Doctor shortage looms as baby boomers retire
Medical Study News
Published: Thursday, 21-Jul-2005
The retirement of 'baby boomer' doctors and nurses will place unprecedented pressure on Australia
's medical workforce in the next 20 years, according to a study by two University of Sydney researchers.
In their paper published in the current issue of the Medical Journal of Australia, John Beard and Deborah Schofield suggest governments should consider offering incentives to ageing health care workers.
Professor John Beard and Associate Professor Deborah Schofield, at the Northern Rivers University Department of Rural Health, University of Sydney (part of the Australian Rural Health Collaboration), say policies and incentives to encourage ongoing employment among older clinicians, albeit at reduced hours, are crucial if the Australian health workforce is to adequately meet the growing community demand of the 21st century.
The authors used previously unpublished data from the past four Australian Bureau of Statistics (ABS) Census surveys (1986, 1991, 1996, 2001) to examine trends in the work and retirement patterns of GPs, medical specialists and registered nurses.
Results show the age profile of the medical and nursing workforce has aged since 1986, with the baby boomer generation making up more than half that workforce in 2001.
A large proportion of GPs continued to work beyond the traditional retirement age of 65 years, with nurses retiring at a younger age than doctors.
All groups of GPs worked fewer hours in 2001 than they did in 1986, with generation X GPs working fewer hours than the baby boomers did at the same age.
"If the baby boomer cohort of nurses leaves the workforce at the same rate as previous generations, all but a handful will have retired within the next 15 years. This reflects a loss of more than half the current workforce," say the authors.
"Baby boomers represent just over half the GP workforce and while they tend to retire later, by 2001, those remaining in the workforce typically worked fewer hours. They also make up about half of the specialist population," they say.
The authors say doctors and nurses leave the workforce at different rates because of available differences in their capacity to generate satisfactory incomes in retirement, flexibility of working arrangements, and health status.
They say addressing workplace safety and health issues, or increasing the flexibility of shift work, may be as important to workforce longevity as economic incentives when it comes to encouraging nurses to remain in the workforce.
Medical workforce report confirms GP shortage, RACGP urges action on solutions
11 November, 2005
Australia
needs long term vision in general practice workforce planning, the Royal Australian College of General Practitioners said today in response to The General Practice Workforce in Australia
report. The report was released yesterday by the Australian Medical Workforce Advisory Committee (AMWAC).
“The announced shortage in general practitioners has long been predicted by the profession. The RACGP has been lobbying the Australian Government for years to take effective action to address this shortage,” Professor Michael Kidd, RACGP President said.
“The RACGP has long advocated that the key solution to the general practice workforce shortage lies in attracting the best and brightest of Australia
's medical graduates into a career in general practice.
“Increasing the number of places available will only be a successful strategy if we are able to attract medical graduates into a career in general practice. To do so, issues of remuneration, the status of general practice within the health system, removal of the restrictions imposed by excessive red tape and attention to causes of workforce pressures must be addressed.
“Existing policy frameworks, including the bonding of medical student places, may have an unintentional adverse effect and lead to GP registrar training positions remaining unfilled. The RACGP holds the view that these workforce requirements risk undermining the attractiveness of the specialty of general practice.
“Many recent medical graduates are reluctant to take on a career in some disadvantaged areas due to concerns about professional isolation, the needs of their families and burdens associated with on call requirements and limited access to hospital facilities.
“We know that general practice registrars place family and personal considerations at the centre of their career decision making processes. Conditions must be created within general practice for a workforce policy that supports these considerations.
“The RACGP supports recent Australian Government announcements of new medical school places. However, we acknowledge the report’s findings that it will still be a number of years before these policy solutions begin to deliver an increase in the number of general practitioners.
“In order to further enhance the attractiveness of a career in general, the RACGP believes that AMWAC should consider the role of incentives and flexibility in programs. The RACGP believes that the evidence supports incentives and flexibility as being more successful in achieving sustained workforce distribution to areas of high healthcare demand than bonding and restrictive training requirements.
“We know that two forms of incentive have had a positive effect; rural retention payments, and the funding of the RACGP’s Graduate Diploma in Rural General Practice, a training opportunity that supports a genuine interest in practising in areas of high workforce demand.
“The RACGP supports incentives that will assist to reduce the health inequalities by encouraging general practitioners to work in areas of low doctor-patient ratios. We support initiatives that have low red tape such as student scholarships to rural locations, and rural retention payments.
“The use of international medical graduates being recruited from overseas is a short-term stopgap measure for this nation’s workforce shortage.
“Australia
has a moral and ethical obligation to train our own medical workforce, rather than relying on recruiting doctors from developing nations which can least afford to lose their own health professional workforce. In fact, Australia
should be extending a helping hand to developing nations by training enough health professionals so that we can assist developing nations in meeting their own health care demands. In order to achieve this we need an expanded medical workforce and more training opportunities.
“Resolving the general practice workforce shortage requires creative policy solutions.
“The viability and validity of new models of providing general practice care need to be explored to ensure they are able to deliver workforce enhancements and maintain the standards and quality of care rightfully expected by the people of Australia
.
“The RACGP has successfully lobbied the Australian Government for the introduction of new care plan items and the introduction of support for general practice nurses. It is now time for these positive policy initiatives to be built upon to further strengthen the delivery of quality general practice care in Australia
.
“The RACGP believes that practice nurses have an important role to play as part of a general practice team focused on the delivery of high quality patient care. We need to see policy initiatives that will deliver practice nurses to every general practice in the nation.
“Through adopting new and creative policy settings that build whole of care teams in general practice, we can move to a more sustainable setting for the continued delivery of quality general practice care.
“The RACGP will be raising these issues with the Minister for Health and Ageing in our 2006 Federal Budget submission.
“The RACGP looks forward to working with the Australian Government to bring about changes in policy that are needed to meet the health care needs of all Australian communities.”
IMG program tackles GP shortage
16-Nov-2005
by Claire Sweeney
MORE than 500 international medical graduates (IMGs) not currently practising medicine in Australia
are being pulled back into the workforce with the support of a $1 million RACGP project in a bid to ease chronic workforce shortages.
The Permanent Resident Overseas Trained Doctors program was developed by the college last year in response to concerns over the lack of support available to IMGs living in Australia
to pass the Australian Medical Council exam.
Under current requirements, IMGs living permanently in Australia
must sit the AMC and FRACGP exams before they can enter general practice ? although some do gain exemptions to these requirements by practising in areas of workforce need.
Previous estimates have suggested there are about 2500 IMGs in Australia
who are not working as doctors.
Through the Federal Government-funded program, the college determines individual doctors? further training needs and supports them while they sit the AMC and FRACGP exams.
From 716 applications received by March, the college chose 541 doctors to participate in the program.
So far 343 participants have completed individual learning plans, while the remaining doctors are still working through the program.
Dr Morton Rawlin, RACGP director of educational services, said a small number of participants who had yet to complete the AMC exam were working in supervised positions within hospital practice.
?We would hope the participating doctors would choose a career in general practice. However, the project provides scope for participants to consider other careers within medicine,? he said.
However, Dr Ian Cameron, CEO of the NSW Rural Doctors Network, said the college program was a duplication of services already being provided by rural workforce agencies.
?We?ve already assessed most of the people in NSW,? he said. ?It would have been better to work with the rural workforce agencies who were already doing similar stuff. The big problem is that there is just not enough resources for extra education for [permanent-resident overseas-trained doctors].?
The future role of the Medical Board of Queensland has been thrown into question after it was castigated for allowing more than 1000 overseas-trained GPs and specialists to work in the states health system without adequately testing their competence, checking their references or monitoring their performance once they began treating patients.
All the doctors obtained rights to practice under the Area of Need Program aimed at addressing workforce shortages by recruiting international medical graduates (IMGs) who lacked the qualifications expected of Australian-trained doctors.
In its 570-page report released last week, the Queensland Hospital Commission of Inquiry found the board was even registering some IMGs as specialists without invoking the ?safeguard? requirement that the relevant specialist college, including the RACGP, check their qualifications.
And the commission found that until last year the board did not test whether the doctors applying to work in an area of need could speak English proficiently.
The report paints a picture of a board overwhelmed by its duty to protect patients, with fortnightly meetings where officials would effectively rubber-stamp an average of 50-100 and sometimes 200 area of need applications.
?Neither the registration officers nor anyone else within the board would as a matter of practice contact referees nominated by the applicant or even satisfy themselves that the task had been carried out by anyone else,? the report stated.
Had checks on doctor?s references been in place it was unlikely Dr Jayant Patel ? the so-called ?Dr Death?? would have been allowed to practise in Australia
, the report concluded.
The report recommended the board?s powers ?to investigate and adjudicate against doctors? be removed to free resources for registration processes.
The commission also found evidence to support claims that the Queensland Government preferred to employ IMGs because they were ?more accepting and malleable? due to their tenuous visa situations....
It was good news to many of the 1000's employed through the Area of Need route in Queensland.
But now, I suppose they are going to put in some restrictions or probably raise the eligibility criteria. Like they didn't even need to take the IELTS
earlier and now they do.
Nevertheless it does say that there is shortage of Doctors particularly GP's in Australia
Queensland alone has been absorbing 50-200 doctors every fortnight.
Huge hole in GP workforce 16-Nov-2005 by Claire Sweeney
More than 1200 GPs ? double the number currently going through the training system ? will have to be trained every year to end the chronic undersupply and deal with increasing demand.
The figures, released by the Australian Medical Workforce Advisory Committee (AMWAC), reinforce the daunting scale of the GP workforce crisis but are unlikely to surprise anyone in the profession.
AMWAC estimated that the health system was short between 800 and 1300 GPs, and an additional 600 GPs would need to be trained every year between 2007 and 2013 to meet the demands of an ageing population with growing levels of chronic disease.
The report is an effective reversal of AMWAC?s controversial findings nine years ago, which suggested the workforce crisis was a result of maldistribution of GPs rather than a shortfall in GP numbers.
However, AMWAC independent chairwoman Dr Jeanette Young warned that simply increasing the number of GPs would still not be enough to meet health care needs ? the Federal Government also needed to consider ?what doctors are doing?.
Changes in the whole framework in which GPs worked meant general practice was ?not as cut and dried as it used to be?, particularly with more doctors working in specialised areas such as skin clinics and sports medicine, she said.
This year 709 junior doctors applied for the 600 GP training places offered through General Practice Education and Training. Although a 4% improvement on the previous year, the numbers are still dwarfed by the 1200 trainees a year AMWAC estimates are needed.
GPET chief executive Mr Peter Harrison said several initiatives should be considered ? including accelerated general practice training for appropriately qualified and experienced doctors; accelerating the introduction of new medical school places, and strengthening the re-entry program for doctors not currently practising.
Insane’ red tape fuelling GP shortage
by Sophie Blakemore
10 February 2006
AREAS of critical GP shortage Australia
-wide are missing out on trained doctors from overseas because of lengthy delays in bureaucratic recruitment processes that fail to assess clinical competence.
Recruiters are battling with the red tape involved in verifying doctors’ qualifications, along with stringent and inconsistent medical board rules, in order to get doctors placed.
It comes as the latest figures by the Australian Workforce Advisory Committee confirm a nationwide shortage of 1300 GPs.
“Government and medical boards are raising paperwork barriers which are not assessing clinical competence, in the hope it will sift the good doctors from the bad, but it is simply delaying good doctors getting into practice,” said Jennifer Elwin, co-director of one of Australia
’s largest recruiters, Recruit-A-Doc.
Overseas-trained doctors (OTDs) are placed only in areas classified by the government as ‘districts of workforce shortage’ (a status declared for three months) or ‘areas of need’ (which can be ongoing).
However, bureaucratic hurdles make placement difficult before an area’s workforce shortage status expires.
Ms Elwin said, as a result, one UK GP had been waiting for four months to start work in Australia
because time frames were “blowing out”.
She said Recruit-A-Doc should be able to recruit double the 60 GPs and hospital doctors it placed each year.
Medical director of recruiter Chandler Macleod Dr Peter Cronin agreed complexities in current recruitment procedures “disadvantaged Australia
as a destination for OTDs” and urged a move towards national regulation.
Recruit-A-Doc and the Australian Doctors Trained Overseas Association had written to the Prime Minister calling for the issue to be discussed at this week’s Council of Australian Governments meeting.
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