19 September 2019

Checking the health of Australia’s GPs

The Royal Australian College of General Practitioners (RACGP) has launched General Practice: Health of the Nation, its annual health check-up on general practice.

RACGP President Dr Harry Nespolon presented the report to some of Australia’s key-decision makers, including Federal Health Minister Greg Hunt, Shadow Health Minister Chris Bowen and Greens leader Richard Di Natale at Parliament House this morning.

Dr Nespolon said this year’s report took a careful look at not only the health of patients, but also the GPs responsible for caring for them.

“Each year the report has a special area of focus, and in 2019 that topic was GP self-care and wellbeing,” he said.

“It’s not often enough we stop and ask ourselves whether we are doing enough to help those who are helping others in the community.”

Dr Nespolon said the health of GPs, particularly their mental health, deserved close attention.

“We know that healthier doctors will equal a healthier population. It’s vital to ensure our GPs are getting the care and support they need so they can continue to provide the best possible healthcare to all Australians,” he said.

“Research shows that doctors experience higher levels of mental distress than the general population. Yet four in 10 GPs report that they have personally delayed seeking treatment or care in the past two years.

“Part of this can be attributed to time constraints, but some doctors also feel uncomfortable seeking care from other GPs.”

A significant deterrent in seeking care, Dr Nespolon said, was GPs’ fear of mandatory reporting of health problems.

“With the exception of Western Australia, all of Australia’s states and territories require doctors to report their colleagues if they believe patient safety is at risk, and this includes if a colleague has sought their help as a patient,’ he said.

“Almost one in 10 GPs surveyed indicated they had delayed seeking care for their own health because they were worried about being reported to regulatory bodies.

“We believe doctors should be exempt from mandatory reporting so they feel free to discuss their health issues confidentially.”

Dr Nespolon said it was easy to see how general practice work could impact on practitioners’ mental health outcomes, particularly given so many are under pressure to keep pace with their workload.

“Half of GPs surveyed in 2019 – 49% – said their workload could be excessive, a 6% increase from the previous year,” he said. “And almost one third – 31% – reported that their workload had increased in the past two years, compared to 27% in 2018.

“That tells me GPs are under the pump and feeling increased pressure in their roles.

“More and more is being expected from our GPs, and this can have an impact on their own health and wellbeing.”

One in four GPs (24%) report that this excessive workload can sometimes or often impact their work.

“These figures are alarming, but the solution is not to outsource the important work of general practice by increasing the scope of work for other health professionals like pharmacists. The solution is to appropriately fund the system so that the burden on our GPs does not become too great,” Dr Nespolon said.

The RACGP President noted that this situation was having an obvious impact on work–life balance.

“GPs are working longer and longer hours and feeling more pressure; just 61% reported being able to maintain a good work–life balance,’ he said.

“Predictions for the future aren’t looking good, either, with 26$ of GPs believing that balance will not improve in the next year.”

This could have long-term consequences for the general practice workforce, Dr Nespolon warned.

“Being a GP is never easy and we need to make sure that general practice is considered an attractive option for medical graduates,” he said.

“However, the signs aren’t promising. Although the overall number of medical graduates nationwide is increasing, more and more of them are choosing specialities over general practice.

“For every new GP there are almost 10 new other specialists. The gap is getting worse – the difference between the total number of GPs and non-GP medical specialists has increased from 119 in 2009 to 4271 in 2017.

“So we have plenty of medical graduates but fewer of them are opting for a career in general practice. If they have concerns over excessive general practice workloads and the impact this will have on their mental and physical health, it is going to be harder to attract more graduates to this field.

“More than one third of GPs are over 55 years of age, so we need plenty of young people choosing to enter the general practice workforce. Ensuring they view being a GP as an attractive career path is essential to the nation’s healthcare system.”

Other key highlights of the 2019 General Practice: Health of the Nation report reveal that:

  • patients talk to their GP about mental health more than any other issue
  • GPs are avoiding or delaying seeking their own healthcare for a range of issues, in part due to concerns about being reported to regulatory bodies
  • out-of-pocket costs are increasing at double the consumer price index, with the average patient cost now higher than the rebate for a standard GP consultation.
  • 14% of those delaying a GP visit do so because of cost concerns
  • there is a decline in the proportion of services bulk billed outside of major cities
  • more and more medical graduates are choosing other medical specialities over general practice, in part because a large amount of general practice work is unfunded
  • the costs of providing care are increasing year on year and not being matched through appropriate health funding
  • Medicare rebates remain the top priority health policy issue for GPs.

You can read the report here.

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