I find myself pondering on how the Media and the Public perceive Canberra’s GP workforce.
As Scientists medical practitioners are taught to deal with facts and not with anecdotes so let’s review the facts:
Who is the typical Canberran?
According to the 2016 Census the typical ACT Resident is :
- In their mid 30s
- has a 47.9% change of being married
- Has a median weekly personal income of around $ 998 and a household income of $ 2, 070 per week
Other sources paint an even better picture:
- The Full-time Adult Average Week Ordinary Time Earnings (AWOTE) in the ACT in 2017 was $1,776 (and note this does not include the overtime and other entitlements that Public Servants and private employees get)
- AWOTE recorded the highest growth of all jurisdictions in 2017
- ACT unemployment rates are the second lowest in the country at 4.8%
- 9.9% of ACT residents works for the ACT Government
- in 2015/16 the 73,700 Commonwealth public servants in the ACT earned an average income of just less than $ 100, 000 for the year
- A Senior Doctor working in the Health Department would earn a base salary of around $ 170,000. Typical entitlements would increase that amount considerably
Who are the ACT GPs?
The vast majority of General Practitioners are either self employed contractors or own their own businesses. They are therefore not drawing wages or having any of the typical entitlements most of their patients would have at work – things taken for granted by many such as holiday leave, personal leave, overtime, maternity leave, study leave, etc.
According to the Health Department the ACT GP workforce in 2016 was made up of:
- 523 doctors of whom 481 were registered as Specialist General Practitioners and on the Vocational Registered list (this group includes a small number of Trainees as well) – these are people with a minimum of ten years formal training.
- 202 of these doctors were over the age of 55 which suggests they have likely been working in the field for 20 or more years after qualifying
The best guide on what the work environment for General Practitioners across Australia consists of is found in the MABEL surveys:
- A typical male GP works 42h a week and a female GP works 33h a week – averaging out to 38h per week
- There is an increasing move to working for large (6 or more full-time GP) clinics as smaller clinics are increasingly nonviable and closing down.
- The bulkbilling of patients remains static at around 60% of all attendances (as opposed to measuring the services provided)
- The median GP personal income is around $100 per hour – assuming the GP takes four weeks of (unpaid) leave a year that would be similar to what a senior doctor working for the Commonwealth would earn as a baseline
- The need for extra, very expensive support staff keeps increasing
The reader might be tempted to ask – why is he writing about this?
The first was a series of letters appearing in the Canberra times
Having read the first section of this post my readers would clearly understand the fallacies and inaccurate claims in this letter, not to mention a total lack of understanding of how Medicare functions, and I accordingly wrote a detailed reply to the Canberra Times on the matter. Unfortunately this publication has a tendency to only publish letters that suits a particular discourse and my letter was ignored.
Prof Robson from the AMA also wrote in and the Editor saw this as manna from heaven
This was perfect fodder to start the old “AMA is the mightiest Union in the Country” refrain and a series of letters along this line followed with the creme de la creme being the letter today in which the author wishes to advise readers that
“many general practitioners are now charging up to an incredible $700 per hour”.
Given that this narrative suits the longstanding and proud tradition of doctor bashing by the Canberra Times they obviously had no concerns in reproducing such factually incorrect nonsense.
My second reason relates to the longstanding concerns that I, and most other Canberra GPs have with the wasting of ACT tax money on the expensive duplication of existing GP resources (note the complete absence of the likes of Mr Kelly in this debate).
A while ago my open letter to Minister Fitzharris was penned – this created a brief bit of Media attention and I even had a brief appearance on TV before the issue was hijacked by Win News as an opportunity to play the two major political parties off against one another instead of focusing on the issue at hand.
After three months’ of agitating I thought we would get somewhere when we finally had a meeting in Gungahlin about the proposed new $ 13 million Walk in Clinics. A significant number of GPs attended to hear what ACT Health Representatives (sans the Minister who had more important commitments elsewhere) had to say.
The meeting was “interesting”:
- There was to be no discussion on whether the Clinic would be built. It was a foregone conclusion.
- It was pointed out that the services being provided offered nothing that was not already offered by several GP clinics within walking distance from the site – bulkbilling and open on weekends. It did not matter
- It was pointed out that there has not been any needs assessment nor evidence that there was any need for this duplication of GP services. It did not matter
- It was pointed out that all data suggests these services are 4-5 times more expensive than when provided by a bulkbilling GP. It did not matter
- It was pointed out that these models were failing overseas and being closed down. It did not matter.
- Many examples were provided of major deficiencies in service provision at The Canberra Hospital and how the money could be spend on rectifying that. It did not matter
- It was pointed out that ACT taxpayers, the GPs in the room, were seeing their own taxes being used to set-up a directly competitive service. It did not matter
In the end the attending GPs were effectively told to suck it up, accept that their Government was going to spend millions on these clinics and that the only role for GPs was to find ways to incorporate the existence of the WiCs into their daily workflow.
So it seems we live in a world where anecdote and political agendas trumps facts and data at every corner. Where the illusion of rich greedy GPs who are gouging the poor and vulnerably Canberrans is rolled out by the Media despite all the facts and statistics pointing towards the average Canberran having an equal, or often better, financial package and working hours that their GP could ever dream of having.
Not to mention ACT Health lavishly spending limited resources on their own version of pink batts – or was that white elephants?