GPs' flight threat to care system

Doctors are turning their backs on what used to be considered the core of general practice - the fulltime owner-operator clinic.

A survey by the College of General Practitioners found that 37.7 per cent of GPs were self-employed fulltimers last year - in contrast to 52 per cent in a similar survey in 2003.

Just over a quarter in last year's survey intended to change their work arrangements within five years, according to the latest statistics from the research, released this morning.

Of them, just 4 per cent intended to become fulltime self-employed, far fewer than the 27 per cent in the earlier study.

The latest survey also found that around 15 per cent of the 2057 GPs who participated intended to leave general practice, leave medicine, go overseas or retire.

The college foresees a crisis since the GP workforce also is ageing faster than it is being replenished.

The move away from owning your own city or rural practice has been attributed to growing Government bureaucracy linked to rising patient subsidies and the maturing of a new generation of GPs, especially women, who want to be paid a salary, clock out at 5pm and spend more time with their families.

"People want to work less. Therefore we need more bodies in the system," said college president Dr Jonathan Fox.

GPs opting out of fulltime self-employment, the "backbone" of general practice, put more pressure on the declining numbers in that role, leading to more hours of work, increased difficulties recruiting and retaining GPs, and some clinics closing their registers to new patients.

A stocktake was needed of the future of general practice, especially who would own the infrastructure.

New Zealand was already short of GPs, Dr Fox said, urging the Government to double the number of general practice training places it funds each year from the present 54.

Health Minister Pete Hodgson said general practice training was growing in popularity, 140 doctors entering the field annually - at least four times the number intending to retire each year.

But the college says 140 is the number who sit its training programme's primary exam and the 54 funded places is a better guide to workforce entrant numbers.

Ian Powell, executive director of the Association of Salaried Medical Specialists, said there had been a lack of planning for the generational shift in which younger GPs wanted to be salaried workers, not business owners.

In areas having recruitment and retention problems, the association advocated district health boards employ GPs directly.


GP shortage

* Around 9 per cent of GPs intend to leave general practice, leave medicine or go overseas within the next 5 years.
* 6 per cent intend to retire.
* GPs on average are paid $93,000 a year and work 48 hours a week.
* New Zealand has around 3000 practising GPs. Sources: Royal NZ College of General Practitioners survey completed by 2057 GPs; Medical Council