Number of GPs bulk billing all patients halved over last year, report finds

The proportion of GPs bulk billing all of their patients has halved over the course of just one year as the cost of providing care to patients continues to grow.

The findings come from the Royal Australian College of General Practitioners’ (Racgp) annual health of the nation report, published on Wednesday, which surveyed 2,048 GPs, including 183 GPs in training.

Each year almost nine in 10 Australians visit a GP, the report said, with less than 1% of people reporting they were unable to see a GP when they needed to in 2021–22.

But the survey, conducted throughout April and May 2023, found only 12% of GPs said they bulk billed “all” of their patients in 2023, compared with the 24% who reported doing so in 2022. Meanwhile, 30% of GPs said they fully bulk billed “the majority” of their patients, down from 40% in 2022.

Patients who are bulk billed do not pay anything for their consult, with GPs billing the government directly through Medicare instead.

For those GPs charging a private fee to patients in 2023, $74.66 was the average cost for a standard consultation lasting less than 20 minutes, with patients receiving a $39.75 rebate from Medicare. The cost increased significantly from 2022, when the average consultation fee was $64.

The significant decline in bulk billing “is reflective of anecdotal reports from GPs about the increasing cost of providing healthcare services in general practice and further compounds patient access issues,” the report found.

“The rapid decrease in bulk-billing rates is more evident in metropolitan areas than in remote and very remote areas.”

GPs working in corporate or non-corporate group practices were least likely to bulk bill, while those working for an Aboriginal medical service or Aboriginal community-controlled health organisation were most likely to bulk bill, followed by those working in aged care facilities.

There was also a downward trend in GP job satisfaction, the report found. GPs reported that their overall job satisfaction had decreased from 70% in 2022 to 66% in 2023. Simultaneously, there has been an increase in those GPs who report that they are “very dissatisfied” with their overall job satisfaction, which rose from 4% to 6%.

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Those working for an Aboriginal medical service or Aboriginal community-controlled health organisation were most satisfied with their job, while those running a solo practice were least satisfied. GPs practising in regional or rural areas reported higher levels of job satisfaction.

In 2023, six in 10 GPs reported working fewer than 40 hours a week, similar to 2022. Meanwhile 5% of GPs reported working more than 60 hours a week, and most of those were in solo practice.

Less than half of practising GPs indicated they would recommend their profession to their junior colleagues. “We continue to see a decline in the number of medical students reporting general practice as their preferred specialty,” the report found, while 29% of GPs said they intended to retire within the next three years.

The Racgp’s president, Dr Nicole Higgins, said the report shows sourcing and retaining GPs remains the issue that most practice owners rank as their biggest challenge.

“Our report is further evidence that we are facing a looming shortfall of GPs, and we need to do much more to attract and retain this essential workforce, for the health of Australians now and into the future,” she said.

She called for GPs to be offered an incentive payment in their first six months of community general practice training, as well as study leave and paid parental leave.

“It’s unfathomable that in today’s age GPs in training don’t get paid parental leave, and more so when you consider that more women are becoming GPs each year than men,” Higgins said. “Addressing these three key barriers would make an immediate difference in getting more GPs training and working in the communities that need them.”


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