GP interns to go bush and save millions

Allowing junior doctors to fill rural vacancies could save Medicare more than $70,000 a year for each job swap.

One initiative involves offering junior doctors a new rural Medicare provider number and further support until they became fully qualified, vocationally registered GPs. Picture: iStock

Allowing junior doctors to fill rural vacancies that might otherwise have gone to overseas-trained GPs could save Medicare more than $70,000 a year for each staff swap.

Documents obtained by The Australian under Freedom of ­Information laws show the financial windfall for the federal government as one aspect of its training and workforce overhaul.

The government already expects to save $415.5 million over four years by restricting visas for overseas-trained GPs in metropolitan areas.

In last year’s budget, the government unveiled several initi­atives to reduce Australia’s reliance on overseas-trained doctors and provide more opportunities for domestic medical graduates and junior doctors.

One initiative, then still under development, involved ­offering junior doctors a new rural Medicare provider number, paying 80 per cent of a normal number, and further support until they became fully qualified, vocationally registered GPs.

Various government-funded training programs are being consolidated and the new Rural Primary Care Stream being finalised with the aim of diverting hundreds of junior doctors from hospital internships to non-metropolitan GP clinics.

The government commissioned the Melbourne Institute to determine the likely impact of the RPCS on the supply of doctors and Medicare expenditure in rural areas.

Its analysis shows that ­between 89 and 115 non-vocationally registered doctors currently working in hospitals would likely be interested in the RPCS.

Up to 292 non-vocationally registered GPs working after-hours might also want to make the switch, but it appears they were not factored into the final calculations.

The institute found “more than enough vacancies” in rural areas — between 521 and 616 — for junior doctors under the RPCS, although some employers may not be willing or able to cut their costs by enough to offset the 20 per cent reduction in income from Medicare.

Employers would have no ­direct financial incentive to hire junior doctors on the program — whose lower level of remuneration would motivate them to ­become a GP registrar and gain a full provider number — and more doctors would lead to greater Medicare billing.

“If the vacancies would have otherwise been filled by (overseas-trained) GPs or GP registrants, then there will be a net saving to the Medicare Benefits Schedule … of $71,755, or in total between $6,386,195 and $8,251,825 per year,” the documents state.

Internally, the initiative is part of an overhaul the Department of Health has referred to as “Signalling Quality through Medicare Benefits Schedule Rebates”.

It coincides with regulatory efforts to ensure some visa-holders meet the standards enforced by the Medical Board.

Department officials argue that, over time, various training programs introduced to address workforce shortages have helped address the supply issues but “blunted the financial incentives” for doctors to obtain vocational registration.

In order for a GP to become vocationally registered, they must achieve fellowship of either the Royal Australian College of General Practitioners or the Australian College of Rural and ­Remote Medicine.

The Australian revealed in ­November that there had been an ­unexpected decline in people ­applying for, and taking up positions through, the Australian General Practice Training ­Program.

The analysis suggests RPCS marketing “emphasise the large reduction in hours worked, the reduction in unsocial hours and shift work, and opportunities for procedural work in rural areas”.