How a Tasmanian clinic increased profits by 20% – and beat burnout

Filip Vukasin

18/08/2022 4:43:26 PM

‘Burnout Prevention’, where GPs work altered hours and are encouraged to do restorative activities outside of work, has benefited clinicians and patients alike.

Collage of John St Medical social events.
Dr Bailey Dunn (bottom right) and her clinic staff organise regular social events, such as quiz nights, barbeques, fundraising events and casual get togethers at local restaurants.

Dr Bailey Dunn, originally Canadian but living in Tasmania, bought John Street Medical with her husband in 2019.
The clinic has been in existence for 52 years but soon after Dr Dunn took over, the effects of COVID began to take their toll.
‘We were suddenly struck by COVID and lots of doctors calling in sick, plus the demand for appointments increased,’ she told newsGP.
‘It can be hard to recruit and retain GPs so BOP [burnout prevention] was done to protect staff and patients.’
BOP involved creating a new system of work. Weekend work was eliminated and weekday appointments were increased, leading to opening times of 7.30 am to 7pm.
Doctors only work a half day; either 7.30 am to 1 pm or 1.30 pm to 7 pm.
Dr Dunn says patients are happy with this schedule because they can come in before or after work, and she is often surprised by who is willing to pay.
‘Early morning and late afternoon appointments are premium, so we only privately bill for those times,’ she said.
‘For example, I’ll see a student at 6 pm who says they are happy to pay because that time works for them.’
Dr Dunn is passionate about burnout prevention and says part of that is encouraging other GPs to have activities other than clinical work. All GPs at the clinic are part-time, working 2–3 days per week, and ‘nearly everyone has a side hustle’.
While she is a lecturer at the local university, other GPs do policy for health pathways and some choose to work in alternate clinical settings. For their spare time, Dr Dunn encourages GPs to do a restorative activity that they may not have done before.
‘I started swimming, which as a Canadian I hadn’t done much in the past,’ she said.
‘I feel so much better for it … like a normal human being who isn’t burnt out.’
Dr Samantha Wyton, another GP at the clinic, reports other benefits.
‘It was hard working 9–5 and I was struggling with commitments and two young kids,’ she told newsGP.
‘Now I work a late shift on Mondays and an early shift on Wednesday, and I have time to drop my kids off at school, do some exercise and fit in time to see my husband for lunch.’
The clinic also organises social events, such as quiz nights, barbeques, fundraising events, or casual get togethers at local restaurants, and overall, the changes have led to a 30–40% reduction in GPs calling in sick.
But benefits are not just limited to the GPs.
The practice has five clinical rooms for 13 doctors, and under their previous schedule, the clinic had 125 available appointments per week. Now they offer 199 and Dr Dunn says the profit margin has increased by 20%.
‘I get 2–3 calls per week from GPs who want to work in the practice,’ she said.
‘[The] outcome that has led me to believe BOP is a success – more than increasing profit margins, appointment accessibility and reducing doctor sick days – is having the pleasure of working in a medical centre where people are genuinely happy to be at work.
‘Anybody who has ever been employed will know that job satisfaction may sometimes feel impossible to achieve and I’m immensely proud that we’re doing it.’
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Dr Murray John Schofield   19/08/2022 7:23:18 AM

Great concept and well done.
As a rank and file GP…I have thought about this concept in several practices but owners tend to be a little deaf. But I think the costs to operate after hours my be the reason…let alone the after hours times of Medicare.
I wonder is some of the GP’s are employees rather than contractors in this story?
But just fantastic all the same well done.

Dr Sanjeevan Nagulendran-   19/08/2022 8:24:17 AM

Great example of team work- hope we can also find ways of incorporating some of these ideas into our practice. Reminds me of my time in the army where we worked hard but also had plenty of down time. Thank you :)

Dr Christopher Mark Jones   19/08/2022 2:01:02 PM

I totally agree that flexible working is the way to go; it maintains interest, energy and resilience. I work split shifts: Monday-Thursday 06.30-13.00 Monday, Wednesday and Thursday 16.00-20.00 and Friday 10.00-13.00 The time off allows me to do a lot of sport and exercise and have family time. In addition, every year, I spend at least two weeks locuming in rural/ Indigenous communities or volunteering overseas. This has taken me to the Solomons, Vanuatu, Christmas Island, Nauru and Bangladesh; I encourage all doctors to find their niche and interests inside and outside of medicine to ensure a long, fulfilling and happy career

Dr Craig Bernard Hilton   22/08/2022 2:45:15 PM

I found the headline intriguing, but having read the whole article, I still can't see what the 'magic ingredient' is, one that (as far as I could tell) will let the doctors work fewer hours and earn more money. The anti-burnout aspects, of how they choose to spend this extra spare time and all the efforts to make the worksite more social, are nice, but they're peripheral and don't explain the main focus.
Was it previously so bad that GP's were frequently calling in sick?
And now, is the main difference that the practice is only taking privately billed patients at some sessions of the day? Is that where the extra income is coming from, which is making all the difference?
The article left me with unanswered questions.

Dr James Berryman   27/08/2022 9:13:11 AM

I remember our conversation before you brought the clinic and it is great to see and read about what you have done. You are an inspiration! Well done.

Dr Glenn Tasman Richardson   11/11/2022 1:45:03 PM

Is that a typo - 199 appointments a week for a clinical of 13 doctors ? Surely it's 199 appointments per day ??