Too many Doctors in the ACT

My attention was drawn to the article in today’s paper and I had to stop for a moment and wonder if this is the same ACT that I live in that our Honorable Minister is referring to.

I believe a few comments are warranted:

Firstly the article makes it seem that the oversupply accounts for all health services when they are actually referring to positions within ACT Health and the Commonwealth Health sector. Small private GP clinics are still out in the cold. The best we can do is try and pay recruitment agencies exorbitant fees to present us with partially qualified  candidates from overseas as there are simply no fully qualified GPs responding to our advertising for the open positions. It would be interesting to see an actual study on how many small independent clinics remain in Canberra as we seem to be getting fewer and fewer while the large Corporate types pop up around us. The ACT Government’s answer to this is to open more Nurse-led walk-in clinics (again the subject of a different discussion in regards to poor clinical insight, etc.) and to give public support to large groups from Interstate offering bulk billed after hours home visits using partially qualified IMGs (easier to do if you do not have the expenses of actually having to run a clinic)

This brings us to the ACT public Health system – it is really hard to believe this over supply spiel when:

  • Nearly all public joint replacements are now being performed at a private hospital (and today I was handed a note by one of these patients advising us that the patient’s GP is responsible for coordinating the care in the community post-op – first I hear of this new arrangement)
  • We cannot access anything but category one Urology services at TCH
  • We cannot access anything but Cat one or two ENT services at TCH
  • I have had newly diagnosed leukemia patients told that their first appointment with a Haematologist would be three years away
  • GPs are not allowed to send patients directly to Orthopaedic services anymore
  • On the Northside we have no acute Orthopaedic, ENT or in fact most OPD services
  • We effectively have no Public Plastic Surgery in the ACT
  • Pain Unit wait is over a year
  • Neurology OPD services has a similar wait

I could go on but you get the picture. I could be forgiven for cynically thinking that this article is more about politics than medicine

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5 Responses to Too many Doctors in the ACT

  1. “…pay recruitment agencies exorbitant fees to present us with partially qualified candidates from overseas as there are simply no fully qualified GPs…”

    Do you mean that candidates from overseas are just a problem and cannot be a source of enrichment to Australian general practice?

    • Thinus says:

      Off course not Andreas and I fail to see how you can make this a Xenophobia issue.
      In case you have not tweaked I am an IMG, my wife is an IMG and our part-time doctor is one so it would be pretty strange for me to have a problem with overseas trained doctors.

      The issue is very straightforward: If I could source an Australian trained GP with a FRACGP/FACRRM I could simply get them a provider number, sign a contract and they could start working within a few days. No great drama or cost to me if they then bail later on for whatever reason

      With an IMG every single scenario is hard work and potentially a very expensive risk for us:
      a. It nearly always involve a Recruitment Company and costs for these guys range between $ 11,000 and $ 25,000 per candidate.
      b. If they are currently overseas we get drawn into Visa sponsorships, “look-see flights to Australia”, enormous hassles getting them assessed by APHRA and the relevant Colleges, etc.
      c. Even if they are already in Australia on a 457 it still involves most of the issues raised above. In addition there are the various steps to get them a 19AB exemption to get a provider number – once this has been achieved they remain non Vocationally Registered which has very significant implications for our patients when they claim the Medicare rebate in our predominantly privately billing clinic.
      19AA exemptions (IMGs who have not yet gained VR status) cannot work in Canberra other than for a deputising service (hence the new after hours bulkbilling service) or at the Aboriginal Health Centre

      We have over the last 14 years twice bit the bullet and imported an IMG – both times it cost us around $ 50,000 before the Doctor was actually able to see a patient – these type of expenses are very hard to cope with in a small clinic.

      The last point – we have in the past found out that the contracts we sign with IMGs are not worth the paper they are written on. I was reminded by this recently when approached by a recruitment agency. They offered, at an $ 11,000 finders fee, to introduce me to a nonVR doctor who worked in a clinic less than 10km away. I was still considering the possibility of taking his visa sponsorship, etc. on but the dealbreaker was when the recruiter told me I could ignore his current employer’s restriction of trade clause as “these things never held up in court”. This told me enough about the people I was dealing with to pass on the opportunity but unfortunately her comment is very true

      • Didn’t know you’re an IMG. 😉 Just started reading here, not at least to improve my language skills.

        I have already realised the vast bureaucracy (Visa, RACGP) – I don’t think it is realistic to cope with all that without a recruitment agency. On the other side, here in Germany it is much too easy for IMGs to get a work permit…

        However, I hope to survive the paperwork, learn what I have to learn and find a nice place to live in Australia next year!

  2. Don’t even get me started. Seems to me it’s impossible for IMG to get GP training position in ACT before 10 yr moratorium even if circumstances such that can’t travel. If we refer pt’s from ED to GP takes up to 4 weeks to see your regular GP so we end up spending at least half of our time on non emergency matters. And agree with you on specialist waiting times. And politics.

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