General Practice
Health of the Nation

An annual insight into the state of
Australian general practice

General Practice: Health of the Nation 2022

General practitioners (GPs) are the first point of contact for most Australians seeking healthcare.

A thriving, accessible and high-quality general practice sector is vital to the health of Australia.

The RACGP’s General Practice: Health of the Nation  report provides annual insights and draws on specifically commissioned research spanning six years to highlight point-in-time and longer-term trends in Australian general practice. The 2022 report reflects the experiences of GPs from across Australia who were surveyed between 20 April and 15 May 2022. Their feedback was collated with data from a variety of sources to provide a unique overview of the general practice sector.

Each year, members select a topic of focus for the report and this year’s area of focus was sustainability of general practice.

The 2022 General Practice: Health of the Nation report highlights concerning issues that have arisen after years of chronic underfunding. These include:

  • burnout among the profession
  • unsustainable workload and mounting administrative and regulatory burden impacting on the provision of patient care
  • a declining interest in the profession as a preferred career path and a declining willingness from current GPs to recommend the profession as a career.
  • worsening workforce issues with increasing numbers of GPs intending to retire or cease practicing over the next 10 years
  • underfunding of general practice and the unsustainability of general practice as a business

Adj Prof Karen Price 

Hello and welcome everybody.

I acknowledge the traditional owners of the land in which I record this message – the Wurundjeri people. I pay my respects to their elders past, present, and those who are emerging as leaders.

It is an honour to officially launch this year’s General Practice: Health of the Nation report.

The last 12 months have continued to present challenges due to the ongoing COVID-19 pandemic and natural disasters like bushfires and floods. GPs, practice managers, nurses, receptionists, and administrative workers have persevered, and you have done an incredible job. Thank you.

But these pressures in addition to years of chronic and devastating underfunding is taking its toll. While we as GPs we know this, and feel it every day in our practice, this year’s report presents us with the hard evidence that we can and will use to advocate for change. Several concerning themes have emerged from this year’s report which highlight that general practice is in crisis and unless there is immediate policy intervention, the health of the nation will suffer.

Whilst some of the statistics that I will highlight are troubling, it is really important to remember that most GPs do like what they do, and they enjoy their role in caring for their communities. This is shown by the fact that 70% of GPs reported positive job satisfaction. Being a GP is such a rewarding career for so many reasons, but more needs to be done to ensure it is an appropriately supported and valued role – otherwise, frankly, doctors will go elsewhere. And unfortunately, the data is indicating quite strongly that this is already occurring.

The report tells us that less than half of GPs would recommend their profession as a career to junior colleagues. The reasons for this have nothing to do with feeling unfulfilled or disgruntled by their chosen vocation, but rather result from frustrations associated with the impact that burnout, workload, mounting administrative and regulatory burdens, chronic and devastating underfunding and workforce shortages is having on their ability to care for their patients.

Almost three-quarters of GPs reported that they have experienced feelings of burnout over the past 12 months.  Burnout among medical professionals is not new, and many doctors across the world report feeling burned out at some point in their career. However, the pressures of the last few years, particularly the ongoing COVID-19 pandemic and recent natural disasters have exacerbated this trend,

For the very first time, managing workload was reported by GPs as their highest ranked challenge, even ahead of managing practice income. Part of this can be attributed to an emerging theme related to administrative and regulatory burden that GPs face in their roles. Nearly two thirds of GPs identified that the time required to understand and adhere to regulatory changes was a challenge. In addition, more than three-quarters of GPs reported that ensuring compliance with Medicare is taking time away from delivering care to patients. And that includes me. GPs need more time directed toward the care of their patients.

For the sixth consecutive year GPs have reported that psychological issues are the most common health issue that they manage and mental health, especially youth mental health, was the health issue causing GPs most concern for the future.

GPs are carrying a large share of the mental health workload, with patients reporting they are more likely to see a GP for their mental health concerns than any other healthcare professional.  Around 38% of GP consultations incorporate a mental health component.

We know that mental health care is complex and we know that it takes time, but complex and longer care is not supported by the current funding model.

And onto the sustainability of general practice
Many patients are reporting that they are unable to find a bulk billing practice.
For the first time in almost 20 years, the number of GPs services bulk billed has dropped. This is despite GPs bulk billing all COVID-19 vaccinations, and the majority bulk billing key services such as services for children, older patients, and chronic disease management.

Why aren't GPs bulk billing as much as they once did? Well, the rebate simply isn’t enough and without charging a fee for some services on top of the government rebate, we would not be able to keep our doors open.

Only 3% of GPs surveyed feel that the standard Level B Medicare rebate is sufficient to cover the cost of high-quality care. Only 3%.

General practice is up against it, and unless government boosts investment in GP care, more and more practices will be forced to pass the cost on to patients.

This as you know, is not a decision taken lightly and no one relishes the thought of asking their patients to pay more, particularly those struggling to make ends meet at a time of increasing costs of living. However, practices have no other choice because their own practice costs are rising.  Earlier this year there was an increase to the Medicare patient rebates but it was only 1.6% which equates to just 65 cents for a standard GP consult.
nflation over the same period of time was 6.1%. This is not a case of greedy doctors the average income of GPs in Australia sits well below the international OECD average, even though our GPs provide world-class standards of care.

So it’s no surprise that almost half of GPs reported that they feel it is financially unsustainable to continue working as a GP. And 70% of practice owners surveyed reported that they are concerned about the ongoing viability of their practice.  And that’s an increase.

Investment in general practice is sorely needed because the future of general practice care must be secured.
Almost a quarter of GPs surveyed state they plan to retire within the next 5 years.  Less than half of the GPs surveyed believe they will still be practising in 10 years.

Added to this we don’t have enough future doctors choosing general practice as their career. The proportion of final year medical students listing general practice as their first preference has been steadily dropping and has now fallen to just 13.8%.  General practice workforce is also being affected. The nation’s maldistribution of GPs is disproportionately affecting rural and remote areas nation-wide.   Sourcing and retaining GPs has now become the biggest challenge reported by practice owners in 2022. We must do more.

Role substitution is not the answer to a workforce shortage. Ask any GP and they will tell you that they need more time with patients to get to the bottom of what is going on, particularly for mental health issues and people with complex chronic care needs. Distortion is not a solution to general practice. There is no alternative workforce.

It is rare for patients to present with one clearly defined health problem and consults often require expertise in assessment, investigation and in differential diagnosis. We are experts in complexity. We build relationships with our patients over time which help elicit pertinent information to improve their care. Those relationships ensure compliance. GPs know their patient’s medical history and understand care coordination. We ensure patients are not only getting the medicine that they need but also avoiding the medicine that they do not need, or which may cause them harm.

The complexity of GP presentations is why we are doubling down on our calls for at least a 10% increase to Medicare rebates for consultations lasting 20 to 40 minutes and for those 40 minutes plus. As well as a brand-new Medicare item for consults lasting more than hour. Boosting Medicare rebates will have a lasting impact on the health and wellbeing of people who need to have multiple health conditions carefully managed and result in fewer patients ending up in a hospital bed with a problem that could and should have been managed by their GP.

An immediate boost in rebates would send a strong signal from government that they are committed to patient care in general practice.

GPs and general practice teams continue to do a tremendous job, but we need more investment to meet the needs of the communities that we care for.

Only when the vital role performed by general practice is properly recognised and greater support and resources are given to our hardworking practices can we honestly say that we are committed to improving the health of the nation.

Please read our report, and please use our report as proof of the issues we are facing in caring for our communities and help us fight for the necessary changes to our system. It cannot go on.
To all practices I say keep up the great work, your communities need you now more than ever before.
The RACGP will continue to fight for the resources that you need to do that excellent job.

Thank you.

Senator the Hon Anne Ruston

Firstly can I acknowledge the Kaurna people who are the traditional owners of the land on which I speak to you from today, and pay my respects to elders past and present. Can I also extend that respect to any Aboriginal or Torres Strait Islander People at this virtual launch.
Can I acknowledge Nicole Higgins your new President and thank Karen Price for her tireless patience in trying to get me up to speed on all things GP over the last couple of years.
Most particularly, thank you to the Royal Australian College of General Practitioners for the opportunity to speak at today’s launch of the sixth annual General Practice: Health of the Nation report. It’s a sobering report, but it's also very important to understand what's really happening because general practice is at the heart of primary care, you are the frontline of Australia's health system, and this annual survey provides critical information not just for the sector but for governments to help inform policy development and understand further support needs.
For those watching who don’t know me, I'm a country girl from Renmark in the riverland  of South Australia. As the daughter of one of only two nurses in our community growing up, the health portfolio holds special personal interest for me. The local doctors and hospital in Renmark were something that our community was immensely proud of and the concept of community care was just how things were done. Also before coming into Parliament in 2012 I was a member of our Local Hospital Advisory Council. What these experiences highlighted to me is how important the local hospital is to the attraction and retention of GPs, how important GPs are to the strength of the community, how important the permanent relationship with your GP is and how strong community involvement and ownership of health outcomes can deliver real benefits.
Now in my role as the Shadow Minister for Health and Aged Care, I intend to rely on the advice of our health professionals, peak bodies and the patients they support to understand how we can better support these critical aspects of our health system. Over the last couple of months, I’ve been completing a listening tour, or as my staff call it ‘speed dating the healthcare sector’, to build my understanding of health and aged care system. I recognize that I don't know what I don't know, which is why I've been so interested to read the Health of the Nation report being launched today.
I think most would agree that Australia’s healthcare system is world class, but that doesn't mean it can't be significantly improved. But it also must be sustainable and clearly you agree given the topic of interest of this year’s report is the ‘sustainability of general practice.’ Right now it looks anything but sustainable given you’re reporting on GP workload, burnout, administration and regulatory burden and the inadequacy of remuneration provided.
Considering the tireless work of the healthcare sector through Australia's COVID response it's sad to hear, but not unsurprising, that burnout is a significant issue facing the sector. I’m not telling you anything you don't know, but these past few years have been difficult. However, Australia's health response has been recognized as one of the best, if not the best, in the world. I want to take this opportunity to acknowledge the tireless efforts of all our frontline health responders who saved so many lives and livelihoods. And whilst we remain focused on COVID, I acknowledge that health sector is also having to tackle other significant issues, like the highly infectious strain of Monkeypox, a severe flu season and a rise in the number of cases of RSV. I also note that we are yet to fully understand the ongoing impacts of COVID, whether that be the health consequences of the lasting effects of the virus, or the long-term impacts on the health system due to deferred elective surgery and lower levels of GP checkup throughout the height of the pandemic. But one thing is for sure, we need to understand them, and we need to plan for them. Because if we don't, the burden of these long-term issues will fall on our already hard-working health professionals.
It was also concerning to read in the report that the main concern of GPs right now was cited as managing workload, which has overtaken managing income for the first time since the survey began. No doubt the critical workforce shortages facing the entire health system don’t help the burden on out GPs across the country particularly in the rural and regional areas. Everywhere I go and just about everybody I speak to cites workforce is the most critical issue facing their part of the sector today.
Clearly, we have a huge challenge ahead of us to address these health challenges not the least of which is to make being a GP in the bush and attractive decision for medical graduates. It seems to me that this is the fundamental question that needs to be addressed because without it, all other challenges will continue.
I also want to better understand how we can reduce the burden on our health system through preventative measures, because I think the sustainability of the health and aged care systems can only be guaranteed if we focus on vertible interactions with it. We have got to turn our system into one and focus on health and not one that is designed only to respond to disease and illness.
As I’ve said before, I have great ambition to work with Australia’s health professionals and organizations like the RACGP to to find the answers to many challenges that face Australia's healthcare sector. I'm ready to hear your concerns and listen to your solutions to the pressing issues facing you and your communities. I'm keen to take a patient focused approach having always believed the best policies are formed when all the people that are impacted by them are sitting around the table when the decisions are made.
I'm here with an open door and commitment to listening and learning and of course to hold the new government to account.
I wish the RACGP all the best for the launch of this important report and I look forward to us developing a strong working relationship in the best interest of a healthy Australia. Thanks.

The Hon Mark Butler MP

Hello, and thank you for inviting me to launch the sixth annual General practice: Health of the Nation report.
I firstly want to acknowledge the traditional owners, the Ngunnawal people here in Canberra where I'm talking to you from, and pay my respects to the Elders past, present and emerging. This acknowledgement is an important reminder of the work that we still have to do to close that gap in health outcomes and life expectancy between Indigenous and non-indigenous Australians. I also come to you as a proud member of the Albanese government which is committed to a constitutional enshrined voice to Parliament, the first element of the Uluru Statement from the Heart.
I understand this report currently draws on an annual survey of GPs with responses from over 3000 practising GPs and a further 93 GPs in training. This is an important and valuable report and a resource that highlights the issues facing our primary care sector.
Demand for healthcare is skyrocketing and as GPs you are seeing the reality of this every single day. During the recent election campaign, I remember Prime Minister Albanese saying “Every day, everywhere I go, people talk to me about how it's getting more and more difficult to see a doctor” and this is why as a Government we’re committed to working with the primary care sector to strengthen Medicare and make it easier for Australians to access their local GP and other healthcare professionals. Without this it's  going to get even harder to see a GP and the out-of-pocket expenses will only increase. Importantly it's only through fixing primary care that will take the pressure off our overburdened hospitals.
Australians trust their GPs, you are the backbone of our primary care system and I want to take a moment to recognise this and thank you for the work that you do every single day. It’s through the vital relationships that you have with your patients that ensures all Australians can get the quality healthcare they deserve. I’ve said multiple times now, that general practice today is in a truly parlous state. As the new Minister, what I'm confronted with is a sector that's under more pressure than it’s been under at any time in the almost 40 year Medicare era.
Strengthening Medicare was right at the centre of our election health policy and that's why I've convened the Strengthening Medicare Taskforce. We decided to put strengthening Medicare right at the centre of our election pitch to the Australian people because all of us, me, the Prime Minister, and all of my colleagues, we've all been inundated with feedback from our communities about just how difficult it is to get an appointment to see a GP. And it's not just because of Covid, this is been the case over the last decade. This issue points to one you're experiencing which is the pressure to deliver care to your communities under increasing cost pressures. There are so many other issues that need to be addressed as we work together to improve our primary care system. Like improving and expanding multidisciplinary care.
As you know the RACGP is a member of the Strengthening Medicare Taskforce, and I look forward to working with you and hearing your solutions to the challenges that we are facing.
There is no higher priority that I have as a Health Minister and our Government has in the Health portfolio than strengthening general practice. Because we know that without a strong vibrant general practice sector our health care system is going be much much poorer.
Again I look forward to working closely with the College to strengthen Medicare and Australia's primary care system. Thank you all very much

Previous reports

General Practice Health of the Nation 2021

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General Practice Health of the Nation 2020

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Health of the Nation 
Infographic summary

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General Practice Health of the Nation 2019

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General Practice Health of the Nation 2018

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General Practice Health of the Nation 2017

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