Health of the Nation: Investment needed to secure the future of general practice

Matt Woodley

28/09/2022 4:00:26 PM

Business sustainability, burnout, red tape and an impending youth mental health crisis headline concerns raised by GPs.

RACGP President Adjunct Professor Karen Price
RACGP President Adjunct Professor Karen Price speaking to reporters at a press conference to launch the 2022 Health of the Nation report.

‘If general practice were a patient, it would have several serious underlying health conditions that if not properly addressed will lead to grim outcomes.’
That is the assessment of RACGP President Adjunct Professor Karen Price, who has used findings from the General Practice: Health of the Nation 2022 report to urge for greater investment and support for Australia’s GPs.
‘The future of general practice care is in crisis and it’s not of our making,’ she said.
‘The disrespect and disinvestment in general practice has had predictable and shameful effects.  
‘Unless things change, more and more practices will face the impossible decision of hiking fees for patients or closing up shop.
‘The ball is in the Government’s court and action is needed right away. Unless that occurs, the health of the nation will deteriorate.’
According to the 3219 practising GPs who took part in this year’s report, general practice is facing a number of significant challenges, including business sustainability concerns, burnout, increasing administrative and regulatory requirements, and a growing mental health burden.
Specifically, nearly half of GPs believe it is financially unsustainable for them to continue working as a GP, while 70% of practice owners surveyed are concerned about the ongoing viability of their practice.
Meanwhile, almost three-quarters of GPs have felt burnt out in the past 12 months, with two-thirds stating the workload is difficult to manage, and less than half having a good work–life balance.

Speaking to reporters at a press conference promoting the report’s launch, Professor Price said general practice is becoming unsustainable for a variety of reasons.
‘It’s a great career … [but] there’s a lot of pressures on GPs. They want to do the work; they love the work. They’re just finding the system they’re working in to be unsustainable,’ she said.
‘We’re having far more complex presentations in general practice and GPs love to spend time with their patients, but Medicare doesn’t support a longer consultation with complex cases.
‘They need to fund patients to be able to access high quality healthcare, regardless of their income, and regardless of where they live. That will go a long way to resolving the challenges that we see now in general practice.’
It would also help ward off a projected shortfall of 11,000 GPs by 2032, Professor Price says, by retaining existing practitioners and encouraging more medical graduates to specialise in general practice.
‘Just 13.8% of future doctors are choosing general practice as their career, and sourcing and retaining GPs has now become the highest priority challenge reported by practice owners in 2022,’ she said.
‘Government can help secure the future of the GP workforce by immediately boosting investment in general practice care so that it is put on a more sustainable, long-term financial footing. This will help ease the pressure on vulnerable patients, their GPs, and general practice teams.
‘Proper resourcing will help attract more future doctors to the profession and make sure all patients, including those in remote and rural areas, get the care they need when they need it.’
Aside from increased funding, the RACGP President also said the Federal Government should ease the administrative burden on general practice, with the Health of the Nation report showing that three in four GPs are spending time ensuring Medicare compliance that could otherwise have been used delivering care to patients.
‘What we have are highly trained skilled professionals, who know what they are doing, being harassed with robo-audits,’ she said.
‘The odd bad apple should of course be subject to rigorous compliance action but the near constant looking over the shoulder of GPs must stop. 
‘It is hardly surprising two-thirds of GPs surveyed for this year’s report identified “understanding and adhering to regulatory changes” as a challenge and that is particularly galling when you consider that this red tape administrative work is largely unpaid time for harassed GPs.  
‘Let’s cut the red tape and let our GPs and general practice teams get on with the job of doing what we do best – providing world-class care to our patients.’
The spectre of compliance action is also impacting business sustainability – and contributing to burnout – with 47% of GPs reporting that they either avoid providing certain services or claiming certain patient rebates due to Medicare compliance fears.
‘The near constant threat of compliance action hanging over GPs … is ridiculous. It is causing undue stress on GPs and impacting access and affordability of care,’ Professor Price said.
‘It’s important to consider the toll that this takes on GPs, with 61% reporting that the complexity of Medicare is something that worries them outside of their workday. 
‘We don’t want to get political – we just want to see our patients. So let us do the job we were trained to do.’
Other major findings are contained in Health of the Nation 2022 report, including that: 

  • only 3% of GPs stated that the current Medicare rebate is sufficient to cover the cost of care
  • one-quarter of survey respondents plan to retire within the next five years, an increase from 18% in 2021
  • only 13.8% of medical students now indicate general practice as their preferred career path
  • less than half (49%) of practising GPs would recommend general practice as a career to their junior colleagues
  • mental health, particularly youth mental health, is the issue causing GPs the most concern for the future
  • for six consecutive years GPs have reported that psychological issues are the most common reason for patient presentations, with 38% of their appointments including a mental health component.
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Dr Peter James Strickland   29/09/2022 11:18:05 AM

This whole process of Medibank/Medicare goes back to the Labor Govts of the 1970s and 1990s ---the problems were totally predictable from the start. Medicare rebates are NOT GP fees should be the policy of the RACGP and tell the government that.---they are what the Govt INSURES the patients against. Rebate retardation over the last 50 years is the result of governments and public servants decisions, and has slowly undermined the viability of GP practice. Tell ALL patients to write to pollies, but charge a fee that keeps you viable and happy ---lawyers and tradesmen do it all the time, so don't worry ---the public need us, and the majority should pay something for their medical care, both at the GP and the hospital ED, and they CAN afford it!

Dr Susanne Jane Oldmeadow   29/09/2022 12:07:38 PM

I applaud and thank Karen Price for her work in advocating for general practice.
She states with clarity the issues that concern us and the obstacles that face us & puts forward solutions in clear and practical terms. For the sake of our patients (including ourselves, as we are all patients at some point) I hope the government will listen.

Dr Peter Enten   29/09/2022 1:49:33 PM

For decades we have pandering to the Government to increase Medicare rebates. They have not done this in the past in any meaningful way and they will not do this in the future.

Practices need to realise that that their future is in their own hands and start charging patients privately. Let's move away from worrying about the Medicare rebate. I think the College should be educating the public that there are no government rebates for physios, and dentists, and to expect to have out of pocket fees for GPs.

Dr William John Dryden Howson   30/09/2022 6:34:05 AM

The changes to CME are a further reason older GP s such as myself will decide enough is enough.It’s hard to replace experience.

Dr Babak Afshar Ebrahimi   19/10/2022 1:39:08 PM

The way Govt is managing Medicare towards GPs, There will be absolutely "No Future" for GP practice in Australia.
Imagine a 25YO, fresh out of Uni who has the opportunity to become, say a Radiologist, and retire at 50. Would they chose to become a GP and still struggle to retire at 80?