Lindsay was locuming in the UK, when she was given the opportunity to work in Australia for a few years.
I started work in Melbourne, Australia, in December 2013. Prior that I had worked as a locum and salaried GP in Leeds since 2010, taught at Leeds University and worked with the RCGP First5 team. When my boyfriend was offered a job in Melbourne, not knowing anything about it, I turned to Google. It sounded great!….the world’s most liveable city! GP pay significantly higher. Good work/life balance, lots of sunshine, so I thought, why not?!
Admittedly, at the time, I was becoming increasingly frustrated with UK general practice for many of the reasons that I saw in others’ frustration - the demand, poor media coverage, paperwork, QoF requirements… and so forth! So I was willing for the change.
I first signed up with some agencies, but in the end I began to chat to a doctor on a doctors.org.uk forum who told me about a job opportunity at his practice. The downside to moving is that there is a huge amount of paperwork to complete, and the whole process takes a minimum of 6 months.
Starting a new job in a new country is quite daunting. At first I had only 2 patients booked per hour! I thought it would be a breeze, but sadly not. I had to remember to bill for each patient, how to handle private vs government referral, and learn about Care Plans (the Aussie equivalent(ish) of QoF). It truly felt like I was a trainee again, but without the comfort blanket of a trainer. Things that I could do in my sleep suddenly became a challenge. One of my first patients was a pregnant lady: I dutifully told her how pregnant patients are managed, the scans, the midwives, etc. - only to find out that things are done completely differently here. It was hard at first, but thankfully the other doctors were helpful and supportive. It took me around 2-3 months before I knew fully what I was doing, and things are much easier now.
The main problem for overseas doctors moving to Australia is that there are restrictions on where you can work - the ‘moratorium’ - which means one cannot work in the popular, big cities for 10 years; hence my job is on the outskirts of Melbourne. I work at a fully bulk-billing practice, which is equivalent to the NHS, free at the point of use. Other GP practices charge a private supplement, and thus earn more per patient, but see fewer people per hour. In general, Australia is mainly a private health system, with more patients having private insurance than relying on government health care.
My working day in Australia is much easier than in the UK - the only thing I do is see patients. I get the blood results and letters for my patients, and that takes me 10 minutes at most each day. I never finish late and there are never extra duties. There are walk-in patients whom I can see if I wish. I get paid for what I do. I charge more for longer consultations, chronic disease management and for procedures. The patient takes the responsibility of arranging scans or hospital appointments, which eases the load on the GP. The simplicity and patient-centred working feeIs like being a locum in the UK (which I liked); however, I am part of a team in a nice clinic, with patient continuity (which I missed).
Overall, I am much happier in my working day here. The system just makes more sense and better supports GPs. There are a lot of overseas doctors working here, some just coming to work for 1 or 2 years to try it out, but others fall in love with the way of life and stay forever. Because of this it is getting harder to get jobs in nice areas; the same problem applies to the hospital specialities.
Will I go back to the UK? Yes of course, it’s where all my friends and family are. But leaving behind a fabulous city, great weather and a good working life to return to the NHS is not something I want to do in a hurry. When I go back I would certainly locum again, and would join a locum chambers for the peer support.
You can follow Lindsay on twitter @lindsmoran