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Chapter 2: General practice access

2.2 GP workforce

2.2.1 Distribution

GPs are the only category of doctor in Australia that has seen faster growth in numbers in major metropolitan areas than in regional, rural and remote areas. The number of doctors working outside major cities has grown by 4.8% since 2013, compared to 3.9% in major cities. For GPs, growth outside major cities has been 3.4% per year since 2013, compared to 3.9% within major cities.24

There is strong interest in rural health among Australian GPs. RACGP Rural has more than 20,000 members, 9500 of whom live and work in rural and remote Australia. Almost three in five (59%) GPs in training reported an interest in rural practice, compared to two in five (40%) of other specialists in training.25

One in four (25%) Australian General Practice Training (AGPT) Program participants surveyed said they would like to work in a rural or remote location in the future, with 17% saying they would like to work as a rural generalist in five years’ time.26

2.2.2 Work setting

More than four in five (83%) GPs reported working mainly in group practices, with just 5% working in solo practice. These figures have remained stable over the last five years.3

Figure 18. GPs work in a variety of settings

GPs work in a variety of settings

*‘Other’ responses included private hospital, community healthcare, COVID-19-related setting, headspace, non-government organisation (NGO), family planning clinic, Royal Flying Doctor Services, regional training provider, services for asylum seekers/refugees, telehealth, cancer clinic/services, justice/correctional health, after-hours and medical deputising services, consulting, medical defence organisations (MDO), research, sexual health clinic.
Measure: GP responses to the questions, ‘Which setting is your main practice, where you spend the most time?’ and ‘In which of the following settings have you practised in the past month?’
Base: Total survey respondents, n = 1386.
Source: EY Sweeney, RACGP GP Fellow Survey, May 2021.

Fewer than one in five GPs reported working in an aged care facility in the preceding month, and 56% of those GPs who had not worked in an aged care setting in the past month indicated they were somewhat or very unlikely to work in aged care in the future. Fewer than one in five (19%) reported they were somewhat or very likely to work in aged care in the future, and one in four were unsure.3 Section 1.2 Issues requiring policy action discusses drivers for GP participation in aged care settings in more detail.

Figure 19. The number of GPs at each practice varies

The number of GPs at each practice varies

Data of less than 5% not labelled.
Please note this data cannot be directly compared to previous editions of the report due to differences in the question and response options in the RACGP member census.
Measure: RACGP member response to the question, ‘Approximately how many other GPs do you work with at the location you currently work or spend the most time working?’
Base: Survey responses, n = 2078.
Source: RACGP member census, February 2021.

2.2.3 Demographics

Age

The GP workforce is ageing, with the proportion of GPs over the age of 65 increasing each year, from 11.6% in 2015 to 13.3% in 2019.27

Figure 20. Distribution of the GP workforce by age

Distribution of the GP workforce by age

Measure: GP full-time equivalent (FTE), by GP age, 2019–20.
Base: Total number of FTE GPs in 2019–20, n = 29 853.8.
Data source: Productivity Commission. Report on government services 2021. Canberra: Productivity Commission, 2021.

Retirement intention

Almost one in five (18%) GPs surveyed said they intend to retire within the next five years, an increase from 14% in 2017. The proportion of survey respondents who stated they will not retire within the next 10 years has fallen from 64% in 2017 to 57% in 2021.3 This could be related to a higher proportion of survey respondents aged over 45 years in 2021 (66%) compared to 2017 (60%).3

Figure 21. Almost one in five GPs intends to retire within the next five years

Almost one in five GPs intends to retire within the next five years

Measure: GP responses to the question, ‘When do you intend to retire from practising medicine?’
Base: Total survey respondents, n = 1386.
Source: EY Sweeney, RACGP GP Fellow Survey, May 2021.

Country of initial qualification

In regional, rural and remote areas, international medical graduates (IMGs) can be a flexible and mobile solution for temporary or ongoing medical workforce shortages. Until 2019, the number of GPs who are IMGs was increasing more quickly than the number of locally trained GPs. However, this growth slowed when the 2020 border closures caused by the COVID-19 pandemic reduced overall immigration into Australia by around 90%, although medical practitioners remain on the Priority Migration Skilled Occupation List.24

The percentage of GPs who are IMGs is reported to have grown from 43.1% in 2013 to 44.8% in 2019.24 In 2020, the proportion of vocationally registered GPs who attained their medical degree overseas was 51% (Figure 22).

Figure 22. A higher proportion of GPs attained their basic qualification overseas than in Australia or New Zealand

A higher proportion of GPs attained their basic qualification overseas than in Australia or New Zealand

Measure: Proportion of FTE GPs, by place of basic qualification and GP category, 2020.
Base: Total number of GPs in 2020 (head count), n = 37,785.
Please note that due to changes in the way the Department of Health reports GP workforce data, this information cannot be compared to data included in editions of the Health of the Nation report prior to 2020.
Data source: Department of Health. Health Workforce Division. Unpublished data provided to the RACGP, June 2021.

2.2.4 Practice owners

Almost one in four (23%) GPs reported that they own all or part of a practice.3

Almost two-thirds (63%) of these practice owners are in metropolitan areas, more than half (58%) are male and almost four out of five (77%) are aged 45 or older (Figure 23). These proportions have not changed significantly over the five years of the Health of the Nation survey.

Of AGPT Program participants surveyed, 14% said they would like to own their own practice and 18% would like to purchase or buy into an existing practice in the future.26

Figure 23. Practice ownership varies according to rurality, gender and location

Practice ownership varies according to rurality, gender and location

Measure: GPs who reported they own all or part of a practice, split by rurality, gender and age.
Base: n = 167.
Source: EY Sweeney, RACGP GP Fellow Survey, May 2021.

2.2.5 Aboriginal and Torres Strait Islander people in the health workforce

Organisations providing Aboriginal and Torres Strait Islander primary healthcare services employ about 4300 full-time equivalent (FTE) health staff, nearly half (48%) of whom identify as Aboriginal and/or Torres Strait Islander.28

Nurses and midwives are the most common type of healthcare worker in these facilities, followed by Aboriginal and/or Torres Strait Islander healthcare workers and practitioners and GPs (Figure 24). The number of FTE GPs employed in Aboriginal and Torres Strait Islander primary healthcare services increased from 568 in 2018–19 to 596 in 2019–20.28

Figure 24. GPs are an important part of Aboriginal and Torres Strait Islander primary health services

GPs are an important part of Aboriginal and Torres Strait Islander primary health services

Measure: Number of FTE healthcare workers employed by Aboriginal and Torres Strait Islander primary health services in 2019–20, according to Aboriginal and Torres Strait Islander status.
Source: Australian Institute of Health and Welfare 2021. Aboriginal and Torres Strait Islander specific primary health care: results from the nKPI and OSR collections. Cat. no. IHW 227. Canberra: AIHW.

In 2019–20, Aboriginal and Torres Strait Islander primary healthcare services saw around 469,000 patients and provided 3.5 million episodes of care. This has decreased from 500,000 patients and 3.7 million episodes of care in the previous year.28 This decrease likely reflects the impacts of the COVID-19 pandemic, such as restrictions on travel, reluctance to travel and barriers to using telehealth.

The rate of Aboriginal and Torres Strait Islander medical practitioners has increased from 1.7 per 10,000 Aboriginal and Torres Strait Islander people in 1996 to 5.3 per 10,000 in 2016.23 General practice is the most common specialty of choice for Aboriginal and Torres Strait Islander medical graduates (Figure 25). Of RACGP members, 86 Fellows, 63 GPs in training and 170 other types of members identify as Aboriginal and/or Torres Strait Islander in 2020–21.

More than half (56%) of GPs in training surveyed agreed or strongly agreed with the statement, ‘I have an interest in Aboriginal and Torres Strait Islander health/healthcare’, compared to 44% of trainees in other specialties.25 In 2017, the majority of employed Aboriginal and Torres Strait Islander medical practitioners (62%) were aged under 44 (62%).23

Figure 25. General practice is the most common career for Aboriginal and Torres Strait Islander medical graduates

General practice is the most common career for Aboriginal and Torres Strait Islander medical graduates

Measure: Rate per 100,000 of registered practitioners employed in their field by profession and Aboriginal and/or Torres Strait Islander status, Australia, 2017.
Source: Australian Institute of Health and Welfare. Aboriginal and Torres Strait Islander Health Performance Framework report 2020. Canberra: AIHW, 2020.

More than 10% of AGPT Program participants reported they were in an Aboriginal health training post in the first semester of 2020. A further 11.6% reported they had already completed training in an Aboriginal health post.26

Almost one-third (28%) of AGPT Program participants surveyed reported they are considering training in an Aboriginal health post in future, and 16% said they would like to work as a GP in Aboriginal health in future.26

  • 3. EY Sweeney. RACGP GP Fellow Survey. Melbourne: EY Sweeney, 2021.
  • 23. Australian Institute of Health and Welfare. Aboriginal and Torres Strait Islander Health Performance Framework 2020 summary report. Canberra: AIHW, 2020.
  • 24. Scott A. The evolution of the medical workforce. Melbourne: The Melbourne Institute, 2021.
  • 25. Australian Health Practitioner Regulation Agency, Medical Board of Australia. Medical Training Survey 2020. Melbourne: AHPRA, 2021.
  • 26. Taylor R, Clarke L, Radloff A. Australian General Practice Training Program: National Report on the 2020 National Registrar Survey. Melbourne: Australian Council for Educational Research, 2021.
  • 27. Productivity Commission. Report on Government Services. Canberra: Productivity Commission, 2021.
  • 28. Australian Institute of Health and Welfare. Aboriginal and Torres Strait Islander specific primary health care: Results from the nKPI and OSR collections. Canberra: AIHW, 2021.
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