GPs keen to quit, says study

By MARTIN JOHNSTON health reporter

Medical groups are worried about the future of general practice after a survey of GPs indicated many plan to drop out of full-time, self-employed work.

The study by the Royal New Zealand College of General Practitioners found that 52 per cent work full-time and are self-employed.

But only 27 per cent expect to be doing so in 2008 (although 18 per cent either will retire by then or did not answer the question).

The study's author, Sarah Talboys, blames "poor rewards and increased bureaucracy" for the decline in the attractiveness of owning a general-practice business.

The study follows several cases of GPs selling their practices cheaply or simply closing them after having difficulties attracting a buyer.

College spokesman Dr Jonathan Fox said the survey's main finding was "a worry. It should be to the New Zealand public, as it is to the college".

"The message was that the majority of GPs love medicine but are burdened by running a business and a practice and the compliance issues that go with it."

He knew a number of GPs who were considering quitting, or reducing their bureaucratic load by switching to locum work or joining a group practice.

In a separate question the survey, completed by 268 GPs, shows that nearly a third plan to quit general practice, retire, reduce their hours or go overseas to work by 2008.

Dr Fox said the finding that half of GPs each had 1500 to 2500 patients, rather than the 1230 claimed by the Health Ministry, showed that GPs were "under-valued, overworked and should be earning more.

"GPs do not earn as much as other professionals such as dentists and solicitors."

Ethnically, only 1.5 per cent who replied said they were Maori, compared with 4.5 per cent Chinese and 3.7 per cent Indian.

The survey was taken last September, just over a year into the Government's re-shaping of frontline healthcare through primary health organisations.

Medical groups welcomed the injection of more than $400 million extra Government cash over three years.

But they objected to the two-tier funding set-up which leaves many adults paying up to $55 a visit, but gives lower fees to all patients, irrespective of income, in areas that have high numbers of poor, Maori or Pacific people.

The chairman of the Medical Association's GP council, Dr Peter Foley, said general practice was becoming unattractive to medical graduates burdened by big student debts. Many preferred higher-paying specialties.

But the ministry's chief adviser primary care, Dr Jim Primrose, said there was strong demand for GP training places.

The number of places rose to 114 this year after dipping to 68 in 1999.

What doctors hate

Nearly 9 per cent of GPs in a survey say they want better working conditions. Their gripes include:

Workload too heavy.

Government interference and red-tape excessive and increasing.

Expectations of some patients unrealistic.

Uncertainty about primary health organisations.

GPs' pay Half earn between $60,000 and $120,000. A fifth earn more.