20 July 2021

I’m a junior GP. Please pay me a salary

Comment Training

I am a NSW rural gp trainee, with advanced skills in emergency and obstetrics.

Although I grew up in Sydney, I fell in love with rural generalism as a medical student after I spent a year with some fantastic rural mentors who did general practice, emergency, obstetrics and anaesthetics in a small town where their skills keep the hospital thriving, and their community is ever grateful for their hard work.

I chose rural general practice because of the continuity of treating a patient from start to finish throughout every stage of their life. I meet women planning to fall pregnant, look after them through their pregnancy, deliver their baby and earn a newborn patient while continuing to care for mum too. 

It’s a wonderful journey and a privilege to be part of. Patients are often grateful for the care I provide and this gives me the career satisfaction to continue in my training.

I also chose rural general practice because I wanted to help where I am needed most, where they can’t find enough doctors to train.

My qualifications are highly sought after because there aren’t many young doctors like me around. Part of the reason for this is the way we have designed primary care training in Australia.

Junior doctors in Australia begin their careers in the state-funded hospital system. They enjoy the privileges of a salary with accrued sick leave, annual leave, parental leave, salary packaging, public resources and collegiality.

This crucial time in their lives is often when they are thinking about the specialty they wish to pursue, whether they will buy a house or start a family. 

Imagine offering these young junior doctors a career pathway where they suddenly lose their accrued leave entitlements and actually face a drop in income by leaving the hospital system. If they or their partner get pregnant, they may not get any pay when they aren’t working.

While their colleagues continue in the familiar environment of the hospital, they face a little-taught system of Medicare billing. If you bill incorrectly, you may be audited and face penalties. If you bill poorly, your income suffers. This career path is general practice, and it is no wonder our young doctors are turning away from it.

What I am asking for is a Single Employer Model, where I can work between community general practice and rural hospital inpatient services with a salary.

For this to work, it needs to be a salary that reflects my level of experience and my additional skills. For example, I should be earning more than the unaccredited PGY5 in the hospital who hasn’t done an advanced diploma in Obstetrics and Gynaecology, but I should be earning less than my PGY 15 GP colleague and mentor.

Ideally this salary model should start from the time I sign up for GP training and continue into my career as a fully qualified fellowed specialist rural general practitioner.

I am sure there are many senior and experienced GPs who wish to be small business owners later in their career, after they have completed their family and mastered the art of Medicare billing, outgrowing the value of a salary. They should have the option of becoming small business owners as an alternative model.

But this model does not appeal to young doctors, especially those with children.

Why can’t GPs be paid a negotiated salary by their practice, who recoups their Medicare billings, with the usual components of annual and sick and maternity leave, until they choose to take the risk of becoming a partner in or starting their own practice?

We owe our nation the value of having a sustainable general practice workforce in the future, and can only achieve that by listening to the needs of trainees.

I dream of a future training model where I don’t need to worry about how many patients I am seeing, and whether I am billing smart to maintain my income. A model where I can continue to focus on being a great doctor, across community and hospital settings. A model where I can fall pregnant and still have some income to support my family, or know that if I catch covid or become unwell, I will still have money to continue paying my mortgage.

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13 Comments on "I’m a junior GP. Please pay me a salary"

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Julie O\'Connell
Julie O\'Connell
1 day 18 hours ago

Yes this is so true. Also i find the public believes we are in a salary often and that is why they ask for things while we are at the practice. Assuming if you are there you are being payed. Also having to have your own business to be billed and not having super are all things we arent trained to expect in Gp training. And very sad for us we dont have payed maternity leave. I agree.

2 days 11 hours ago
Well said Adrian & Peter ! The Govts. of the day, for quite a few Decades now, have been having a FREE RIDE on the Backs of us GPs. One possible Solution : A Nation Wide Protest Strike, organised by the AMA ( like the one they had done when the Specialists stood as One during the Indemnity Issue ) – a widely publicised Pen-down Nation-wide Strike, with good Media Coverage – NO GP SERVICES for 24 hours on a Monday Nation-wide. This will very definitely bring the Govt. of the Day to the Negotiating Table with AMA / RACGP… Read more »
Marc Heyning
Marc Heyning
4 days 17 hours ago
Well put!!! It is really not fair to take an income drop, lose leave entitlements, etc because you have a passion for general practice. I am a practice owner and I feel for my GP registrars. there is not enough ‘fat’ in the system for me to pay them enough to compensate them for all the negatives they have taken on by beoming GP registrars. At least in NSW, the work they do as GP VMO registrars is paid at a reasonable rate but not so in Sth Australia – they are really hurting in rural SA trying to attract… Read more »
Helen hopkins
Helen hopkins
4 days 20 hours ago

Sounds reasonable
Sounds fair and sustainable
Sounds like it would encourage rural young doctors , increase the workforce to provide excellent doctors for rural service.
Therefore don’t expect the government to be interested.

5 days 4 hours ago
I hear of these problems all the time in my network, there can be no doubt that the declining numbers entering the GP specialty is a major issue for healthcare delivery. These problems need creative solutions, but I would warn that this employee road is one that is best reversed on. Broader adoption of employed doctors is the road to : – Subjugation of the profession – Power in the hands of employers – and particularly government – Value leakage to administrators – loss of clinical independence The broader professional workforce is moving the other way, escaping the trappings of… Read more »
Peter Bradley
Peter Bradley
4 days 12 hours ago
People, don’t listen to this old clap-trap of subjugation, loss of clinical autonomy, etc, etc. The painful fact is GP does not lend itself to (quoting)…”escaping the trappings of employer-employee relationships to strike their worth directly with the buyers of the value they deliver…” Because the politicians don’t want that – the public don’t want that – much of the public have been given the expectation they should not have to pay – or only very little..! They don’t know enough to properly value what they are receiving – never have – never will..! However, referencing those posts who point… Read more »