A Queensland doctor with more than 40 years’ experience warns Australia’s doctor shortage is likely to get worse and that more practices could close as graduates abandon general medicine as a specialty.
- The Royal Australian College of General Practitioners says medical graduates prefer other specialties to general medicine.
- One family doctor says that’s because medical professionals with a narrower focus make three or four times as much as family doctors
- The Federal Minister of Health admits that young doctors are leaving the general practice “in droves”.
Susan McDonald, who has practiced in Cairns for 26 years, says GPs are “the domestic workers of the medical world”.
Because they see dozens of patients every day, Dr. McDonald tells GPs to fill out ever-growing mountains of paperwork and reports for everything from workers’ compensation to jury excuses.
dr McDonald believes the long hours and relatively low pay — particularly for bulk billing doctors — discourage young doctors from becoming general practitioners.
“It’s easier to go into specialty, a lot easier because it’s a narrow focus,” she said.
“You can be good at this one thing and you’ll get paid four times more than a family doctor.”
dr McDonald said the practice where she works has three fewer doctors than usual.
She said that like many other medical practices, it is on the brink and warned it could have wider implications for patients and the community.
“If we don’t get more doctors, then the practice will have to close, and that has happened to a number of other practices,” said Dr. MC Donald.
Go out in droves
A survey by the Medical Deans of Australia and New Zealand found that 16.7 per cent of senior medical students listed general practice as their first preference for their future specialty in 2017.
The same survey in 2021 found the numbers fell to 14.7 percent, the lowest rate in 10 years.
One doctor-in-training, who requested anonymity out of concern for future career prospects, said the stress GPs face and the rate they are paid discourages medical graduates from their specialty.
“To be a good and confident general practitioner requires an enormous range of skills,” they said.
“You have to know a little bit about medicine.
“It’s a huge job that doesn’t just require medical school and general practice training – it’s something you take 15 to 20 years to do well and feel comfortable in what you know.
“For all that training and all that stress and treating hundreds of patients a week when you’re working full-time, it doesn’t reward well.”
In a statement, Federal Health Secretary Mark Butler admitted that young doctors were “dropping out of general practice in droves” and blamed the previous administration for “nine long years of cutbacks and neglect of Medicare.”
“The Albanian government is committed to investing in primary care and strengthening Medicare with investments of nearly $1 billion,” he said.
dr McDonald said it’s a common misconception that GPs who do bulk billing are paid a salary.
“We don’t get any salary at all,” she said.
“We are private companies – contractors.
“We have to pay our super, holiday pay, sick pay, educational leave, etc. ourselves, and we don’t earn enough for that.
“The younger doctors will have a hard time paying back the huge loans they got.”
The junior doctor said it was well known among medical graduates that choosing to major in general practice would mean persistent HECS debt.
“I work in a hospital doing my first year of GP training and as an intern in the hospital I make more money there than as a first year GP who is actively in training,” they said.
“I’ll be taking a pay cut next year to go to community and train as a general practitioner, but for me it’s a pathway to other career opportunities.”
Mental health presentations are on the rise
The latest figures from the Australian Bureau of Statistics show that 43.7 per cent of Australians aged 16 to 85 have experienced a mental disorder at some point in their lives.
In 2020-21, one in six Australians of the same age group had suicidal thoughts or behavior.
In the same year, 3.4 million Australians sought medical advice about their mental health.
Of these, 12.9 percent went to a general practitioner.
dr McDonald said managing patients’ mental health issues is becoming increasingly difficult under the current billing model.
“Psychiatrists have half an hour to an hour and we’re supposed to try to do it in 10 minutes,” she said.
“To find out if they’re having suicidal thoughts, if it’s something really serious, if we can put it off or if we can try to make another appointment.
“It’s going to be an awful juggling game trying to figure out how to do it.”