The RACGP just outed itself as the biggest competitor in the CPD education market. But curiously, it also denies it
Someone in the RACGP executive isnât thinking.
And it seems very likely that the executive right hand is not talking to the non-executive, doctor-led left hand (the RACGP Council). Either way, the organisation is starting to tie itself into giant knots by defending an indefensible stance on its QI&CPD changes for the next triennium.
The facts arenât disputable because they have been set out clearly in a recent letter, sighted by The Medical Republic, to the 450 commercial medical education providers from the RACGP itself.
The College letter, intended to calm providers over claims the changes are anti-competitive, assures readers that, âSuggestions that the [changes were] selected to push providers out of the market are not correct.â
That is a very defensive statement. Especially given that as far as The Medical Republic is aware, no-one has actually made this suggestion.
What did emerge at a recent education provider briefing in Sydney was that the RACGP would benefit substantively from the changes the College itself came up with. Given many of the suppliers regard the College as both their governance body and their competitor, this was not a good look.
However, the Collegeâs reaction to providers concerns and subsequent media coverage has been largely to pretend there is nothing to be concerned about.
âThe suggestion the RACGP is in competition with providers is not supported by evidence,â the letter says.
âThe RACGP provides less than one in four continuing professional development (CPD) activities and RACGP accredited education events focus mainly on areas where choice is limited.â
Iâm not quite sure what the College defines as competition, but a player who provides 25% of a marketâs activities would generally be considered an active and strong market participant. This is a very strange way to deal with the providersâ heartfelt belief that the College is not playing fairly.
This statement by the College suggests that it is, by a huge margin, the number one provider of CPD education activities in the market. If you took the remaining 75% and divided it by participants, the average competitor to the RACGP would only have 0.17% of the market each.
Of course, markets donât work in such a well-distributed manner, but the above calculation illustrates the likely dominance of the College in this market. As someone whoâs been in this industry for a long time, I can make a reasonable estimate of how much the Collegeâs nearest three competitors turn over in revenue, which in turn provides some indication of share.
And my guess is that the top three competitors of the RACGP control only about 8%, 6% and 5% respectively of the market.
The irony is that the only body who truly know the answers to these questions is the RACGP, because it processes all providersâ
data, apart from that processed via ACRRM. But the College is keeping schtum. Feels a little like poor use of market power to me.
If youâre starting to suspect the College is just a little dominant, thereâs more. Of around 50,000 Category 1
activities GPs need to complete in the next triennium, half of those can now only be provided by the College in the form of the new mandatory PLAN Quality Improvement activity.
Itâs quite feasible that this could result in a College market share well north of 50%.
Yet the RACGP maintains it doesnât compete, that theyâve consulted with all parties as required by the Australian Medical Council, and that it isnât behaving anti-competitively.
On top of all this, the PLAN program will provide the RACGP with data that gives it even more advantage and power as a supplier of education in the market. No other supplier has access to this comprehensive market data that can be used to plan and execute better, or more competitive, education programs.
The letter sent to education providers goes on to explain that if the College had really wanted to exercise market
power, it would have simply limited the number of programs accredited, or the number of providers.
In other words, the College as player and the referee, could just send a few players off. The very fact it could do something like this is a sign of unusually overt and significant market power.
The kindest conclusion you can draw here is that the college genuinely believes what it is telling the market. Yet many people, both education providers and College members, donât seem willing to interpret the Collegeâs behaviour so generously.
But Iâm not sure which is a bigger worry. An organisation that deliberately fixes the game in its favour, or one that does but has no clue it is doing it.
I tend to think itâs the latter.
Itâs like playing against someone who also happens to be the referee, keeps penalising your team, and canât understand why people are getting upset.
If the RACGP doesnât wake up to this issue soon and work out that they are rapidly alienating key stakeholders, they risk serious brand damage to an organisation that generally does a lot of good for GPs.
One thing that might happen is that the ACCC steps in â now thereâs a referee you donât want to mess with â and determines that the RACGP simply canât be both referee and player.
If that occurred, the RACGP would significantly damage its revenue base, and presumably, its ability to do good when needed.
The RACGP needs to stop and have a serious think about what it is doing. Itâs not illegal to be dominant in a market or to exercise your muscle if you built that dominance in fair and open way.
But it is if you exercise your dominance unfairly, and damage other businesses and peopleâs livelihoods in a reckless manner.
