The lack of a specific Medicare rebate for assisted dying is a major factor preventing GPs from participating.
GPs with no in-principle objection to voluntary assisted dying say the time, paperwork and lack of adequate remuneration prevented them from participating in the process during the first year of it being legalised in Queensland.
According to a new study out of QUT’s Australian Centre for Health Law Research and published in the Australian Journal of General Practice last month, there are ongoing structural and logistical barriers to GP participation in voluntary assisted dying.
The paper looked at the experiences of 12 Queensland-based GPs, four of whom had not participated in voluntary assisted dying in any capacity save for having no particular opposition to it.
“Some GPs, both those who successfully became authorised practitioners and those who did not, reported the initial application process was arduous, requiring specific paperwork and references,” the QUT researchers wrote.
“Further, the legally mandated training was also prohibitive for some, as it took a long time to complete, was difficult to pass and was frequently unremunerated.”
The mandatory training itself takes between six and eight hours and is online. The final assessment is a set of 30 multiple-choice questions and requires a score of 90% or higher to pass.
In some areas of Queensland, GPs were given funding to complete the training or participate in voluntary assisted dying. According to the study authors, this contributed to “feelings of disparity between regions”.
“I actually considered becoming a provider or part of the process myself, but it was quite onerous to actually join up,” one GP participant was quoted as saying.
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“So even things like wanting my degree certificates and all sorts of things, which are probably somewhere in boxes somewhere, but it wasn’t enough that I’m registered with AHPRA or that I’m a current member of the RACGP. That wasn’t good enough.
“I had to go back and get quite a lot of historical certificates, which is, it’s just not super inviting to have to get on board with all that.”
Of the eight GPs who did train to become authorised practitioners in voluntary assisted dying, one doctor had not participated in any cases and one had chosen to only serve as the “consulting practitioner”, the secondary doctor whose only role is conducting an eligibility assessment.
“Logistical barriers to participation identified here include the time required and demands of paperwork, which are known challenges in Australia resulting from the VAD process,” the QUT researchers wrote.
“Changes in law and policy would be required to address these issues; however, designated time, or clear remuneration to allow for allotted paid time within usual general practice, may overcome these barriers to GP participation in VAD.”
Two of the GPs interviewed had participated in more than 50 voluntary assisted dying cases in one year and another four had handled more than 10 cases.
Some of these doctors described voluntary assisted dying as part of their end-of-life care process, which simplified their remuneration and billing practices, while others booked patients for long appointments and absorbed the paperwork requirements into their “usual paperwork time”.
“It needs to be funded to ensure the longevity, you can’t (keep hoping) that private practices will provide the service when there’s no Medicare billing numbers for it,” one respondent said.
“And people feel terrible about charging people for the consults, the massive gap.”
Another GP participant said it was close to impossible to provide the service at no extra cost to the patient unless there was additional funding through the local primary health network or the doctor accepted the financial loss.
Australian Journal of General Practice, January-February 2026.
