Are your small, local, three-or-four doctor general practices becoming a thing of the past? Quite possibly.
Are your small, local three or four doctor general practices a thing of the past? Quite possibly, if trends from the recent MABEL study into general practice are anything to go by.
Since 2009, the proportion of practices with six or more GPs rose from around 45% to around 60% by 2015. Meanwhile, those with two to five GPs dropped from 45% to 30%. There were also fewer GP principals by 2015 compared with 2008.
Perhaps unsurprisingly, the percentage of solo general practices has also shrunk.
Speaking at the MABEL Research Forum in Melbourne last Thursday, lead analyst Professor Anthony Scott told audiences that general practice was undergoing significant changes to its structure and organisation.
These figures could mean smaller general practices were on their way out, Professor Scott told TMR.
“It is not clear what impact this is having on patients’ access to care or their quality of care,” the University of Melbourne health economics researcher said.
Bigger practices are often better at claiming fees and more organised in their billing, which could be driving up the average size of practices, he said.
Because the data are essentially a head count, Professor Scott said the growing size of practices could also be partly explained by more women entering the profession and more GPs choosing part-time.
“Although business models might be driving the growth in the size of practices and falls in the number of practices, that also means that you don’t have one every street corner anymore and you have to travel further,” he said.
When those patients do go to a practice, the increasing proportion of part-time GPs means the patient may not be able to see their preferred doctor on that particular day, he said.
MABEL data also show the number of staff per practice is growing. In addition to a 20% increase in general practitioners, the number of nurses increased 40% between 2008 and 2015. Allied health staff grew more than 25%, and administration staff increased more than 15%.
The changing landscape of general practice has occurred in the face of continuing funding pressure, increased supply and competition, and a move away from fee-for-service business models, Professor Scott said.
Based on the results of the doctor surveys, it appears job satisfaction and work-life balance have been etched away over the seven-year period, Professor Scott told the crowd.
This and the increasing corporatisation of general practice could dissuade medical students from choosing the specialty, AMSA vice president Doug Roche said on Twitter.
Potentially a worrying trend – Will ?? corporatisation dissuade med students from GP? #MABELforum pic.twitter.com/7DVYG7rJw4
— Doug Roche (@douglasjroche) May 25, 2017
