RACGP recently released its General Practice Health of the Nation 2019 report analysing Australian general practice trends. The report’s data was collected from 1,174 survey respondents, as well as from public sites, like the Australian Bureau of Statistics (ABS) and the Australian Institute of Health and Welfare (AIHW). For your convenience, we’ve summarised some of the highlights of the report in this article.
A surge in mental health consultations
Once again, RACGP found that patients most commonly consult their GPs for psychological reasons (65%). This percentage has actually risen 3% since 2018, which is significant when you consider the fact that mental health issues were already topping the list last year.
An even bigger concern is that these psychological issues – like depression, anxiety, and mood disorders – aren’t just relegated to patients. GPs are struggling with these same problems.
As the Health of the Nation report noted, “GP wellbeing has also been flagged as a key area of focus in 2019, with almost 1 in 10 GPs who delayed care [for themselves] reporting that they did so due to concerns about being reported to regulatory bodies.”
The number of patients per GP has fallen
Since last year, 2,000 additional GPs have joined the workforce. The number of GPs rose from 38,000 in 2018 to 40,000 in 2019. According to census data, this means there were 655 Australian patients per GP in 2018, whereas today, there are only 630 patients per GP.
While this is great for patients, it does create an increasingly competitive environment for doctors. Still, the number of GP registrars is slowing, so this should reduce some of the strain on GPs in the coming years.
GPs see 20 fewer patients per week than in 2018
One of the biggest surprises in RACGP’s Health of the Nation report was that GPs are seeing significantly fewer patients in 2019 than they were in 2018.
On average, GPs saw 114 patients per week in 2018, compared to 94 patients a week in 2019. This is a drop of 18%.
Digging in, this massive drop appears to be unrelated to a change in GPs’ tasks. According to RACGP’s report, GPs are performing the same tasks in 2019 that they did in 2018, for roughly the same amount of time.
For instance, in 2018, GPs spent 17 minutes on average per patient. That number remained unchanged in 2019. GPs also said they spent 73% of their time in direct patient care, 18% of their time in indirect patient care, 6% of their time doing management and admin tasks, and 8% of their time doing other tasks. These figures also remain unchanged from 2018.
This means we can’t attribute a changing workload to the drop in weekly patients. The drop may, however, be related to the growing number of GPs considering there are 2,000 more GPs today than there were in 2018. While this is one hypothesis, the drop in patients could also be related to a legislation/accreditation change.
Patients see their GP more than any other health professional
Unsurprisingly, GPs have again proven themselves to be the most visited healthcare providers. In 2019, the percentage of patients who reported seeing a GP rose slightly to 84% (up 1% from 2018).
Visits to dentists and specialists also rose slightly. 50% of patients reported seeing a dentist (up 2% from 2018) and 37% of patients reported seeing a medical specialist (up 1% from 2018).
Most patients have a positive view of general practice
Much like 2018, it’s all good news when it comes to patient’s perception of GPs.
This year, 76% of patients reported that their GP always spends enough time with them. This is up slightly from 75% in 2018.
Similarly, 81% of the 2019 survey respondents said that their GP always shows respect and 74% said their GP listens carefully. These numbers were 81% and 76%, respectively, in 2018.
The percentage of GPs choosing to work in rural and remote Australia is declining
Since 2014, there has been a shift in where GPs are choosing to work. In the decade prior to that year, the percentage of GPs working in remote and very remote locales was growing. At the same time, the percentage of GPs working in urban environments was declining.
In 2014, that trend began to reverse itself. Over the last 5 years, more and more GPs have opted to work in major cities. As a result, there’s been a significant decline in remote and very remote GPs.
For instance, in 2013-2014, 4.29% of GPs worked in remote or very remote areas. The most recent figures from 2017-2018 indicate that percentage has since dropped to 3.72%.
This is particularly concerning when the Australian Institute of Health and Welfare says, “Australians living in rural and remote areas tend to have shorter lives, [and] higher levels of disease and injury.”
Medical centres are employing more nurses and allied health professionals, and fewer specialists and pharmacists
There has been a slight bump in the number of clinics employing nurses since last year. In 2019, 92% of clinics employed a nurse. This is up 1% from last year. There was also a slight increase in medical centres employing allied health professionals. The percentage of clinics employing an allied health professional rose slightly from 62% in 2018 to 64% in 2019.
In the same year, there was a slight decrease in the number of medical centres employing pharmacists and medical specialists. Pharmacists dropped from 14% in 2018 to 13% in 2019. And medical specialists dropped from 28% in 2018 to 26% in 2019.
Larger practices are becoming more prevalent
One growing trend the Health of the Nation 2019 report uncovered is that practices are continuing to grow in size. This growth is significant too.
For instance, in 2017, 7% of GP practices had just 1 GP, 31% had between 2-5 GPs, and 41% had 6-10 GPs. Today, just 2% of GP practices have 1 GP (a 5% drop), 28% have between 2-5 GPs (a 3% drop) , and 37% have 6-10 GPs (a 4% drop).
By contrast, larger practices have grown in number. While only 21% of practices in 2017 had 11 or more GPs, today that percentage has grown to 34%, an increase of 13%.
GP owners most concerned about maintaining income
While GP owners face a number of different challenges, chief among them in 2019 are sourcing/retaining quality staff (49%), maintaining work-life balance (55%), and most importantly, maintaining income (61%).
These challenges have changed a little since last year. For instance, in 2018, GP owners reported their biggest challenges being maintaining cash flow (55%), sourcing/retaining quality staff (58%), and maintaining work-life balance (69%).
From these statistics, we can conclude that between 2018 and 2019, GP owners have found maintaining cash flow to be more difficult (an increase of 6%). In that same time period, fewer GP owners reported a challenge in sourcing/retaining quality staff (a 7% decline) and in maintaining work-life balance (a 14% decline).
This said, because some of the answers respondents could choose from changed between 2018 and 2019, it’s difficult to accurately compare these statistics to the previous year.
Twice as many GPs are recommending health apps to patients
GPs are recommending health apps far more frequently to their patients than they have in the past. For instance, in 2018, one-third of GPs reported recommending health apps to their patients at least weekly. By contrast, 47% of GPs said they rarely or never recommended health apps.
In 2019, only 26% of GPs reported rarely or never recommending health apps (a decrease of 21%). While almost two-thirds of GPs reported recommending health apps to their patients at least weekly (twice as much as 2018).
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