Quarantine

Karen-and-Clover

Oh the irony; this is like a plumber getting his toe stuck in a bath tap or a chef getting food poisoning.

Breaking a Leg: UK and Australia Compared

Last time I attended a hospital accompanying a broken leg victim it would have been in 2001 and back in the UK. Here’s how that went:

The UK

  • Arrive at hospital around 9 PM
  • Queue to see receptionists to give details
  • Wait to have an x-ray
  • Wait to see the specialist to show him the x-ray
  • Having confirmed the leg is broken, await treatment
  • Have leg set in plaster
  • Finally leave hospital at around 6 o’clock in the morning

Yes, that’s how it really happened; it was not uncommon to spend between 6 to 10 hours in an emergency department of a hospital in the UK. On the negative side, that’s a long time, on the positive side, everything was done completely free of charge apart from the (at the time) £3.00 cost to park in the hospital car park.

Australia

So, it would have been around 5:30 PM when I got a telephone call from Mrs Bobinoz explaining the situation and asking me to come and pick her up as she couldn’t possibly drive her car.

Before I left to pick her up though, I telephoned our local doctors reception and explained the situation.

Yes, swing by and we’ll get the doctor to look at your wife’s leg” said the receptionists.

By about 6 PM Karen’s leg was already being inspected by the doctor, he wasn’t convinced it was broken but did want her to have an x-ray first thing in the morning. Meanwhile he gave her some tablets to relieve the pain.

  • Cost of consultation: $80 less Medicare rebate of $36 equals $44.

They lend us crutches…

crutchesNext morning we went to one of the local x-ray departments, in our case we went to Queensland Diagnostic Imaging (QDI) but we could have chosen from any one of around three or four that are within a 10 km radius. These are privately run places, they do charge a fee for their services but we have no idea what it is, it’s covered by Medicare.

When that happens here, it’s called ‘bulk billing’. So, Karen had her leg x-rayed, handed over her Medicare card and walked out with the x-rays under her arm without having to pay. We had arrived without an appointment at around 9:20 AM and we were back in the car on our way home by about 9:55.

We then had to return to the doctors to show him the x-rays, by the time we got there he already had the report sent by email from QDI.

It turned out that the x-ray was not conclusive. The leg did not look broken, but there was a very thin grey line in evidence, both the QDI report and our doctor could not decide whether it was a break or not.

The advice given was to keep her weight off of the leg, see how it felt over the next few days and if it didn’t appear to be getting less painful, to go back to the x-ray department to have a CT scan which would show more detail.

  • Cost of another consultation: $80 less Medicare rebate of $36 equals $44.

CT Scan

8:30 AM on the Monday morning Karen is on the phone booking a CT scan. She gets a 10 AM appointment, but needs to be there by 9:45 AM. She is, fills in the forms and at about 10:05 somebody pops their head out to where Karen is waiting in the reception to apologise for the delay.

By 10:30 AM Karen is walking (sorry, hobbling) out of the place with her CT scan under her arm to be picked up and driven home by her friend who took her there as this place is right next to a shopping centre she was happy to visit.

Monday afternoon, back at the doctors, a break in the leg is confirmed and the doctor recommends we attend the emergency department at the hospital as soon as possible.

Cost of another consultation: $0 – “Let’s just call it an ongoing consultation” the receptionist said, probably feeling sorry for her by now.

So, by 2:45 PM on Monday we were at…

Royal Brisbane Women's Hospital

  • We go to window number 1 to be assessed in terms of how ‘urgent’ our case is
  • We go to window number 2 to give over personal details, name, address, etc
  • Then we wait
  • About an hour later, somebody comes out to speak to Karen and apologises for the delay explaining that they are very busy today
  • About 4:20 PM Karen is seen by the doctor who confirms that no movement in the fracture has occurred and he fits a removable splint
  • The doctor also arranges an appointment for the next available date, which turns out to be Thursday, with the Orthopaedic Department. So tomorrow we will be going back to…

Royal Brisbane Women's Hospital… for advice on whether any further treatment is required.

There you have it, we are now all up-to-date. That’s breaking a leg in the UK compared with breaking a leg in Australia.

Which is best?

It’s hard to say, spending nine hours up through until 6 AM in the morning in an emergency department in the UK is thoroughly uncivilised, but it is also free and gets the job done in one go.

Here in Australia things seem to be far more civilised and waiting times vastly reduced. But adding it all up with (including all travelling time) two visits to QDI at about an hour and a half each, two visits to the doctors at about 30 minutes each and then two visits to the hospital at about 3 1/2 hours each, we get to 11 hours and of course, we’ve also had to pay $88.

Oh, I forgot, parking at the Royal Brisbane Women’s Hospital was $23, so $111 in all.

So, on the face of it, the UK wins.

Here’s the problem though; if the leg hadn’t been broken then we would have saved heaps of time by going to the doctors first, but as it turns out the leg was broken. We may well have been better off driving straight to the emergency department of the hospital on day one.

In that case, our experience may have been similar to the UK one except quicker but more expensive, as in $23 instead of £3.00. Maybe not though, it’s impossible to tell unless we break another leg to test it.

So it’s not really possible to tell you which system is best, but I hope you have found this insight into Australian medical care interesting. Here is the only conclusion I made:

It’s best not to break a leg, wherever you are.

Note: not all doctors charge $80, prices vary, some can be as low as $50 but the rebate remains the same.

Survey:

Have you recently broken a leg? Wherever you are in whatever country, we’d love to hear your story to find out how quickly or slowly you were fixed up, what you had to do to get sorted and how much it cost you. Please let us know in the comments below…

Update: part two of this post can be seen by clicking…

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{ 34 comments… add one }
  • Dr Aniket Shukla October 31, 2013, 6:47 pm | Link

    Read the Broken leg Story and really feel sorry for Mrs Bob and wish her a speedy recovery.
    I am a doctor (a Psychiatrist) and currently writing from INDIA but about to move to Melbourne in a couple of months. I was taken aback at first stance when I read the entire process and cost involved in getting a fracture leg fixed in Australia. Believe me it is much better to fracture your leg in INDIA if given a choice. Being a doctor I can assure that the entire procedure from getting into emergency dept to getting the limb plastered will be completed (or rather is completed) in hardly no more than 2-3 hours. There are no appointments required in emergency and atleast for a emergency like fracture. Specialist will see the patient directly. The estimated cost of entire consultation and procedure can be usually around 2000 Indian rupees (i.e. 35 $ approx) in private hospitals and just upto 500 (8 $) in semiprivate or govt hospitals. And of course the parking fees at the best of the parking lots wont be more than $1. So to sum up the entire consultation and treatment process in a tertiary care World class hospital can get over in 2-4 hrs with all investigations and at the cost equivalent to parking fees in Oz. Only problem in India is that the health economics is not taken seriously so doctors like me are always in mode to move out.

    • BobinOz November 1, 2013, 12:32 am | Link

      Thank you Doctor, I will pass on your good wishes to Mrs Bob, I hope she has a speedy recovery too. She’s got me running around doing everything, fetch this, fetch that! 🙂

      In hindsight the process and the path that we took could have been made much quicker had we known the leg was really broken, but at the time it didn’t really look that serious, after all she only had a couple of dogs run in to her. If we had known it was broken from the onset, we would have gone straight to emergency and would have surely had a quick outcome.

      If you read some comments above you’ll see that others who went straight to emergency were dealt with very quickly and efficiently.

      Now, the money. This is a hard yakka thing. I have to point out to you that as cheap as it looks from here, those prices are hugely expensive in India for the average Indian.

      You would have to tell me if my figures are wrong, I have no idea from my limited research whether this is correct or not, but I have tried to verify my sources in a few places to make sure it is correct. Here goes:

      Seems to me that the average annual salary in India is around Rs.45,000, that roughly speaking is about $800 AUD per year. As an hourly rate that’s about 40 cents.

      Average salaries here are closer to $70,000 per year, $35 per hour. Average Australians then earn about 90 times more than the average Indian worker.

      So I could have got my wife’s leg fixed for $35 in a private hospital or for $8 in a government hospital, but here that’s the equivalent of $3150 for the private hospital and $720 for the government hospital.

      Let’s just ignore the parking fees for now 🙂

      For that kind of money not only do I think I could have got my wife’s leg fixed really quickly, but I could probably have afforded to employ a juggler and a comedian to keep her amused whilst they went through the process.

      As I mentioned earlier, I don’t know for sure what the average wage is in India, but several sources have suggested the above mentioned figures are correct. On the other hand, I do know that skilled workers probably earn between Rs.300,000 to Rs.600,000 and for them these prices aren’t so bad. But I can only compare averages with averages to make it equal.

      It is good to hear though that you do have a system to treat people as quickly as you do, but the very fact that even the government hospital can be so relatively expensive for the poor does make it a little exclusive.

      Thanks for taking the time to tell us this information, and I do hope you have a successful move to Melbourne and get to love this country is much as I do.

      Thanks, Bob

      • Dr Aniket November 1, 2013, 1:11 am | Link

        Thanks for the good wishes Bob. I do agree with you to a great extent. And as I had mentioned in my previous comment, that health economics in India is kinda funny. People tend to and are more comfortable consulting in private hospitals here rather than utilizing govt services. In addition health care is available at a highly discrepant levels. Same facility and same doctor may be available at different costs. And that is because of a largely varied population in terms of Socioeconomic status. Basically India has large number of people from every cadre and class. So something that might be out of reach for certain percentage of people, might be very much affordable for equal percentage of other class at the same time.
        Though this is slightly out of context and not the exact topic of discussion, I would still like to mention that, The area in health sector in which India really scores above any developed nation is the highly reduced cost with a world class facilities available for some treatments like In vitro fertilization, coronary bypass surgery or stent implants, Joint replacement surgery, transplant surgeries as well as a few cancer related treatments. So If anybody from a developed country wishes to get a speedy and quality treatment for above procedures at merely fraction of cost involved there, then India is the best medical Hub.

        • BobinOz November 1, 2013, 2:15 pm | Link

          Well yes, I can certainly see the advantages for somebody to travel to India for treatment for a procedure that would cost maybe tens of thousands of dollars here. I’ve even heard that it is quite common for Australians to travel to Thailand for expensive dentistry.

          I would imagine your country does a fair trade for health tourists 🙂

          Cheers, Bob

  • Scarlett October 31, 2013, 4:17 pm | Link

    My little sister’s various broken bones have all required trips to Emergency. We’ve learned that how fast that process is depends a lot on what time of day you rock up and how loudly you’re screaming.

    For her first break, an elbow break that left her subdued and a bit teary but otherwise collected, we waited about 3 hours in mid-afternoon at the Children’s Hospital. X-rays, casts, slings, all sorted quickly and efficiently, which may have been because she was so young.

    For her most recent broken leg, a ridiculously severe mess of an injury that required an ambulance ride, despite the 45 minute wait for the ambos everything at the hospital was immediate. I was honestly shocked at how fast she was admitted considering it was a weekend and they were understaffed, but I think her screaming got to them.

    On all the other trips we’ve found that Saturday night is the worst possible time to require semi-emergent hospital attention. The ER is packed with people who can’t possibly live with their flu until Monday to see their GP, or are very drunk and dragged in by ambulances for a banana bag and stomach pumping. In between, the broken bones get missed and shoved down the queue.

    On GPs: My practice bulk bills and because I’ve been seeing the same doctor since I was very young, there’s no gap. If you develop a bit of a relationship with your GP and they know you, they’ll often give you a discount or just bulk bill, gap-free. Of course this is difficult if you move around a lot and are relatively healthy!

    • BobinOz October 31, 2013, 9:42 pm | Link

      Hi Scarlett

      What is it with your little sister, does she like climbing trees or something? 🙂

      Again, it sounds like she has been sorted out very swiftly and efficiently on the occasions she has needed treatment, which is great. I’m sure the screaming helped a bit, I don’t know why my wife didn’t think of that 🙂 Joking aside, I’m sure your little sister was in genuine pain.

      Saturday night is always going to be a bad time to turn up, but as it happens that was when I made my one and only trip to emergency when I splashed chlorine in my eye. I know I arrived early morning at about exactly the time the Saturday night crowd would have been at their most disorderly, so I expected a long wait but didn’t really get one.

      Interesting that a few people like yourself have mentioned there being no gap with all doctors fees being covered by Medicare. Does that mean your doctor only charges $35.60?

      I’ve been with the same doctor here for nearly 6 years, he hasn’t given me and discount yet.

      Cheers, Bob

  • UKAussi October 31, 2013, 2:46 am | Link

    I think the benefit of having small charges for visits and prescriptions in Oz helps to reduce the burden on the tax payer (who ultimately pays for the “free” healthcare) by reducing/eliminating a lot of the unnecessary visits from hypercondriacs etc.

    Similar in that aspect to the US if you have insurance, where you pay “co-pays” for every visit and prescription etc. Difference is you pay $80+/month for Family health insurance if you are lucky and your employer gives you health insurance and subsidizes the cost. If you have to pay 100% of your own health insurance then that gets VERY expensive, at least $250-300 /month for family if you are all healthy and non-smokers with no previous conditions etc. Or it could cost you $1000+/month if you have high blood pressure or cholesterol etc.

    Daughter recently broke her arm last month so will have to ask wife what the costs were under our insurance but we have “urgent care” facilities here which are like doctors offices but deal with most non-life threatening stuff such as breaks, cuts etc and take some burden away from ER’s which are often slow like the UK but you pay a fortune in co-pays for so best stay out if you can.

    • BobinOz October 31, 2013, 1:45 pm | Link

      That is a very interesting thought UKAussie, it hadn’t crossed my mind. But yes, anyone who thinks it’s great going to see the doctor every other week with a pimple or slight sniffle will think twice if it’s going to cost them $30 or $40 a time. So I’m sure it does reduce the pressure on the health service.

      We also have some of those urgent care type facilities here, there’s one about 20 minutes away. I couldn’t remember if it had x-ray facilities though, so that’s why I took the short journey to our doctors first.

      Cheers, Bob

  • jo shaw October 30, 2013, 10:52 pm | Link

    Hi Mr Bob, and get better soon Mrs Bob.
    We are in Perth, and recently had a fall off my bike. Hobbled home with a sore hip and decided to have a nights sleep and see how I felt in the morning.
    Trip to emergency, xray and then an operation 12 hrs later to pin it in place, stayed in hospital for 3 days. Have to say other than waiting hrs for an ambo to take me to another hospital an hr away, (well it is Perth) and the wait for the op, everything was fine. It didn’t cost us 1 cent. So I would say ‘public system’ here is on a par with the good old NHS.

    • BobinOz October 31, 2013, 1:25 pm | Link

      Thanks Jo, I’ll pass on your good wishes to Mrs Bob.

      Sounds like you also had excellent service over in Perth, and again it hasn’t cost anything. I think Australia has a balance between public and private health that seems to work very well. The NHS might have struggled to match the health care you received.

      Another thumbs up for the Australian health service, I think.

      Cheers, Bob

  • Dillon Baldwin October 30, 2013, 10:47 pm | Link

    wow that must have hurt. I honeslty have never had a broken leg but i did cut my calf in half with sheet metal (funny how that ryhmed) and i was able to get out in 3 weeks but not very painfull. Hope she makes it through okay 🙂

    • BobinOz October 31, 2013, 1:22 pm | Link

      She’s fine thanks Dillon, and your injury sounds like it must have hurt far more than hers. Cheers, Bob

  • Denise October 30, 2013, 6:42 pm | Link

    Hi, Our services here in Melbourne are mostly all bulk billed, so no cost. If we have a big problem with anything, we always go to the emergency department at our local hospital, never to the local GP.

    I haven’t broken a leg, but have cracked a bone in my ankle (being nosy looking over next doors fence and stepped into a hole my dog had dug and twisted my ankle)!!

    Straight to the emergency department, didn’t wait very long, xray not sure, but like your wife was a grey line on xray . They then put on what is called a back slab, which is plaster but not all the way round. Problem sorted and back home within a few hours, cost nothing.

    In the Uk did something similar in a car park. Fell over twisted my ankle, went to local emergency hospital ,got seen a few hours later, then to xray, back to emergency, waited, put in a cubicle where they promptly forgot about me for hours, finally seen and said no break and could go home. Was free as well but moral of the story OZ definitely better.

    • BobinOz October 31, 2013, 1:13 pm | Link

      So, what exactly was the next-door neighbour up to Denise? 🙂

      Thanks for your story, sounds like you got sorted out pretty swiftly in Melbourne. For those who wonder what “bulk billed” means, here’s a quick explanation. Services that are covered by Medicare can be paid for and then a refund applied for later by keeping the receipt. Bulk billing means the doctor or the hospital (as in this case) claim the rebate directly on your behalf so you end up paying nothing.

      If Medicare only pay part of the bill, then you have to pay the difference which is called the “gap”.

      For those who don’t know what Medicare is, see part two of this post.

      Anyway Denise, your experience is pretty conclusive, Australia wins in your example.

      Cheers, Bob

  • John Oh October 30, 2013, 5:46 pm | Link

    Not insane. Dogs are better than humans. They never lie…
    Yet we humans have a saying “lying dog!”
    Trust me.

    • BobinOz October 31, 2013, 1:00 pm | Link

      You’ve rubbed shoulders with too many pollies John 🙂

      • John Oh October 31, 2013, 2:55 pm | Link

        Not any I have cared to move in with…. Plenty I would have moved out on.

  • John Oh October 30, 2013, 5:03 pm | Link

    By “they” I meant the hospital…..of course….Re 30 millions views Here’s some more: TV interview on this….
    http://www.youtube.com/watch?v=K5jBK6aR7CQ
    30 millions plus one!

    • BobinOz October 30, 2013, 5:05 pm | Link

      It’s a funny world that we live in. Dogs getting interviewed on TV following a successful YouTube appearance?? It’s insane 🙂

  • John Oh October 30, 2013, 5:00 pm | Link

    By “they” I meant the hospital…..of course….

    • BobinOz October 30, 2013, 5:03 pm | Link

      Sorry, there was a typo in my reply, I have now changed the word said to what it should have been which was saved. Yes, I understood what you meant by “they”.

  • John Oh October 30, 2013, 9:25 am | Link

    Bob, the mistake was taking the Mrs. to the local doctor. The running around would have been prevented. They have all the gear to treat Mrs. in one spot.
    The other?Find out who’s guilty. Interrogate your dogs.
    Like this : http://www.youtube.com/watch?v=B8ISzf2pryI

    • BobinOz October 30, 2013, 4:57 pm | Link

      Ah, but if the leg hadn’t been broken I would have saved lots of time. If I’d made Mrs Bobinoz hop to the doctors and then get a bus to the hospital, I would’ve saved tons of time 🙂

      Good video John, but I can’t believe it had over 30 million views!

  • Tanya October 30, 2013, 6:34 am | Link

    Thanks so much! I’m an American doc thinking of practicing abroad one day. It’s nice to see how other countries handle health issues.

    Very nice,
    Tanya

  • Sarah Quirk October 30, 2013, 6:04 am | Link

    Hiya…I have a query…I see u had to pay to see the doctor initially. Is this the case with all things in Oz?? For example my 7month old woke with an ear infection sat morn. Quick phone call to docs and they said to pop in and theyd squeeze us in. Antibiotics and paracetamol prescribed all free of charge. Are visits like this free in Oz?? Sarah

    • BobinOz October 30, 2013, 4:48 pm | Link

      I’m sure there are some circumstances where somebody could get this for free, but it’s probably the low paid only who are on what are called here “concessions”. Everybody else pays, including children. (Or should I say the parents of children). The rebate you get from Medicare depends on your personal circumstances.

      The same applies for your medication, you will have to pay but the rebate you get from Medicare will vary depending on your situation. No NHS here 🙂

      • Sarah Quirk October 30, 2013, 5:53 pm | Link

        Well I guess purchasing antibiotics once in a while is a small price to pay to enjoy the sunnier climates of Oz. And on the plus side maybe my children will get less poorly in the nice weather 🙂

  • Fiona Turner October 30, 2013, 3:43 am | Link

    We still live in the UK, near Oxford. Although I haven’t broken my leg, I have to say my experiences of the NHS recently have been excellent. I have always been informed about waiting times, health care professionals introduce themselves and apologise for any delays, appointments and treatments have been arranged to suit me. The main difference would probably be the GP appointments. We can always get an appointment if it is ‘urgent’ or a telephone appointment, but may no see our usual GP.
    As all our children now live in Australia, we are keen to join them there. One of our main concerns is the health service, both the cost to us, both over 65, and the different system. Your article certainly helps us to understand some of the differences and how they might affect us. Thank you!

    • BobinOz October 30, 2013, 4:39 pm | Link

      I couldn’t agree more Fiona, although I did have that very long wait to get a broken leg seen to, I think the NHS do a marvellous job. My brushes with the health service here have been extremely efficient as well, certainly speedier but often more expensive.

      I’m going to be posting more about the health service later on today, hopefully that will help you understand it more.

      Cheers, Bob

  • John October 29, 2013, 7:25 am | Link

    You’re right that it is hard to compare based on the scenarios given. As you pointed out, if the leg hadn’t been broken it would have saved lots of money. Additionally, if the leg had clearly appeared broken on the initial clinical exam or the fracture was identified on the initial xray, then it would have also saved some time/money avoiding the CT and additional consultation.

    The direct comparison would be based on–what is the time and expense of going straight to the emergency room for a leg fracture in Australia. Would it take all night? What would they charge you? And on the flip side in the UK, if you went to your GP initially for a possible broken leg, how long would it take before you had xrays, a CT, and were scheduled to see an orthopedist?

    • BobinOz October 29, 2013, 1:53 pm | Link

      That’s right, it is quite impossible to tell without more information. Glad you reminded me, I have now added an additional note to this post, it now includes a Survey.

      Hopefully we can get a few readers to tell us about what happened when they broke a leg and how it got fixed.

      Cheers John, Bob

  • Tim October 25, 2013, 8:54 am | Link

    Good luck to Mrs BobinOz.

    • BobinOz October 25, 2013, 6:49 pm | Link

      Thanks Tim, she is getting by, we are just trying to grin and bear it at the moment.

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