Specialists now outnumber GPs with fears it’s driving unnecessary operations

THERE are now more medical specialists than GPs as medicos chase higher incomes and fees putting patients at risk of unnecessary procedures.

THERE are now more medical specialists than GPs in Australia as medicos chase higher incomes and fees putting patients at risk of unnecessary procedures.

The surge in specialist numbers is likely to be a factor in driving up health insurance premiums which are growing at three times the inflation rate as medical costs rise.

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And it means medical care costs more with specialists earning more than three times as much as GPs and charging nearly 10 times as much, up to $300 a visit.

New data released today shows specialists now make up 35 per cent of the medical workforce, specialists in training make up another 18 per cent while GPs make up just 33 per cent.

The supply of specialists increased 18 per cent from 121 to 143 per 100,000 people between 2005 and 2015 Australian Institute of Health and Welfare (AIHW) data reveals.

However, the number of GPs per 100,000 people increased only 4 per cent from 109 to 114 between 2008 and 2015, the AIHW said.

Royal Australian College of General Practice president Dr Frank Jones said specialists earn many times more than general practitioners even though the best bang for the health care dollar comes from GPs.

“More specialists means we’re pouring more money into the hospital system and it’s not sustainable, we should be investing in primary care to stop people going to hospital,” he said.

He said the data is alarming and shows governments don’t have a good handle on the number of doctors needed or the fact that most of them work in cities while there is a shortage in the bush.

AMA president Dr Michael Gannon said GPs feel wounded, and have been hammered by successive governments freezing their income and underfunding primary care.

The problem is starting to be addressed with more GP training places funded by the government, he said.

There is also concern rising specialist numbers could be driving unnecessary procedures as doctors compete to earn an income.

Health fund spokeswoman, Australian Private Healthcare Australia chief Rachel David, said demand for medical procedures grows in tune with the number of specialists available to perform them.

“Just look at South Australia where there is a high number of doctors per head of population, they have significantly more medical procedures than would be suggested by the disease burden,” she said.

The problem is “significant” and is being driven by the number of medical schools more than doubling from seven or eight 25 years ago to 20 today, she said.

Former health department chief and Grattan Institute researcher Professor Stephen Duckett said the fact the number of specialists is growing faster than the number of GP’s is a “disturbing trend”.

“If the growth is occurring in regional areas and is improving access that is good,” he said.

“If its occurring in wealthy inner metropolitan areas it might lead to overservicing.”

The Federal Government is so concerned about overservicing it has set up a review which is investigating waste in Medicare.

Assistant Minister for Rural Health Dr David Gillespie said the AIHW report confirms that we continue to face a significant health workforce issue in terms of the distribution of medical specialists other than GPs.

“Many people in rural and regional communities must still travel for long distances and experience lengthy delays in order to see a specialist for diagnosis or treatment. This must change.

“The Coalition Government has provided a range of incentives to encourage the recruitment and retention of medical practitioners in rural and remote areas coupled with undergraduate education and training programs, post graduate training programs and a range of incentives all promoting distribution. This has certainly worked.

“Encouraging GPs, specialists, nurses and allied health professionals to live and work in regional and rural Australia will be one of my greatest challenges as Assistant Minister for Rural Health,” Dr Gillespie said.

Australian taxation data shows GPs earn $185,000 a year while medical specialists occupy 18 of the top 20 highest earning male jobs in Australia and 17 of the top earning 20 female jobs.

Male neurosurgeons earn almost $600,000 a year, male ophthalmologists $550,000, female neurosurgeons earn $323,000.

There has been a rapid increase in medical graduates trained in Australia, rising from 1660 in 2000 to 3484 graduates in 2014, many graduates now can’t find the hospital internships they need to complete their training.

Medical workforce 2015

Specialists: 31,189

Specialists in training: 15,336

GPs: 28,329

Source: Australian Institute of Health and Welfare

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