Where Have All The Doctors Gone
In the seventeen years that we have been involved in GP recruitment throughout Australia, surgeries have consistently complained about the difficulty in recruiting GPs and the extraordinary length of time that it can often take. From our own experience we have found this to be true. There are plenty of GP vacancies, but their location has rarely matched that of the available doctors. Location has always been the biggest challenge in GP recruitment. Why is this so? Why is it so easy for a doctor to find a job but so difficult for a surgery to find a doctor? Why are surgeries often left with no option but to take the only doctor that comes along, regardless of their suitability for the practice? In order to investigate the issue further we turned to the Department of Health GP Workforce Statistics (1) which was published in 2017 and came up with some remarkable findings. Please note that the following is not an attempt at a scientific study but merely a tool to help to illustrate to surgeries the difficulties in recruitment in different regions of Australia. The original data is available by following the link above. Combining their data with other, general demographic information (2), the GP workforce in Australia can be summarised as follows: There are 35,943 Registered GPs, working in 9,600 medical practices, providing medical care to a population of 25,120,237 people, who are living in 15,264 towns, villages & suburbs, across 7,692,000 square kilometers of Australia. At first glance of the original GP Workforce Statistics, everything appears perfectly fine. There is a healthy average of 3.75 GPs working in each medical practice, which is in turn only responsible for the healthcare of an average 2617 patients (3). So why is it so hard to find a GP and how can we use these statistics to gain a better understanding of supply and demand in the GP workforce? Fortunately, we are able to break these statistics down by their remoteness classification (ASGS RA No) and what they reveal is nothing short of remarkable. There are a number of major issues that directly affect your surgery’s ability to recruit GPs. There is a big difference between a Registered GP and their Full Time Equivalent Practice Managers who are attempting to replace a full time GP should be aware that there are very few full time GPs working in Australia, with an average nationwide working week of only 27 hours. The problem is exacerbated if you are seeking a female GP or are located in a remote area.
Whilst the number of Registered GP’s throughout Australia is 35,943, the Full Time Equivalent is only 23,911 GPs. That means the average GP is only working 27 hours a week.
This disparity is even greater with Registered female GPs, who number 16,322, whilst their Full Time Equivalent is only 8,866 GPs. The average female GP is working 22 hours a week.
The disparity is greater still in Remote and Very Remote Areas with 1,371 Registered GPs, but their Full Time Equivalent is only 352. The average remote GP is working 10 hours a week.
The Major Cities have all the doctors When it comes to recruiting a local GP, your chances of success are in direct relation to where you are located. The further your medical practice is from a major city, the smaller the pool of doctors that will be living within commuting distance of your surgery. Your opportunities to recruit a “local GP” progressively diminish to the point of becoming non-existent in remote areas. The national average distribution of GPs is one GP per 214 km2 but fluctuate significantly, depending on your location.
Major Cities account for only 1% of the land mass of Australia but hold 69% of the medical practices and 69% of the Registered GPs. They also account for 69% of the population. There is one GP per 3.86 km2.
Inner Regional Areas have 6,649 Registered GPs across 246,244 km2. There is one GP per 37 km2.
Outer Regional Areas have 3,266 Registered GPs across 830,736 km2. There is one GP per 254 km2.
Remote Areas have 662 Registered GPs across 1,020,000 km2. There is one GP per 1,541 km2.
Very Remote Areas have 709 Registered GPs across 5,500,000 km2. There is one GP per 7,757 km2.
Doctors don’t come onto the job market in your area very often The best opportunity for most medical practices to recruit a new GP will come from the general pool of doctors who live within commuting distance of your surgery. Assuming an average job incumbency of 7 years and using the data on the demographic distribution of GPs, it is possible to estimate the number of GPs, living within commuting distance of your surgery and how many will come onto the jobs market each year. Throughout Australia 5135 GPs are estimated to come onto the jobs market each year and will be distributed as follows:
Major cities will average 8.33 available GPs per surgery, per year.
Inner Regional Areas will average 2.41 available GPs per surgery, per year.
Outer Regional Areas will average 1.4 available GPs per surgery, per year.
Remote Areas will average 0.33 GPs per surgery, per year.
Very Remote will average 0.09 GPs per surgery, per year.
It takes time for GPs to become available in your area Having established the average number of GPs coming onto the jobs market each year that are within commuting distance of your surgery, it is possible to get an estimate of the average recruitment time in your area. These figures are based on Registered doctors and do not take into account your need for a Full Time Equivalent doctor, which could increase this recruitment time.
Major Cities 8.33 GPs per year equates to recruitment time of 1.44 months,
Inner Regional Areas 2.41 GPs per year equates to recruitment time of 4.98 months,
Outer Regional Areas 1.4 GPs per year equates to recruitment time of 8.55 months,
Remote Areas 0.33 GPs per year equates to recruitment time of 35.95 months (3 years)
Very Remote areas 0.09 GPs per year equates to recruitment time of 132.98 months. (11 years)
You are competing against other surgeries for a GP’s services While it is difficult to quantify the actual number of medical practice vacancies that occur each year, it is thought to comfortably exceed the annual supply of GPs. Suffice to say that, because GPs never have to struggle for long to find a job, demand for GPs at least equals supply. From the standpoint of medical practices looking for a GP, you can assume that for every GP that comes available, there is probably at least one other local surgery competing for their services. The relative attractiveness of your surgery as a workplace could impact on your recruitment time. To summarise the GP labour market in Australia Statistically speaking, for the 97% of surgeries in Australia that are located within the Major Cities and Regional Areas (RA1 – RA3), recruitment of a new GP is certainly feasible within a reasonable timeframe. The average surgery will have 12 GPs living within commuting distance, 2 of whom will likely come onto the jobs market each year. Each doctor will probably only be available for an average of 27 hours per week and surgeries will almost certainly have to compete with up to 3 neighboring clinics to secure their services. The average recruitment time to secure a new GP will be 7 months. In conclusion It should be noted that as the population density fluctuates in different parts of Australia, so does the general availability of doctors and the level of competition for their services. As a result, surgeries in major cities with plenty of local doctors will also expect a corresponding increase in competition from other surgeries. It is quite common for metropolitan surgeries, who are surrounded by GPs, to languish without a doctor for an extended period of time. Particularly if they don’t adequately market their vacancy or their surgery does not live up to the standards that modern doctors expect. It is important for surgeries to have realistic expectations of their recruitment challenges and the time it will take them to recruit in order to plan their recruitment strategy more effectively. At the end of the day, while you may not be able to control the availability of doctors in your area, there are plenty of things you can do to gain the attention of the ones that are, and to present your surgery in the its possible light, to give you an edge over your competition.
Notes & Bibliography Please feel free to explore the following links for our data sources and further discussion on the GP Workforce Distribution in Australia, from far more eminent experts in the field.
General Demographic Information includes the following:
Total population divided by total medical practices
We are working towards gaining more accurate data on the actual distribution of medical practice across the various ASGS Remote Classification Areas of Australia. For the time being we have based our medical practice distribution calculations in direct proportion to an average of the population distribution and GP workforce distribution, across the various RA catchments.