GPs despair as work pressures on the rise

Medicare freeze may end

Malcolm Turnbull has given the clearest indication yet that the freeze on the medicare rebate given to GP's may soon end.

Family doctors may become harder to find as higher patient expectations and lower financial returns dissuade medical students from becoming GPs.

A new report by the University of Melbourne has seen a drop in job satisfaction, work-life balance and private practice ownership since the Medicare freeze of 2013.

The report released last week states Australian GPs face continuing and significant challenges due to decreasing Medicare revenue and more complex medical problems presented by patients.

"We work very hard and the expectations of patients is higher than ever before": Dr Amanda Newman.
"We work very hard and the expectations of patients is higher than ever before": Dr Amanda Newman. Photo: Joe Armao

The number of GPs is growing relatively slowly, and for every new GP there are now 10 new specialists it said.

"We work very hard and the expectations of patients is higher than ever before," said Dr Amanda Newman, a GP of 40 years' experience currently working in bayside Melbourne. 

Dr Newman is one of 32,275 general practitioners around the country, a growing number of which are women. But those women are paid 25 per cent less than men.

"There's a financial disadvantage in spending longer with your patients and, on the whole, female GPs tend to spend longer than male GPs" she said.

Medicare currently compensates $37.05 to clinics for each consultation under 20 minutes.

Dr Bastian Seidel, chief of the Royal Australian College of General Practitioners, is worried the pay gap will deter young women in medicine.

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"If you are a medical student and you're coming out of university with significant debt, you have to make a decision" he said.

Dr Seidel says financial security is a problem for men and women GPs alike. 

According to the ANZ Melbourne Institute Health Sector Report, Medicare revenue for a GP working the equivalent of full-time hours has fallen in real terms since the Medicare freeze in 2013.

One doctor spoken to for this report said the drop in income was resulting in "dispirited" doctors.

"Financial security for GPs is a massive issue. On average, they are earning less than half than a hospital doctor," said Dr Seidel.

Dr Seidel, who works in Huonville, Tasmania, said his privately-run practice is virtually non-profit based on the percentage of concession holders, including pensioners and veterans in his area who all need to be bulk-billed.

"I've changed my income protection to 70 because I just know I'm going to work that long now," he said.

"Where do I get the income from considering I have to pay my staff well? Considering I have rent, electricity, materials and medical indemnity all going up?"

Another major shift reported in the University of Melbourne findings is the lower proportion of GPs who own their own practice, suggesting a rise in corporate ownership.

Australian General Practice Alliance vice-chair Sean Stevens believes red tape and government policy is responsible for the decline.

"It absolutely rings true for me there are more and more corporate clinics. The financial benefits of being a practice owner are being eroded," he said. "Red tape is driving a lot of GPs to distraction."

Director of the Hornsby-Brooklyn GP Unit Dr Elizabeth Marles said a further concerning element of the report was the emergence of more and more medical students opting for specialisation. It found that for every new GP there are 10 new specialists.​

"We do not need more specialists. What will happen if we have that is higher costs and more fragmented care.

"It means that for most people, the idea of a family doctor is becoming harder and harder to find," she said.

The University of Melbourne report analyses 10 years of the latest available public data about general practice as well as a custom-designed study - the Medicine in Australia: Balancing Employment and Life (MABEL) survey of doctors.

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