How does a GP surgery only half-booked with patients sound to you? Nice, right?
You’d have time to grab a cuppa and a biscuit, have a chat with your other work colleagues who’ve also got a few gaps, and ease yourself in gently to the day. Well actually in Australia that sort of scenario is quite unwelcome, and people have left quiet jobs for that reason. If you’ve only got a half-booked clinic in the morning, then you’ll only be taking home half the pay.
Well that’s exactly the scenario that happened in my clinic recently. We’re not sure why exactly there were gaps, perhaps it was because of the Easter holidays, or because a new GP started, thus our workload was diluted, or maybe because the evening doctor had left, so some patients moved to other surgeries. Whatever the reason, it left all us GPs a little anxious and a bit thin in the pocket for a couple of weeks.
And to further kick us in the teeth, we still had occasional DNAs. Whilst most doctors in the UK secretly delight in DNAs in their clinics (but of course publicly moan about the wastage to precious NHS resources), here we genuinely loathe DNAs. They mean no money. When we get patients who regularly DNA appointments, we GPs blacklist them and refuse to see them because of the financial burden it brings. That’s right, as an individual doctor you are perfectly allowed to refuse to see a patient!
Most GPs in Australia see four patients per hour, some will see five. Rarely will anyone see six; you are too tired at the end of the day to see a patient every 10 minutes, and although it means more money, it often isn’t worth the mental stress to do it. A GP recently joined our practice from the UK and very quickly booked his clinics at six per hour, hoping to earn more. I did the same thing when I first started, but I didn't last long doing that. What he hasn’t realised yet, is that if he manages chronic disease well and takes a little longer with his patients, he could earn more than just trying to see a lot of patients quickly. It's just a different mindset that you get into here; quick medicine is not encouraged.
if he manages chronic disease well and takes a little longer with his patients, he could earn more than just trying to see a lot of patients quickly.
I don’t think I could ever go back to six patients per hour now; I might even struggle with five. However, when I don’t reach my target of four because of slow bookings or DNAs, then that makes me anxious too.
Australia definitely brings a different dynamic and perspective to your working day than the UK does and brings anxieties that no UK GP I know has contemplated.