2018

GP Industry
Insights
Contents
1 Introduction

General Practices Patients of

& Practitioners General Practices

3 General practices overview 9 Practitioner ages 20 Patient overview 25 Patients technology adoption

3 Place of practice/practice 11 Practitioner - place of 20 Chronic conditions/diseases 25 Overall trends

ownership qualification
21 Patients appointment 26 Booking age data
6 General practitioners 13 Practitioner location: Remote volumes
overview and very remote areas 27 Data & security
22 Patient loyalty
7 Practitioner numbers 15 GP technology adoption
23 The family effect
8 Fulltable of headcount per 16 Overall trends
state and population 24 Patient satisfaction with GPs
per state 18 GP perceptions of patient
tech adoption

28 Conclusion 29 Index of sources

 Introduction 1 of 29

Introduction
As the first point of contact for most industry. Understanding the trends and
Australians seeking medical attention, GPs impacts on GPs is important to ensure access
play an integral role in all of our lives. Often and quality are maintained for patients.”
referred to as a “Specialist in Life”, GPs are
increasingly relied upon for a vast array of With so many reports, statistics, trends
patient needs. and predictions available, we wanted to
make it easy for GPs to access the industry
“Not surprisingly, GPs are the first port of However, as with every industry, the GP information that’s most relevant to them.
landscape is evolving due to a number of We’ve coupled our own in-house data with
call for Australians with health issues. They factors: Australia’s population is growing, data scoured from reports, articles, and
patient expectations are changing, and statistics, to produce a snapshot of the
provide diagnosis, treatment and ongoing technology in the medical industry is current Australian GP industry.
improving all the time. For GPs to continue to
care for over 85% of the population each provide the high quality of care, it’s important This report offers a greater understanding
GPs have their finger on the pulse when it of the GP landscape, patient needs and the
year” comes to what’s currently happening in the changing relationship that GPs and patients
industry and where it may be headed. have with technology.

Dr Bastian Seidel, President of The Royal Australian As Natalie Smith, Head of Health at ANZ,
College of General Practitioners1 says: “GPs play a critical role in the healthcare

Highlights
Due to Australia’s ageing population, GPs’ The number of GPs continues to rise but The number of GPs is growing. GPs are increasingly embracing technology
clinical work has become more centred the number of practices does not. GPs are Appointments per Full-Time Service as part of patient care.
on care of older people, more frequent migrating from small practice ownership to Equivalent is down.
management of chronic conditions, more joining larger clinics. Competition is increasing.
clinical and therapeutic procedures, and
more referrals and test ordering.2
General Practices
& Practitioners
 General Practices overview 3 of 29

General Practices
overview

The number of General Practices Some supporting evidence from The proportion of GPs working in

in Australia fell from 8,084 to 7,035 the MABEL4 survey shows that the a practice with six or more doctors

between 2002 and 2011, the latest proportion of GPs who are owners has increased from 47% in 2008 to

year for which reliable data exists.3 (practice principals) has fallen 61% in 2015.5

from 35% in 2008 to 24% in 2015.

General Practices overview 4 of 29

The number of GPs continues to rise but

the number of practices is decreasing.
Despite the number of GPs continuing to rise (partly due to an
increase in both local and international medical graduates), the
overall number of GP practices is decreasing year on year.

This coincides with a decrease in practice ownership6, with

many GPs choosing to join clinics as opposed to opening
their own. With group practices now the most popular choice
for work, GPs are being attracted by the potential for flexible
working hours and part-time work.

Young doctors are being deterred from working in small

practices by the federal government’s promotion of large
medical centres and super-clinics.7
General practices overview 5 of 29

Practices are becoming larger8

Practice sizes are increasing, with more and more clinics
offering a diverse range of medical and allied health services.
Popular services offered by GP surgeries include on-site
pathology, psychology and nutritional advice.

According to the University of Sydney’s 2011-12 Bettering

the Evaluation and Care of Health study program9 of General
Practice data, practices that have five to nine doctors jumped
from 38.6% the previous year to 42.3%.

Corporates on the rise

The proportion of GPs who own their practice is declining,
signaling a potential rise in corporate ownership. Corporate
practices are now estimated to account for 10-15%
of all practices.10
 General Practitioners overview 6 of 29

General Practitioners
overview

There are currently 35,942 GPs Non-Referred Attendance (NRA) Total appointments per

across Australia, up 53% from services are on the rise. GPs practitioner are decreasing, from

23,540 just 10 years ago.11 provided 145.4 million NRA 6,293 10 years ago, to 5,632 in

services in 2016/17, compared 2016/17 (NRA Services per FSE

with 100.3 million 10 years ago.11 GP).11

General Practitioners overview 7 of 29

Changing market
The number of GPs continues to rise but the number of
practices does not. GPs are migrating from small practice
ownership to joining larger clinics.

Competiton is increasing
The number of GPs operating across Australia continues to
grow and is currently outpacing population growth. This is
largely due to the opening of new medical schools in the 2000’s
which contributed to a doubling in the number of new medical
graduates.

With unprecedented levels of choice12 and an oversupply

of GPs, the total number of appointments per practitioner is
decreasing.
 General Practitioners overview 8 of 29

GP headcount per state Population 2017

246 100

GP headcount13 Population13
2006-07 2016-17

7,567 NSW 10,850 Population 2017

5,751 VIC 8,646 4 948 700

4,705 QLD 7,928

2,258 SA 3,714

1,952 WA 2,793

627 TAS 883

361 ACT 572

318 NT 548

Population 2017
GP headcount per 100,000 population13 412 600
2006-07 2016-17
Population 2017 Population 2017
139.2 NSW 110.7 1 726 900 7 895 800
140.7 VIC 114.5 Population 2017

2 587 100 Population 2017

156.7 Qld 111.6 6 385 900
160.1 SA 114.5

131 WA 124.3

168.7 TAS 107.2

Population 2017
222.2 ACT 127.1
522 000
132.5 NT 148.6
 General Practitioners overview 9 of 29

Practitioner
ages GP age groups15
GP headcount

2,154
<35
5,073

6,086
35-44
8,862

7,840
45-54
8,747

5,147
55-64
8,222

1,725
65-74
4,128

588
75+
902

2006 - 2007 2016 - 2017

General Practitioners overview 10 of 29

There is a strong potential for an

oversupply of younger GPs in Australia.
The number of GPs aged under 35 years in Australia has grown
by 135% in the last decade. However, this age bracket still only
represents 14% of the national GP population.

Short-term pain for long-term gain

Despite the potential for an oversupply of younger GPs, having
a strong supply of GPs in general is critical when caring for
Australia’s ageing population, especially when you consider
that GP visits increase with age. Almost one third of the number
of people aged 85 years and over saw a GP 12 or more times in
12 months.16
 General Practitioners overview 11 of 29

Practitioner - place of
qualification

GP’s Qualified Overseas17

7,015

14,584

GP’s Qualified Domestically17

16,525

21,350

2006 - 2007 2016 - 2017

General Practitioners overview 12 of 29

Place of qualification
The number of overseas-born doctors and nurses in Australia
has increased in recent years, with the number of overseas
trained GPs doubling in the last decade.

In 2011, more than half of GPs (56%) and just under half of
specialists (47%) were born oveseas.18
 General Practitioners overview 13 of 29

Practitioner location:
remote vs very remote19

Remote:

GP head count is rising: 664 from 430 10 years ago

GP head count per 100,000 population: 207.9 from 141.7

Very remote:
Very remote Remote Major cities & regional
GP head count rising: 718 from 352

GP head count per population: 354.7 from 191.820

General Practitioners overview 14 of 29

Despite growing GP numbers, the future

remains uncertain for rural generalism
According to the RACGP, around 40% of doctors in rural areas
are international medical graduates.21 This is due to domestic
graduates preferring to work in the major cities and the fact
that doctors who qualified overseas are required by RACGP
to undergo specialist training (including GP training) in rural
areas.

With the numbers of GPs in both remote and very remote areas
rising, one might assume the future is looking bright. However,
due to the potential oversupply of domestically trained doctors,
the Government is looking to restrict immigration to ensure
domestic graduates have jobs. This has the potential to lead to
an undersupply of GPs in both remote and very remote areas,
as mentioned in RACGP’s 2017 Health of the Nation report:

“If current growth trends continue and retirement intentions

are acted upon, the general practice workforce is also likely
to be much more concentrated in major cities and less
prominent in regional, rural and remote areas.”22
 GP technology adoption 15 of 29

GP technology
adoption

Three in four practices said Only a small number of practices 85% are looking to boost their

that leveraging technology (15%) maintain and add data to tech budgets in the next two

and communication channels a paper-based record system in years to support their business

improves the quality of care they addition to their clinical objectives – including one in five

are able to provide to patients.23 information system.24 who are planning a

significant increase.25
GP technology adoption 16 of 29

Technology adoption on the rise

Technology uptake among GPs continues to rise, with many
embracing new digital technology to improve the level of care
they can provide to their patients.

This can be seen in the RACGP 2017 Technology Survey, which

showed that 80% of GPs are satisfied with the way they use
technology in their patient-oriented26 work (up from 71% in
2016).

GPs are increasingly incorporating technology as part of

patient care which is important when you consider that
89% of patients expect to be able to book and manage their
appointments online.27

“General practice is well placed to benefit from technology

innovations to improve patient and population health, and
to lead the development, testing and implementation of new
technologies connecting patients and healthcare providers.”

Dr Nathan Pinskier, Chair RACGP Expert Committee –

eHealth and Practice Systems
GP technology adoption 17 of 29

Practices are benefiting from technology

Practices are also switching to digital technology to optimise
their processes and replace manual, paper-based systems.

85% are looking to boost their tech budgets in the next two
years to support their business objectives – including one in
five who are planning a significant increase.28

Competitive edge
As stated in Commbank’s GP Insights report from
April 2018, “patient expectations and the availability of
practice technology are not always aligned. This presents
an opportunity for practices to gain an edge over their
competitors by investing in digital channels that align with
patient expectations and demands”.

There are still barriers

As stated in the 2017 RACGP Technology Survey, the perceived
barriers for technology adoption include lack of integration
with IT systems, issues related to patient confidentiality and
privacy, lack of funding, implementation costs and lack of
integration with current processes or procedures.29
GP technology adoption 18 of 29

GP perceptions of patient tech adoption

GPs have identified the importance of patient feedback to
not only understand and resolve any current issues within
their practice, but also as a way to identify changes to patient
expectations.

When asked how patient expectations have changed in

the past two years, most practices cited increased patient
demand for proactive reminders for tests and checkups
(87%) and digital services to book, pay, order scripts and
provide feedback online (84%). Practices also said that
patients want access to better appointment management
solutions (80%). In addition, 86% of practices were aware that
patients increasingly want their own health opinions to be
acknowledged and respected, as new technology puts more
health information at their fingertips.30

What does this mean for practices?

Patients are more likely to attend a practice that offers digital
services, in particular those that enable them to manage their
health information, book their appointments and communicate
with their GP.
Patients of
General Practices
 Patient overview 20 of 29

Patient
overview
Key takeaways

Despite the Australian Bureau of Statistics (ABS) 2014–15 National Health Survey Due to Australia’s ageing population, and
social & lifestyle changes, chronic conditions
(NHS), showing 85% of Australians aged 15 and over report their health as ‘good’ or are on the rise placing more and more reliance
on GPs.
better, chronic diseases such as cancer, coronary heart disease and diabetes are
As our population ages alongside the rise
becoming increasingly common in Australia.31 of chronic disease, GPs have an even more
critical role in ensuring increased pressure on
our healthcare system doesn’t jeopardise the
quality of care in Australia.33

In 2014–15, based on self-reported data from the NHS, more than 11 million

Australians (50%) had at least one of eight selected chronic conditions (arthritis,

asthma, back problems, cancer, chronic obstructive pulmonary disease,

cardiovascular disease, diabetes mellitus, or a mental or behavioural condition).32

 Patient overview 21 of 29

Patient appointment
volumes
Key takeaways

The number of non-referred attendances

across Australia is on the rise, adding to an
already increasing demand on GPs.

Total NRA services have been on

the rise over the last 10 years.34

National
100.3 million

145.4 million

2006 - 2007 2016 - 2017

 Patient overview 22 of 29

Patient
loyalty
Key takeaways

Despite there being more choice and more

competition than ever before, patients are
remaining loyal to their GPs. If possible, they
will continue to visit the same practitioner, at
Eight in ten people (83%) saw a 78% of patients have a the same practice.

GP in the last 12 months.35 preferred regular GP. 36

93% of Australians always go to 98% of people aged 45 and over

the same general practice.37 have a usual GP.38

 Patient overview 23 of 29

The family
effect
Key takeaways

The relationship between a patient and a GP

is not always 1:1. It often involves multiple
family members being involved in GP
appointments, resulting in more patients
18.6% of bookings through 34% of HealthEngine users are for the GP.

HealthEngine are made on behalf parents of a child under 18.39

of someone else.39

25% of all bookings made on 70% of bookings made using

HealthEngine are for those 45+ HealthEngine on someone else’s

years old (up from 15% in 2013).39 behalf are for those aged under 18.39
 Patient overview 24 of 29

Patient satisfaction
with GPs
Key takeaways

GPs provide high quality primary care services

across the country.

This is best reflected in the latest Patient

95% of patients claimed to be The proportion of people waiting Experiences in Australia Survey by the
Australian Bureau of Statistics (ABS), which
satisfied or very satisfied with the longer than they felt acceptable states, “of those patients who saw a GP in
the last 12 months, 92% reported that the
quality of care provided by GPs.40 for a GP appointment decreased GP always or often listened carefully to them,
94% reported that their GP always or often
from 23% in 2013-14 to 18% in showed them respect, and 90.6% reported
that their GP always or often spent enough
2016-17.41 time with them.”
 Patient overview 25 of 29

Patient technology
adoption
Key takeaways

“With patients now accustomed to a very

high quality of care, we are seeing other
factors such as technology and digital
communications playing a bigger role in
According to the majority of patients surveyed42, the most appealing shaping what Australians expect from their
GPs. This is particularly true for the younger
forms of digital communications include: generations, with 92% of Gen Z agreeing
that adopting the latest technology delivers
• Notifications around appointment delays (92%) a better practice experience, falling to 72%
for Baby Boomers and just 64% for Pre-
• Appointment reminders via SMS or email (91%)
Boomers.”45
• Book and manage appointments online (89%)

Cameron Ziebell, National Head of Healthcare,

Commonwealth Bank
81% of patients agree that 63% of consumers say technology

technology and communication is important to managing

channels help deliver a better their health.44

customer experience.43
 Patient overview 26 of 29

Booking age
data
Percentage of bookings made on HealthEngine by age.46 Key takeaways
17.7% 17.2% 31% 16.1% 10% 8%
2014
Over the last 4 years, surprisingly, the
percentage of 17-34 year olds making
18.7% 13.5% 26.6% 17.9% 11.4% 11.8% bookings has decreased (by -.5%, -4.5% and
2015 -6.4% respectively)

Even more surprising is the fact that the

18.6% 13% 25.1% 17.9% 12.2% 14.3% percentage of 35 year olds and upwards
2016 has increased (by +2.3%, +2.5% and +6.5%
respectively). The most dramatic rise is in the
55+ age group. This shows a growing adoption
18.2% 12.7% 24.6% 17.9% 12.3% 14.3% of technology among older generations in
2017 Australia.

17.2% 12.7% 24.6% 18.4% 12.5% 14.5%

2018

17 18-24 25-34 35-44 45-54 55+

 Patient overview 27 of 29

Serious about data

security
Key takeaways

Data security is still a key issue when it comes

to the adoption of digital technology. Patients
need to trust their GPs to keep their personal
health information safe and GPs need to
Although Australia is a Only 42% of Australians have the same level of trust in the technology
they’re using.
predominantly tech-savvy country understand digital healthcare

with high use of smartphones, data security.48

digital payments, online shopping

and other digital technologies, Physicians and healthcare providers

there is a general lack of digital are the most trusted entity to keep

healthcare data literacy.47 patient data secure.49

 Conclusion 28 of 29

Conclusion
Short-term pain for Rise and fall A future of digitised Serious about security
long-term gain The number of GPs continues to rise while
healthcare Although technology adoption is on the rise
the number of practices continues to decline. among both GPs and patients, data security
The number of GPs operating across Australia Technology uptake among GPs continues
This is partially due to a decrease in practice is still a key issue. Patients need to trust their
continues to grow and is currently outpacing to rise with many embracing new digital
ownership, as more GPs are choosing to join GPs to keep their personal health information
population growth. However, despite the technology to improve the level of care they
large medical centres and clinics. safe and GPs need to have the same level of
potential for an oversupply of GPs - especially can provide to their patients.
trust in the technology they’re using.
younger GPs - there may not be reason to
The decrease in practice ownership also
worry. With patients more likely to attend a practice
signals a potential rise in corporate ownership
that offers digital services, GPs need to
with corporate practices estimated to now
Due to Australia’s ageing population, and continue to embrace technology to:
make up 10-15% of all practices.
social & lifestyle changes, chronic conditions
• Meet patient expectations
are on the rise which is placing more and
The number of appointments per FSE is
more reliance on GPs. And, considering that • Be more efficient
decreasing. This is mainly due to increased
the number of GP visits increase with age, • Be competitive in the market
GP supply brought about by the opening of
having a strong supply of GPs is critical
new medical schools in the 2000’s, which • Offer patient-centric care
going forward.
contributed to a doubling in the number of
new medical graduates.
 HealthEngine’s GP industry insights: Index of sources 29 of 29

Index of sources
1, 22 https://www.racgp.org.au/download/Documents/Publications/Health-of-the-nation-2017- 24 https://www.racgp.org.au/download/Documents/e-health/2017/RACGP-Technology-Survey-
report.PDF 2017-Results.pdf

2 https://www.racgp.org.au/afp/2016/september/the-changing-face-of-australian-general- 26, 27, 29 https://www.racgp.org.au/download/Documents/e-health/2017/RACGP-Technology-Survey-

practice-across-the-decades/ 2017-Results.pdf

3, 4, 5, 8, 9, https://www.health.anz.com/content/dam/anzhealth/English/Docment/ANZ%20Health%20 31, 32 https://www.aihw.gov.au/getmedia/187c53db-d663-45c7-a789-5966cad077eb/ah16-1-3-how-

10, 21 Economics%20Report_ts%20(spread).final2%20no%20trims.pdf healthy-are-australians.pdf.aspx

6 http://medicalrepublic.com.au/owning-practice-still-worth-effort/12228 33 https://www.medicaldirector.com/news/patient-centric-care-means-australians-2018

7 https://www.clinic238.com/the-family-gp-is-dying-out.html http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4839.0Main+Features12016-
35 17?OpenDocument
11, 14, 20, 34 http://health.gov.au/internet/main/publishing.nsf/Content/General+Practice+Statistics-1
36, 37, 38 https://ama.com.au/article/general-practice-facts
12, 23, 25, https://www.commbank.com.au/content/dam/commbank/assets/corporate/industries/
28, 30, 40, healthcare-insights-gp-study-report.pdf 39, 46 HealthEngine Internal Data
43
41 https://ama.com.au/media/patients-satisfied-their-gp-abs-survey
13 http://www.abs.gov.au/ausstats/abs@.nsf/mf/3101.0
42, 45 https://www.commbank.com.au/guidance/newsroom/patients-of-the-future-will-demand-
15 www.health.gov.au/internet/main/publishing.nsf/content/General+Practice+Statistics-1 more-than-good-quality-care-201804.html?ei=card-view

16 http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/4839.0main+features32012-13 44, 49 https://www.accenture.com/t00010101T000000Z__w__/au-en/_acnmedia/PDF-40/Accenture-

Digital-Health-Consumer-Survey-Research-Brief-Australia.pdf#zoom=50
17, 18 http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/4102.0Main+Features20April+2013#p5
47, 48 https://www.accenture.com/au-en/insight-accenture-health-2017-consumer-survey
19 http://www.doctorconnect.gov.au/locator