High health costs see patients turn to GPs for complex care
A snapshot of general practice in Australia shows patients are struggling to keep up with costs and it means they’re asking their GP to do more.
Patients are asking their GPs to treat complex health conditions because they can’t afford to pay specialists’ fees, according to a new report looking at the state of general practice.
As a result, GPs say they are seeing patients for longer and the demands on them are more challenging because they do not have adequate resources to cope with the changing dynamic.
Those are some of the key findings of the 2025 Health of the Nation Report by the Royal Australian College of General Practitioners.
The report’s release comes as GPs are lobbying the government to increase the financial incentives they get for long patient consultations.
“We’ve got the capacity to provide this more complex care, but it’s harder and it takes more time,” RACGP president Dr Michael Wright said.
“With this increase in complexity, we really want to point to a future where general practice is strengthened and that will mean additional funding, that will mean additional workforce, but that also GPs are empowered to work to their full scope.”
The report is based on a combination of a survey of GPs and government and health data. Together, the results provide a snapshot of the state of general practice in Australia. The focus of this year’s report is the state of multidisciplinary care and preventive medicine.
While mental health concerns remained the most common reason for patients to visit their GP in the past year, 70 per cent of doctors surveyed said it was case complexity that was top of their mind and providing the most challenge.
According to the report, 86 per cent of GPs said they were managing conditions a non-GP specialist would typically treat, and more than half of those surveyed said they did so “often” or “very often”, with cost and access the most common reasons cited by patients.
Concerns about the cost of care also extend to general practice, with patients now paying an average fee of $82 for a short visit. That’s up from $78 a year earlier.
Doctors say driving that price hike is the cost of delivering services and the day-to-day running of a physical clinic.
At the same time, the need for GPs to deal with more complex cases means short consultations are taking longer than before, with female doctors found to be more likely than male doctors to provide more comprehensive care.
“This year, the average consultation was just under 20 minutes, and for female GPs it’s a bit longer,” Dr Wright said.
“That means for female GPs, what Medicare calls a ‘long consult’ is actually the standard consultation that most of our patients need now. But once again, Medicare doesn’t reflect that.”
As previously reported by The Australian, the report also suggests bulk-billing rates have stagnated with just 12 per cent of GPs bulk billing all of their patients.
Of GPs surveyed, 36 per cent said they were bulk billing most of their patients and about 40 per cent said they bulk billed a minority or no patients.
From November, GPs and practices will share in added financial incentives if they bulk bill every eligible service and patient as part of a bid to get more doctors offering gap-free healthcare to patients.
While four in five GPs reported wanting to provide preventive care to patients, 82 per cent said Medicare Benefit Scheme rebates were insufficient to support them doing so.
As a result, only one-third of GPs say they offer it to patients.
Funding gaps, time pressures and the complexity of patient presentations were cited as the main barriers.
Preventive medicine covers a range of services that can help to identify a problem that could lead to chronic illness or disease.
Some of the most common of those services include testing blood pressure and cholesterol, weight management, and screenings for cancer and diabetes but can also include drug and alcohol diversion, mental health assessments, and nutrition.
“The funding and time that would allow us to do that hasn’t followed through,” Dr Wright said.
“Often when someone comes in to see me they’ll have a list of things they want to discuss which are important to them. Then there will also be a number of preventative health things that we could do, which vary depending on how old you are and what your family history is. But often, that takes second priority to what people originally attend for.”
Dr Wright suggests fixes to the problems include training more medical practitioners to ease the worker shortfall, reducing administrative burdens on doctors and practice managers, providing more claimable item numbers, boosting funding for GPs to deliver population health, and for there to be more incentives to support an expansion of multidisciplinary care.
“So you’ll have not just me, you’ll also have my practice nurse, you might have a psychologist who would also be able to help to increase the level of care that we could provide at the practice and deal with more complex cases and also … deal with a lot of preventative health within the practice.
“Better funding and support for multi-disciplinary care, supporting prevention, increasing support for longer consultations … I think they’re the important things.”
It is something the Australian Primary Health Care Nurses Association would also like to see, saying there is a huge opportunity for nurses to do more. The association’s president, Denise Lyons, said data shows only 29 per cent of nurses working in general practice work to their full scope of practice.
“Better utilising the nursing workforce, particularly to support care co-ordination and preventative activities, can have a huge impact on the health of the community, and benefits for nurse’s job satisfaction and workforce retention,” she said.
“With tighter budgets and rising chronic disease, now more than ever it’s important we get the policy settings right so that nurses can utilise their skills and make an even greater contribution.”
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