Would you work for half your hourly rate? Neither would your expert.

A question before the numbers. If a client came to you tomorrow with the same work you always do, the same complexity, the same professional risk, and asked you to do it for half your usual rate, what would you do? You'd decline. Politely, and without losing a minute's sleep over it. You wouldn't build a practice on it.

Now the numbers. Under the workers compensation fee schedules, a psychiatric IME sits at around $1,400 in New South Wales and around $2,200 in Victoria. The private market prices comparable senior specialist work at $3,000 to $5,000, and more at the top end. That's the question in front of senior specialists every week. Not half. Sometimes closer to a third.

Price decides who says yes

Senior specialist time is scarce and it is mobile. An examiner with a full diary is choosing between private matters, scheme matters, clinical sessions and theatre lists. They are not choosing on principle. They are weighing what each hour returns and how much friction comes with it. Same as you would.

Somewhere in New South Wales this week, a psychiatrist looked at a scheme assessment request, looked at the schedule, looked at their diary, and said no. Not because the matter didn't deserve an opinion. Because the same afternoon on private work pays two or three times as much. A price that only works if experts behave differently to every other professional isn't a price that works.

The experiment Victoria already ran

Schemes across the country are wrestling with versions of this. New South Wales is feeling it hardest. Fees low, demand high, experts restricting how much scheme work they will take because their time is worth more elsewhere.

A few years ago Victoria had the same problem. Fees trailing the market. Experts closing their books to scheme work. Panels thinning. Then Victoria lifted its fees, and lifted them properly. What followed was specialists who had stepped back beginning to accept scheme work again, and depth returning to the panel. That's observation, not a controlled study. But the sequence is hard to ignore, and it happened one border away.

The gap inside the gap

There is a second gap, and this one applies to every matter, not just scheme work. The fee on the invoice is not what the expert receives. Between the two sits an administration layer. Booking, briefing, coordination, collection. That layer does real work and has to be paid for, and depending on the model it takes anywhere from a thin service fee to 20, 30, even 40 per cent of the total in parts of the market.

So the expert's real bid isn't the fee. It's the fee minus the clip. Take the New South Wales schedule at $1,400, remove a 30 per cent share, and the specialist is weighing up around a thousand dollars for work the private market prices at three thousand or more. The wonder isn't that experts are stepping back. The wonder is that any are still saying yes.

Five reasonable parties, one bad outcome

Ask each party about expert supply and every one gives you a principled answer. The scheme regulator is doing its job, protecting the pool of premiums from runaway costs. The insurer pays the scheduled rate because the schedule is the deal. The lawyer pushing for better access to the right specialist is advocating. The expert stepping back is making a professional judgement, not a lazy one. And the provider sits in the middle, unable to conjure experts at a price the experts have already declined.

Five parties, each doing their job. One bad outcome anyway. Everyone depends on expert supply. Nobody owns it. And problems nobody owns don't get fixed, because the failure sits in the gaps between everyone's jobs.

What a thin panel actually costs

The cheap fee looks like a saving on the invoice line. Follow the file and it reverses. When the pool of specialists willing to take the work shrinks, choice narrows. The right sub-specialist for a complex matter may not be available to that scheme at that rate at all, so the matter goes to whoever will take it. Geographic coverage thins, and regional claimants travel further or wait for a visiting clinic. The experts who remain carry more of the load. And the person at the centre of the claim waits on a decision that can't be made until someone assesses them. That's the price of a cheap assessment. It's real, it's large, and it never appears on the same page as the fee.

Where AI makes this sharper

There's a tempting story where AI productivity gains solve this. Reports get cheaper to produce, the low rate covers the work again, the gap stops mattering. Issue 05 explained why that story is incomplete. AI reduces the cost of producing a structured report. It doesn't reduce the value of specialist judgement, and complex matters are exactly where the judgement is the job. So the better-paying end of the market gets more productive. The underpaying end stays commercially unattractive. That was true before AI. AI speeds it up.

Augmentation. Transparency. Verification. Transparency is the one that bites here. The full cost of a thin expert panel, the narrowed choice, the geographic gaps, the claims that stay open, is invisible because nobody publishes it next to the fee that causes it. The first party to put those two numbers on the same page changes the conversation for everyone.

The bottom line

You wouldn't work for half your rate. Neither will the specialist whose opinion your matter depends on. Victoria stopped wishing and the books opened. The rest of the country is watching. Or should be. Nobody in this story is the villain, which is exactly why it keeps happening.

If I could publish one number beside every fee schedule, it would be this. How many specialists were approached before one accepted. That's the number the person at the centre of the claim actually experiences. What would yours be?

Next issue: the first AI products have arrived in medicolegal, and every provider deck now has an AI slide. How to tell the real workflows from the theatre.