Health professionals say they are not remunerated fairly and face increasing challenges.

It's a remarkable figure – 44 per cent of healthcare practitioners surveyed recently feel they are not fairly remunerated.

The survey, undertaken by accounting and business advisory firm BDO to see what issues front-line health professionals are grappling with, covered a wide range – from GPs to specialists and surgeons, pharmacists, aged care providers, dentists, radiologists, psychologists and pathologists among others. Nearly 70 per cent of respondents were GPs, specialists or pharmacists.

Asked whether they felt fairly remunerated, 44.65 per cent answered negatively, according to BDO advisory partners Gina Cook and Rachel Shoebridge.

"Of those, 78 per cent were GPs, specialists or pharmacists – with about half of them being pharmacy", Cook says. "That is not a surprise, given the changes in the funding model for pharmacies and challenges facing the industry. It's also not a surprise given the environment of increasing compliance requirements."


Shoebridge says the pharmacy sector has been disrupted by the arrival in New Zealand of Chemist Warehouse – the giant retail operation which has chosen to absorb the small charge made on consumers for prescriptions.

That charge is part the of the funding regime set for pharmacies but Chemist Warehouse's arrival has seen some community pharmacies near Chemist Warehouse sites come under pressure from consumers to do the same thing. There is so far no government action to help; many smaller pharmacies are hurting.

However, the BDO survey also highlighted the primary healthcare sector's vulnerability to change and a potential inability to keep their business abreast of adjustments that needed to be made.

"The changes in the retail sector, including the entry of Chemist Warehouse, have disrupted that industry for some time now and, just as there are plenty of other industries which have had to cope with disruption, so primary healthcare professionals and the medical profession as a whole are likely to have to face the same kind of disruptive issues," says Cook.

"That means they really need to look at their numbers and be able to do a deep dive so that they know what changes to make to adjust."

Unfortunately, she says, one of the main findings of the survey was that, while many healthcare practitioners are "very good at what they do", many are not focusing on the right financial and business information to adequately prepare for change.

There were three main findings which painted that picture:

• 49 per cent of the businesses surveyed (with three or less owners) are not receiving regular, accurate financial reports.


• Only 50 per cent (with more than one owner) have a comprehensive shareholder or partnership agreement setting out the rules of the business.

• Over 78 per cent had no succession plan for when they wanted to sell or hand the business on.

So are healthcare professionals not as good at running a business as performing their core functions? Cook says: "I can't make that assumption. For the vast majority, we'd suggest they have not shown the same aptitude or discipline towards running their businesses as towards practising their craft."

For most, because a good proportion of their income comes from government funding, many healthcare professionals have not had to face the same set of challenges as many other businesses – and maybe that had made them a bit complacent.

In another survey finding, 77 per cent of respondents said New Zealand was only somewhat prepared or not prepared at all for the increasing demands placed on the health system by long term conditions such as heart disease, diabetes, depression, dementia and musco-skeletal conditions.

The survey was conducted before the interim report of the Health And Disability System Review and shows, the partners say, part of the disillusionment in the sector before the release of that interim report. Asked about the upcoming review, 51 per cent said they were not confident the outcome would be better than the status quo.

Other findings from the survey:

• Only 22 per cent said they had no problem finding skilled staff.

• Only 35 per cent had invested in computerised accounting and patient management systems while only 23 per cent were actively adopting new technologies to maximise efficiencies and only 26 per cent had cloud-based technology.

• Only 19 per cent felt they had good work/life balance or did not feel any stress in their role.

Download BDO's Primary Healthcare Pulse Report at