Signs point to looming GP workforce crisis in North QLD

Matt Woodley

20/10/2021 5:18:46 PM

There are widespread reports of GPs working long hours and delaying their retirement simply to ‘not let their community down’.

Sugar cane pic representing drop in QLD GP numbers
The number of graduates choosing to specialise in general practice has suffered a precipitous drop in recent years.

The RACGP is warning that a failure to invest adequately in general practice in North Queensland will result in continued increases in overall healthcare costs.
It comes following the college’s submission to an inquiry into the provision of general practice and related primary healthcare services to outer metropolitan, rural and regional Australia, which are under pressure due to a maldistribution of funding and support.
There are also reports of a critical GP shortage in remote, rural and regional areas across Queensland, and RACGP Queensland Chair Dr Bruce Willett believes strong government action is needed.
‘GPs in North Queensland are doing a tremendous job, but the general practice workforce is heading towards a crisis,’ he said.
‘In the state’s north, there are widespread reports of GPs working long hours and delaying their retirement because they don’t want to let their community down. One of the problems we have is that right across Australia not enough future doctors are opting for a career in general practice.’
To support his point, Dr Willett highlighted that the proportion of final year medical students listing general practice as their first preference speciality for future practice has fallen to 15.2%, the lowest since 2012.
For every new GP in Australia, there are now 10 new non-GP specialists. In 2009, there were 119 more graduates specialising outside of general practice. By 2017, that ‘graduate gap’ had widened to 4271 .
‘Australia’s medical intern program is almost exclusively hospital-based. While gaining experience in a hospital setting is important, we must do more to boost experience in general practice during medical school and pre-vocational years,’ he said.
‘Government should invest more in programs that increase junior doctors’ exposure to rural general practice, such as the newly announced John Flynn Prevocational Doctor Program.
‘Other helpful steps would include medical schools fostering students to pursue an interest in general practice, in particular rural placements, by increasing time spent training in rural areas and exposure to leaders in these fields and focussing on generalist competencies as the core of medical training.’
Aside from efforts to engage more junior doctors in rural general practice training and placements, RACGP Rural Chair and Townsville GP Dr Michael Clements says pay and entitlements must change.
‘It is important to be upfront about this – GPs in training face significant financial pressures once they transition from the hospital training environment to general practice,’ he said.
‘It is hardly surprising we face an uphill battle in attracting more people to the profession when hospital salaries have continued to rise year on year and the Medicare freeze has left GPs behind.
‘Being a GP in North Queensland is an incredibly rewarding profession and I would recommend it to any future doctor, but we need to get them out of hospital roles first.
‘If we don’t address inadequate remuneration, we will get nowhere fast, and the long-term sustainability of general practice and patient access to care in North Queensland will suffer.’
One idea floated by Dr Willett that would both increasing funding and encourage more rural GPs to host medical students and junior doctors is a review of the teaching Practice Incentive Payment to ensure it adequately supports practices.
‘I also support the National Medical Workforce Strategy Steering Committee’s proposal to increase research opportunities,’ he said.
‘This can be used as a lever to increase the profile and prestige of the speciality of general practice.
‘Right now, a lack of research pathways, PhD opportunities and representation of GPs in senior academic positions has a harmful impact on medical students’ perceptions of general practice and this must change.’
Dr Clements said the college has recommended that a national body be established to protect GP registrar pay and conditions. This could be through portability of entitlements across rotations and salary parity with hospital-based registrars, which would improve the attractiveness of training in general practice for younger doctors when compared to hospital roles.
‘The protection of entitlements and guaranteed salaries must be offered to all registrars in GP training,’ he said.
‘If protection of entitlements and guaranteed salaries are only offered to those training as rural generalists or rural GPs, a two-tiered system will be created, dividing the profession, exacerbating AGPT recruitment issues, and undermining patient care.
‘The challenges are in front of us but with the right settings in place we can encourage more future doctors to choose a career in general practice, including in North Queensland.’
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Dr Suresh Gareth Khirwadkar   21/10/2021 7:34:38 AM

Being a GP is incredibly rewarding, but prospective new graduates see the difference between non GP specialists and GPs. Far higher remuneration, much less government control, less administrative burden, nobody forcing them to bulk bill or do extra work when they are already stretched too thinly, and far more support from their respective representatives like AMA. It is no surprise that people are not picking general practice.

Dr Gisselle Hull   21/10/2021 7:09:30 PM

It’s no wonder no one is choosing to do GP anymore. I have just qualified and I was earning more money as a registrar than I am as a fully qualified GP! With no pay for maternity, sick or annual leave! It’s nothing to do with academics or more exposure in medical school. If it doesn’t pay the bills no one will actively choose this career. As a deeply disillusioned newly qualified GP I am considering my options for going back to hospital based work. I already know 2 colleagues, one has left for anaesthetic training and the other for ophthalmology. Can you blame them- they will be earning at least 5 times my pay. The solution is simple- stop short changing General Practice.

Dr DB   22/10/2021 12:58:44 PM

I agree with Dr Suresh Gareth Khirwadkar .

It's all about the pay, nobody is listening to the junior doctors or the registrars. Herding medical students and junior doctors into the bush and rural areas is not going to fix anything - in fact the burden may impact their own mental health especially given the current workforce crisis, coupled with the increasing entitlement of medical treatment and the bulk-billing narrative.

Fix the pay for GPs and GP registrars. Or things aren't going to be any better in years to come.