with the type of services often delivered in primary care settings such as physician advice and the treatment of common conditions attracting lower fees than specialist services the current payment system pushes service providers towards delivering additional services that provide higher fees a further challenge to increasing fees for patient counselling and more cognitive services has been the poor coding showing which services are actually delivered when a doctor provides a standard consultation in a health clinic better coding could provide policy makers with the possibility of increasing fees for consultations for patient counselling and offsetting this through reductions in fees for consultations associated with lab tests such as radiology and endoscopy there is a risk that such a policy may fail to change the underlying culture of doctors not prioritising counselling their patients and indeed could simply be absorbed as a higher payment for a similar amount of work