GP registrations halved in two decades as incentives drop

REGISTRATION as a general practitioner (GP) was about as half as likely for 2004-2007 medical graduates as it was for 1985-1987 graduates, according to the authors of research published online today by the Medical Journal of Australia.

“The number of GPs in Australia has been falling, a situation previously described for nations with poorer health outcomes,” wrote the authors, led by Associate Professor Denese Playford, from the Rural Clinical School of WA.

“The reasons for the decline are many, but this phenomenon has not been described in detail in the peer-reviewed literature.”

Playford and colleagues examined the registration categories, as recorded by the Australian Health Practitioner Regulation Agency (AHPRA), of people who graduated from the University of Western Australia (UWA) medical school during 1985–2007.

“AHPRA registration as a GP was about half as likely for 2004–2007 graduates as for 1985–1987 graduates,” they found.

“This decline in entry into general practice was accompanied by an increase in the proportion of graduates with general registration status alone.

“These findings are consistent with the recently reported drop in the proportion of medical graduates who intend to enter general practice, which may lead to a further decline in the number of AHPRA GP registrations.

“We also found an equally concerning increase in the number of doctors practising as generally registered practitioners alone during 2007–2019, presumably waiting for the opportunity to enter their preferred medical specialty.”

The reduction in the GP workforce is of particular concern in rural settings, the authors wrote.

“The causes of this problem include the perceived lower status of general practice, the generally lower income provided by Medicare fees, the burden of practice accreditation, and specialist-focused teaching in medical schools. Further challenges for rural practice include problems of work–life balance and the focus on fly-in/fly-out specialist service instead of developing extended scope primary care models for regional and remote communities.

“Our findings suggest that solutions for the GP problem are urgently needed if Australia is to continue enjoying some of the best health outcomes in the world,” Playford and colleagues concluded.