Australia has an adequate supply of general practitioners in major cities, but an undersupply in regional, rural and remote areas (Harrison and Britt 2011).
The general practice workforce is rapidly changing:
- The current cohort of general practitioners is ageing – one in three general practitioners is over the age of 55 (Harris and Nicholas 2014), and the average age of a general practitioner in 2012 was 50 years old.
- There will be fewer general practitioners coming through to replace those retiring – fewer medical graduates will pursue a career in general practice, and younger general practitioners are looking for more work–life balance, working fewer hours on average per week (Menzies Centre for Health Policy 2015).
- The general practitioner workforce is more gender balanced – the percentage of female general practitioners rose from 19 per cent in 1991 to 41 per cent in 2012 (Harris and Zwar 2014).
- The general practice workforce is increasingly multidisciplinary – for example:
- in 2014, 12,342 primary health nurses worked in Australian general practice and 63 per cent of practices employed at least one primary health nurse (Australian Primary Healthcare Nurses Association 2017)
- allied health professionals are co-locating with general practice in larger centres
- new and innovative ways of care such as greater use of primary health nurses and pharmacists in the delivery of primary care.
Corporatisation
Up to the 1990s most general practices in Australia had a small business model with a handful of general practitioners.
Practices were owned by independent practitioners trading as sole traders, partnerships, or associateships (Department of Health and Ageing 2012).
The late 1990s saw a rapid increase in corporate general practices with a number of publicly listed companies buying practices and establishing a new model of corporate general practice (Harris and Nicholas 2014).
Besides the large companies, the last decade saw a number of smaller corporates also entering the market.
The corporate model tends to have larger clinics with a focus on keeping cost down through economies of scale and central cost controls combined with strategies to maximise revenue (Department of Health and Ageing 2012).
Primary care nurses working in general practice
Nurses in general practice may be a registered nurse or an enrolled nurse who is employed by, or whose services are otherwise retained by a general practice.
General practice nursing is the fastest growing area within the healthcare sector and covers many areas of nursing practice.
Nurse practitioners
It is important to distinguish nurse practitioners from nurses in general practice.
A nurse practitioner is a registered nurse who is educated and authorised to function in an advanced and extended clinical role.
Nurse practitioners are highly experienced registered nurses who have completed post-graduate education and extensive clinical training in a specific area of practice, for example diabetes, respiratory care, general practice.
Nurse practitioners must complete a nurse practitioner program of study, usually at Master’s level, to meet the Nursing and Midwifery Board of Australia’s requirements for endorsement as a nurse practitioner (Australian College of Nursing 2015).
Aboriginal healthcare workers
The role of Aboriginal and Torres Strait Islander health workers is crucial to improving health outcomes of Aboriginal and Torres Strait Islander people.
They play a vital role in the primary health care workforce, providing clinical and primary care for individuals, families and community groups (Aboriginal Health Council of South Australia 2017).
Aboriginal and Torres Strait Islander Health Workers across Australia work in a variety of environments.
While a large majority are employed in Aboriginal Community Controlled Health Organisations or the government health sector, many also work within mainstream services such as general practices and other non-government organisations (Aboriginal Health Council of South Australia 2017).
Practice manager
A practice manager may have various titles, for example, chief executive officer, business manager, executive director, or director.
The definition of a practice manager is someone who performs all or some of the practice management tasks in a healthcare setting.
A healthcare practice manager's tasks may include strategic planning, review and implementation of processes in a practice that increase efficiency and contribute to the overall notion of 'excellence in healthcare’.
This is achieved using the Australian Association of Practice Management’s (2017) core principles of healthcare practice management:
- financial management
- human resource management
- planning and marketing
- information management
- risk management
- governance and organisational dynamics
- business and clinical operations
- professional responsibility.
References
Harrison C and Britt H 2011, General practice: workforce gaps now and in
Mark F Harris and Nicholas A Zwar 2014, Reflections on the history of general practice in Australia, Med J Aus; 201 (1 Suppl): S37-S40.
Menzies Centre for Health Policy 2015, A model for Australian general practice: the Australian person-centred medical home.
Australian Primary Health Care Nurses Association 2017, What is primary health care
Department of Health and Ageing 2012, State of corporatisation: a report on the corporatisation of general practices in Australia, Commonwealth Government of Australia, Canberra.
Australian Medicare Local Alliance 2012, Nurse practitioners in primary care: benefits for your practice
Australian College of Nursing 2015, Nursing in general practice: a guide for the general practice
Aboriginal Health Council of South Australia 2017, Aboriginal health worker
Australian Association of Practice Management 2017, Definition of a practice
Reviewed 02 December 2021