Reports of ‘million-dollar’ GP packages labelled canary in the workforce coalmine

Matt Woodley

30/01/2023 5:54:15 PM

The Shire of Quairading is the latest local council to dig into its own pockets in a desperate attempt to source a GP – but the RACGP Rural Chair predicts it will not be the last.

Doctor holding a 'help wanted' sign
Workforce maldistribution is making it difficult for some areas to attract and retain GPs.

Rural job advertisements do not typically generate nationwide news.
However, the package a small West Australian town is preparing to offer just to entice a new GP – including an annual salary reportedly approaching seven figures – did just that.
‘The council will not stand by idle when the community has such a critical need,’ Shire President Peter Smith told The West Australian.
‘If we don’t have a doctor, we won’t have a medical clinic. Then we won’t have a hospital, we won’t have a chemist and so the demise will begin.’
In addition to a base salary of $300,000 – supplemented by consulting fees – it’s been reported that the GP would also receive rent-free accommodation in a four-bedroom house in the centre of town, as well as have all costs associated with running the practice covered by the Shire.
The position is the latest in a string of similar job opportunities in other rural and remote areas as Australia struggles to deal with workforce maldistribution, but RACGP Rural Chair Associate Professor Michael Clements told newsGP the trouble these towns are having represent more than just a regional concern.
‘What we know is that in rural and remote areas, these issues play out first,’ he said.
‘They’re the singing canaries – where we see the hardest to fill places either offer the highest packages or do without.
‘But this isn’t just a rural or remote problem, we’ve already seen those shortages creep towards the cities.’
Instead, Associate Professor Clements says the increasingly lucrative offers local councils are having to make to attract doctors are symptomatic of a wider workforce problem that will require significant investment to solve.
‘It’s not just about money, but money needs to be part of the conversation,’ he said.
‘Unless we see something significant out of this Medicare reform taskforce and some real investment, the number of towns having to dig into their own pockets is just going to increase.
‘And the money doesn’t come out of thin air. That council has decided to invest less money into its playgrounds, less money into its swimming pool, less money into all of the other community services so that it can get what it needs.
‘It should send shivers down the spine of our health planners, because this is what it’s going to take in a number of years to fill even city positions unless somebody does something dramatic.’
General practice reform is expected to be one of the top agenda items at Friday’s National Cabinet meeting, ahead of the anticipated release of the Federal Government’s Strengthening Medicare Taskforce report.
Recent media reports suggest increasing Medicare patient rebates – one of the priority reforms identified by GPs – will be overlooked in favour of greater funding for multi-disciplinary teams and a shift away from the fee for service model.
But Associate Professor Clements is among those who believe such an approach would not help towns like Quairading.
‘We need to fund other parts of the team, not just GPs, but the reality is you still need a doctor in these teams,’ he said.
‘Quairading is not screaming for a team of non-GPs to come out and help keep its community hospital open. It needs doctors.
‘At the core of the matter, which is best displayed by our hardest to fill places in these remote areas, it comes down to needing doctors, needing GPs and needing to offer them a package which is going to work.’
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Dr Michael Charles Rice   31/01/2023 8:14:54 AM

What’s the ‘worth’ of a metro consultant in private practice? Or an engineer, barrister, stockbroker of similar seniority?

And now what’s the loading to bring them out of the bigsmoke and into the country?

Dr Gaston Boulanger   31/01/2023 8:18:43 AM

'tout est relatif' a million dollar is what a 9-5, Fridays off, cherry picking specialist easily makes a year

Dr Bradley Arthur Olsen   31/01/2023 10:02:53 AM

When I left remote practice , one of the major reasons was the lack of backup by Queensland health dept, when you are cut off by flood water with no way out but by air . Trying to have your patient with anterior MI, sepsis , hand /limb amputation taken to higher level care , only to be told its to dark or windy ( 10 knots). This lack of help when it is needed ,I feel is the major reason many chose not to work remote, the hard work is not.

Dr Murray John Schofield   31/01/2023 11:18:15 AM

Thanks for the example and the difficulty many rural communities face with ongoing and sustainable health care. A key issue that is often over looked is how the local community/council will employ a partner in the setting...this is on of the key can throw money around but if we don't have a programme that embraces the core needs and supports of a rural GP the problem may just amplify...thoughts?

Dr Suzette Julie Finch   31/01/2023 11:21:46 AM

1) Easy one first: Explain with numbers, I consider them more trustworthy than words, how is $800,000 of billings similar to $1000, 000?
2) It is reported the Council will let the GP keep all billings, worth $800,000.
$800,000 of billings, without an in place PM, GP/ CD nurse & reception staff to boot, in a rural WA town with a population of 1,023??
$800,000 divided by 52 weeks is 15,385 Level B consults charged at the private rate of $80 per week, assuming the populous who are funding the local council will still be happy to pay private fees.
BUT 15,385 x 6 minutes (assuming the populous is willing or able to tolerate 6-minute medicine) 92,307 minutes or 1,538 hours per week.
Not sure whether they plan to provide a time machine with the position.
I don't know someone who can do that, although I know of some who. would try!
Even if there is the population base the billings don't add up for me.. possibly that is why most GPs are calling BS!

Dr Peter James Strickland   31/01/2023 4:49:52 PM

The big picture here is the failure of Medicare over the years to GPs --having spent 50 years in general practice, and since the beginning of the Medibank/Medicare era, the expected rebate increases to viable level are the problem. Putting all the monies into EDs without cost to patients was the start of the erosion and the loss of billions upon billions of dollars loss in the economy. Free medicine is a myth --if everyone paid something for their health care in all areas we would now be all "sweet' ==pensioners can pay for meals in hospital and at least $5-10 with every consultation, patients with minor ailments pay at least $50-100 for an ED appointment. Result --viable general practice, less costly hospitals, less waiting lists, and a high standard of medicine --it was there > 50 years ago before socialism under Whitlam and Hawke ruined the health system by stealth.

Dr Ian   31/01/2023 5:00:41 PM

This will help but the doctors recruited have to have great skills in both physical and mental health care .
They ought be able to support brilliant teams of health workers and have good security protection .
Clinics ought be roomy with great equipment and air-conditioned fresh air filtration engineered systems .
Research projects ought be supported to direct and support health care teams in the vital area of communal wellbeing .

Dr Bethany Reynolds   1/02/2023 3:05:22 PM

I’ve seen this discussed in multiple GP groups. The reasons this is not appealing include; hours required to earn supposed amounts, hours/availability expected, supports both locally and for metro escalation of care, community supports for families.

We’re past the era where they can pay a male GP who will move his family anywhere he needs to go, and leave his wife and kids at home to work 12hrs a day and be on call 24/7.

It’s 2023; most of us are choosing the lifestyle that suits us and our families before chasing money and burnout. Make it appealing (in ways other than just $$$) to practice medicine in these communities and people will come.