But from the way they get remunerated, you’d be forgiven for thinking they were.
GP training numbers are up at least 20% this year, yet nothing has been done to shore up the supervisor workforce, the members of which face financial disadvantage compared to their peers delivering direct patient care.
The National Council of Primary Care Doctors – a kind of advocacy supergroup consisting of the AMA, RACGP, ACRRM, Rural Doctors Association of Australia, Australian Indigenous Doctors Association, General Practice Registrars Australia and General Practice Supervision Australia – released a rare joint statement on Tuesday calling for formal recognition and resourcing of clinical supervision.
“Governments, colleges, training organisations and funders should strengthen supervision by recognising the full scope of supervisory work and ensuring it is viable for practices to deliver,” the joint statement read.
“With additional Government investment in practices and training places, maximising impact may require a stronger focus on the people who are currently, or will in future be, responsible for providing supervision.”
More specifically, the statement called for policy and funding settings that support protected time, alternative supervision models (e.g. remote supervision) and professional development for supervisors.
The GP supervisor workforce generally runs on goodwill.
Unlike their hospital-based peers, who draw a salary, GP supervisors generally only earn money when they’re directly in front of a patient, doing a consult.
The commonwealth does provide a subsidy and teaching allowance, but these go to the practice directly, rather than the supervisor.
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Some face-to-face teaching time is paid, but the clinical supervision element often goes unnoticed.
“[Clinical supervision is] being the person [the registrar is] going to reach out to during that day if they’ve got a clinical problem,” General Practice Supervision Australia chair Dr Candice Baker told The Medical Republic.
“It’s the debrief that they need immediately because they’ve had a distressing consult. It’s catching up with them at the end of the day just to see how the day’s gone. It’s the missed consulting that the supervisor doesn’t do because they’re in with their registrar.
“It’s all of those other things that supervisors have done, because they’ve loved supervising, that I think is starting to run the tank a little bit dry.”
It’s not uncommon, for instance, for supervisors to block off several appointment slots each day to make time to support their registrar.
At the same time, Dr Baker said, these were also the most important pieces of supervision.
“I think all of us as learners remember when our supervisors really took a vested interest in us, and those were the placements you really remembered, not the one hour that they sat down and taught me about osteoporosis,” she said.
“Clinical supervision is really where the magic happens and where a lot of that growth happens.”
Ideally, clinical supervision would be formally recognised and funded by the government.
“There really is no money in private general practice to be funding this,” Dr Baker said.
“To make it equitable and to make it sustainable, it probably needs to be coming through government.”
The national council’s joint statement spelled out some of the potential consequences of inaction.
“If supervision becomes inconsistent, the risks are predictable: weaker learning experiences, reduced training quality, higher professional risk, and avoidable patient safety issues,” the statement read.
Ultimately, if the supervisor workforce was to dwindle further, GP registrars would miss out on placements.
“If the supervisors aren’t there and there’s nowhere to place them in practice, then I guess [registrars] … go back into the hospital system,” Dr Baker said.
“Certainly, there was a number of GPT1s that did not get matched in practices in our last training term in my area of rural Victoria, and they all had to find alternative options.
“… I think we’re a little bit behind the eight ball in terms of having built the supervision capacity for the volume and the pace of which learners are now coming into general practice.”
