There has been a decline in young doctors pursuing general practice over the last half-decade and it is leading to the likelihood of primary care’s collapse.
The number of young doctors choosing to specialise in general practice (GP) has dropped to an all-time low. Over the last five or so years, the drop has not been this low. Doctors are warning that this trend threatens to push primary care to the edge of collapse.
According to the Royal College of General Practitioners (RACGP), the figures indicate that 1394 medical graduates applied to undertake GP training in the college’s latest intake. This is a 30 percent drop from almost 2000 applications in 2017.
“We are at serious risk of running out of GPs. Young graduate doctors have so many choices, but it is not attractive to them to pursue a career in general practice.” Said RACGP president, Dr Karen Price.
Australia is headed toward a significant and serious undersupply of GPs by 2030, with an anticipated shortfall of 9298 full-time GPs according to a Deloitte Access Economic report from 2019. This is almost 25 percent of the GP workforce. Urban areas are expected to see the largest drop-off.
“We have a big workforce issue and general practice has suffered. The system is on the verge of collapse because of a lack of investment in primary care,” said Price.
She also suggested that while COVID 19 has prevented doctors from overseas from applying for training in Australia, the number of applications that have been submitted to the college has been on a slow decline for years.
Young doctors are perturbed by “how rushed primary care is.” According to GP Isabel Hanson, a locum at the Maari Ma primary health care service in Broken Hill. “There isn’t enough time for high-quality medical care for complex patients,” she said.
Hanson chose general practice because of “the sense of meaning and satisfaction that comes from making a real difference in people’s lives,” whether that is picking up cancer early, or providing care to the most vulnerable patients.
Cuts to Medicare have gutted primary care and this has pushed GPs to practice “fast medicine or charge a gap fee, which families on the poverty line can’t afford” according to Hanson.
“Fast medicine is like fast food. It isn’t good long term. If we keep going the way we are going we will see rising rates of diabetes, depression, heart disease, and obesity,” she said, “A healthcare system cannot run on goodwill alone.”
Hanson said that GPs need better access to parental leave and more GP academics teaching medical students at university: “Medical students don’t get taught by GPs, so they don’t imagine their future careers as one.”
There have been government cuts to Medicare funding for GPs to interpret ECGs. ECGs measure whether a person is having a heart attack or life-threatening irregular heart rhythm. This is particularly concerning.
Research published by the University of Melbourne in 2021 found that non-GP specialists are earning almost twice as much as GPs. Incomes increased by 10.7 per cent for GPs (from $189,574 to $209,938) in the decade to 2018, while specialists increased by 21.5 per cent (from $338,554 to $411,575) over the same time.
Kean-Seng Lim, a doctor from Mt Druitt said that medical trainees are choosing other specialist fields due to “lower remuneration compared to other medical specialties… and because general practice is also often portrayed poorly during medical school and hospital training.”
Healthcare CEO at Wentworth, Lizz Reay said she had observed a slow decline in the number of GPs in Penrith and the Blue Mountains over the past five years. These areas now have two-week-long waiting lists.
“If we don’t work out why people are going into general practice, to begin with, we won’t ever solve the problem. We will just keep shuffling doctors from region to region.” She said.
She also suggested that because the Medicare fees have been stagnant for such a long time, and after the COVID fiasco, GPs are being completely burnt out.
“We have more chronic diseases now – like diabetes – and when they aren’t regularly checked people end up in emergency rooms.” She said.