GP workforce shortage issues manifest in many ways, but disrespect for the profession is the one constant.
General practice has been neglected for so long that it’s at a bizarre inverse tipping point, with the labour shortage allowing doctors to finally claim what they’re worth.
Despite recent criticism from both the NSW parliament and individual practice managers, locum agencies deny taking advantage of the GP labour shortage to jack up prices in the bush.
Instead, they say, the failure to properly remunerate general practice is the real supervillain driving the workforce shortage and associated price hikes, albeit indirectly.
Because general practice has been neglected and underfunded for so long – and, as a consequence, so few doctors have chosen to specialise in it – the remaining GP specialists are so in demand that they can afford to be picky about what jobs they do or do not take, and to set higher prices for their labour.
Max Drakeley, a senior recruitment partner with locum agency Prescript Recruitment, told The Medical Republic that before the pandemic hit, GP locum rates had been steady for around a decade.
Over the last two years, as the workforce crisis has begun to bite, Mr Drakeley acknowledged that rates had started to increase. He estimated that there had been a maximum increase of $20 per hour across the board.
“GPs are the ones in demand and the ones that are providing the service,” he said.
“It doesn’t take them very long to look through the jobs that are available and work out the ones that are offering the best package.”
The fees paid to recruitment agencies, he added, had not gone up over this period.
“There are some really caring and hardworking recruiters that are making a big difference,” Mr Drakeley said.
“And I think a lot of us take offence to the idea that we are in control, and it’s us that drive prices up. It’s not – it’s the demand for doctors.”
Typically, according to Mr Drakeley, practices were now offering either a guaranteed hourly rate between $150 and $170 or 70% of billings, with the option to receive whichever one turns out to be higher.
“GPs these days have become quite accustomed to having that guarantee, because the last thing you want is … [to be told] your estimated earnings are going to be $10,000 per fortnight on billings, and then you get there, and you either don’t see the amount of patients or you’re being asked to see too many patients in hour,” he said.
On these occasions, he said, the practices do make a loss.
Outside of the workforce shortage, Mr Drakeley said there were wider trends toward flexible working arrangements that were contributing to GPs’ reluctance to commit to full-time rural work.
Stints as a locum allow doctors to “try before they buy”, he said.
Mr Drakeley also criticised GP-turned-politician Dr Amanda Cohn’s proposal to create a centralised register of casual doctors in place of recruitment agencies, arguing that the job was more complicated than matching available doctors to vacant positions.
The peak body for medical recruiters, the Recruitment, Consulting & Staffing Association, also took issue with the Greens MP’s suggestion.
“For the Greens to blame an agent for representing the increasing price of talent in the middle of a medical staffing crisis indicates they don’t understand how markets operate,” RCSA CEO Charles Cameron said.
“We need structural solutions, not scapegoats, from our political leaders.”
