SOLDIERS wounded in Afghanistan and returned home will be among thousands of military personnel caught up in a backlash against the outsourcing of medical services for the Defence Force.
Surgeons fear the quality and continuity of care for troops will be compromised by what is seen as a cost-cutting move.
Insurance giant Medibank was awarded a four-year, $1.3 billion contract in June to take over the running of health services for the Australian Defence Force, including referrals for specialist care.
Military doctors on bases had previously referred ill or injured personnel directly to qualified civilian specialists, including for general, plastic or orthopaedic surgery. Those referrals were usually based on ties between medical colleagues stretching back years and the reputation of particular surgeons.
But under the new system - set to begin on October 28 - Medibank will provide a central call centre to make referrals to ''preferred specialist providers''.
Surgeons with existing military patients have until the end of this week to agree to sign up with the new system, run by Medibank Health Solutions, or face being barred from treating ADF members, according to letters obtained by The Age.
But the onerous demands for a three-day turnaround for written reports under the new arrangements, coupled with a cut in fees, has meant many specialists are believed to have so far refused to join.
The Australian Society of Anaesthetists met at the weekend and is understood to be planning a complaint that notification of the changes was given only last month.
The military provides free healthcare, including dentistry, to all serving in uniform. The changes will affect the 80,000 personnel and reservists across Australia but not troops on overseas deployments.
Ian Boyd, from Medibank Health Solutions, declined to say how many specialists had so far signed on to the network or how many would be needed. But he defended the demand for a quick turnaround of reports and was confident of winning over an ''appropriate number'' of specialists.
Those who signed the agreements will be preferred but Dr Boyd said rare exceptions could be made.
''We certainly don't want to interfere with the doctor's clinical treatment,'' he said, adding he was very happy with the response so far.
The changes follow an Auditor-General's report last year that found Defence spent around double that of the wider community on health - a cost explained in part by the need to ensure troops are ready for deployment.
Doctors are reluctant to speak openly about their concerns, fearful of being portrayed as greedy.
But one specialist told The Age the changes risked depersonalising the doctor-patient relationship as well as the bond between medical colleagues.
Specialists had previously charged the Defence Department according to the scale set by the Australian Medical Association. The department said in a statement it was not aware of any concerns raised with Defence Minister Stephen Smith and would ensure continuity of care during the transition period.