Overcoming disincentives for the private physician

Dr Gavin Carney, Access Nephrology

Evidence as to whether home haemodialysis is a worthwhile treatment.

This includes

  • the economics of dialysis, and how that relates commercially with the supply dialysis equipment; {Fresenius is the (undeclared) model}
  • how private physicians earn their income, and how this is not conduit with the current model for home dialysis therapies.
  • a review on the medicine, under the title “The Medicine for Home Dialysis is Underwhelming”,
  • and finally, quality of life.

The lecture concludes that currently the only sustainable argument for home dialysis in my precinct (which is Australia, other than Western Australia), is if the patient actively seeks it, can do it, and is likely to benefit in terms of quality of life and personal freedom.

The lecture concludes referring to the Western Australian Home Therapies Model and how some of that could be translated into the ACT/NSW precinct, if there was a relationship between private renal medicine and Government, such that the private sector supplies medical Governance but the Government supplied the hardware and technical/nursing maintenance for home haemodialysis.


Dr Carney trained in Sydney and Cape Town, and became a fellow of The Royal Australasian College of Physicians when the senior registrar at The Grootescheur Hospital, South Africa.

Dr Carney has practiced renal medicine in the ACT and South-eastern NSW over the last 37 years, and manages patients on dialysis, kidney transplantation as well as general nephrology. Currently he is the Medical Director of the Yorke Dialysis Unit, and the Principal of the Access Nephrology Doctors.


The ASM is hosted by Australian and New Zealand Society of Nephrology.

The aims of the Society are to promote and support the study of the kidney and urinary tract in health and disease, and to ensure the highest professional standards for the practice of nephrology in Australia and New Zealand.

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